Investigation and Control of an Outbreak of Imipenem-resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit
The Pediatric Infectious Disease Journal, 06/22/2012
Hong KB et al. – This study identifies the environmental source of an IRAB outbreak in a pediatric intensive care unit (PICU) and describes successful control of the outbreak with a multicomponent intervention program.Methods
- With the recognition of 3 clustered cases with IRAB bacteremia at the PICU of Seoul National University Children’s Hospital, Korea, from August to September 2010, the following outbreak control strategies were implemented: reinforcement of hand hygiene and contact precautions, investigation of environmental contamination, disinfection of the contaminated environment and medical equipment, active surveillance culture upon PICU admission and isolation of IRAB-positive patients.
- The clinical and microbiological data were reviewed for A. baumannii positive cases in the PICU from April 2001 to June 2011. Multilocus sequence typing was also performed.
- Twenty IRAB-positive cases (bacteremia in 10, pneumonia in 3 and colonizers in 7) were detected from January 2010 to February 2011.
- Thirteen IRAB-infected patients were all placed on a mechanical ventilator, had central venous catheters, received broad-spectrum antimicrobial treatment and had underlying diseases.
- Eleven (85%) IRAB-infected patients died probably due to IRAB infection. IRAB grew in 4 samples obtained from sinks and water taps from 38 environmental samples.
- Multilocus sequence typing analysis revealed 2 sequence types: ST138 (n = 16) and its single-locus variant ST92 (n = 4).
- Eleven weeks after the initiation of active surveillance, no further IRAB isolates were identified.