Successful control of outbreak caused by clonally related extensively-resistant Acinetobacter baumannii in an intensive care unit

Abstract

Objective: Worldwide drug resistance in Acinetobacter baumannii is on the rise. We report outbreak of extensivelyresistant (XDR) A. baumannii in a medical intensive care unit (MICU) at a tertiary care referral hospital in Pakistan. During subsequent survey, 10 extensively-resistant A. baumannii were isolated from 8 environmental samples and hands of 2 healthcare workers (HCWs). Methods: In January 2013, XDR A. baumannii (Ab1, Ab2, and Ab3) were isolated from tracheal aspirate, blood and sputum of three patients with ventilator associated pneumonia. The isolates were resistant to piperacillin, ampicillinsulbactam, piperacillin-tazobactam, ticarcillin-clavulanic acid, ceftazidime, cefipime, ceftriaxone, imipenem, meropenem, gentamicin, amikacin, doxycycline, minocycline, ciprofloxacin and trimethoprim-sulphamethoxazole.. Pulsed Field Gel Electrophoresis (PFGE) revealed that isolates from HCWs were similar to the genotype initially isolated from patients’ samples. Results: Control of the outbreak was attained with requisite infection control practices and fumigation of the Medical ICU unit. From February 2013 to April 2013 there were no new cases of extensively-resistant isolates in medical ICU. However, two more cases with similar antibiogram MICs and genotype of extensively-resistant isolates emerged in June 2013 from the same MICU. Conclusion: Stringent infection control measures were implemented this time with continuous monitoring and regular surveillance. Follow up for the next two years has been successful as no clustering of XDR A. baumannii were detected from medical and surgical ICUs. J Microbiol Infect Dis 2017; 7(1): 1-6  

Keywords

• Hospital Infection Control,health care workers,surveillance

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