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Repeated colonization by multi-drug-resistant Acinetobacter calcoaceticus-A. baumannii complex and changes in antimicrobial susceptibilities in surgical intensive care units
- Source :
- Surgical infections. 14(1)
- Publication Year :
- 2013
-
Abstract
- A nosocomial outbreak of multi-drug-resistant Acinetobacter calcoaceticus-A. baumannii (MDR-ACB) complex infection occurred in a newly constructed building at a 2,500-bed tertiary medical center in Taiwan.An investigation was carried out by molecular approaches to trace the bacteria. Antimicrobial susceptibilities, risk factors, and the occurrence of nosocomial MDR-ACB infections were investigated. From January to December 2009, 53 patients were infected with MDR-ACB, and 23 environmental surveys were performed in two surgical intensive care units (ICUs) within the new building. Forty-two clinical isolates were obtained from patients and 22 samples from nine environmental surveys.Forty clinical isolates (95.2%) and 18 environmental samples (81.8%) were positive for MDR-ACB of type A, the predominant outbreak strain. This strain was identical to that isolated in an outbreak in the old hospital in 2006, as proved by repetitive extragenic palindromic-based polymerase chain reaction and pulsed-field gel electrophoresis. Although the outbreak isolates contained blaOXA-23-like and blaOXA-51-like genes, analysis of the antimicrobial susceptibilities demonstrated increases in resistance to cefepime and imipenem-cilastatin in MDR-ACB isolated in the later outbreak.Not only patients or healthcare workers, but also medical equipment, might have carried the predominant outbreak strain from the old district to the new building. Therefore, even in a new environment, infection control programs must be enforced continually, and healthcare providers must be educated repeatedly to prevent recurrent outbreaks of MDR-ACB infection in the hospital setting.
- Subjects :
- Microbiology (medical)
China
Critical Care
Cilastatin, Imipenem Drug Combination
Microbial Sensitivity Tests
Microbiology
Disease Outbreaks
Drug Resistance, Multiple, Bacterial
Medicine
Humans
Colonization
Public Health Surveillance
Cefepime
A baumannii
Retrospective Studies
Cross Infection
Chi-Square Distribution
Surgical Intensive Care
biology
Acinetobacter
business.industry
Outbreak
Antimicrobial
biology.organism_classification
Anti-Bacterial Agents
Cephalosporins
Electrophoresis, Gel, Pulsed-Field
Drug Combinations
Imipenem
Infectious Diseases
Cilastatin
Multi drug resistant
Surgery
Acinetobacter calcoaceticus
business
Acinetobacter Infections
Subjects
Details
- ISSN :
- 15578674
- Volume :
- 14
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Surgical infections
- Accession number :
- edsair.doi.dedup.....61cb0bd9174ace69c556e10cd489a1a3