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Nosocomial Outbreak of Infection With Multidrug-Resistant Acinetobacter baumannii in a Medical Center in Taiwan

Published online by Cambridge University Press:  02 January 2015

Hui-Lan Chang
Affiliation:
Department of Laboratory Medicine, China Medical University Hospital, Taichung
Chih-Hsin Tang
Affiliation:
Department of Pharmacology, School of Medicine, China Medical University, Taichung
Yuan-Man Hsu
Affiliation:
Department of Biological Science and Technology, China Medical University, Taichung
Lei Wan
Affiliation:
Department of Medical Research, China Medical University Hospital, Taichung
Ya-Fen Chang
Affiliation:
Department of Laboratory Medicine, China Medical University Hospital, Taichung
Chiung-Tsung Lin
Affiliation:
Department of Laboratory Medicine, China Medical University Hospital, Taichung
Yao-Ru Tseng
Affiliation:
Department of Laboratory Medicine, China Medical University Hospital, Taichung
Ying-Ju Lin
Affiliation:
Department of Medical Research, China Medical University Hospital, Taichung
Jim Jinn-Chyuan Sheu
Affiliation:
Department of Medical Research, China Medical University Hospital, Taichung
Cheng-Wen Lin
Affiliation:
Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung
Yun-Chieh Chang
Affiliation:
Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan
Mao-Wang Ho
Affiliation:
Department of Internal Medicine, China Medical University Hospital, Taichung
Chia-Der Lin
Affiliation:
Department of Otolaryngology, China Medical University Hospital, Taichung
Cheng-Mao Ho*
Affiliation:
Department of Laboratory Medicine, China Medical University Hospital, Taichung Department of Internal Medicine, China Medical University Hospital, Taichung
Chih-Ho Lai*
Affiliation:
Department of Microbiology, School of Medicine, China Medical University, Taichung
*
Internal Medicine, China Medical University Hospital, 2 Yuh Der Road, Taichung, Taiwan (shihkuo.ho@msa.hinet.net)
Department of Microbiology, School of Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan (chl@mail.cmu.edu.tw)

Abstract

Objective.

To investigate a nosocomial outbreak of infection with multidrug-resistant (MDR) Acinetobacter baumannii in the intensive care units at China Medical University Hospital in Taiwan.

Design.

Prospective outbreak investigation.

Setting.

Three intensive care units in a 2,000-bed university hospital in Taichung, Taiwan.

Methods.

Thirty-eight stable patients in 3 intensive care units, all of whom had undergone an invasive procedure, were enrolled in our study. Ninety-four A. baumannii strains were isolated from the patients or the environment in the 3 intensive care units, during the period from January 1 through December 31, 2006. We characterized A. baumannii isolates by use of repetitive extragenic palindromic–polymerase chain reaction (REP-PCR) and random amplified polymorphic DNA (RAPD) fingerprinting. The clinical characteristics of the source patients and the environment were noted.

Results.

All of the clinical isolates were determined to belong to the same epidemic strain of MDR A. baumannii by the use of antimicrobial susceptibility tests, REP-PCR, and RAPD fingerprinting. All patients involved in the infection outbreak had undergone an invasive procedure. The outbreak strain was also isolated from the environment and the equipment in the intensive care units. Moreover, an environmental survey of one of the intensive care units found that both the patients and the environment harbored the same outbreak strain.

Conclusion.

The outbreak strain of A. baumannii might have been transmitted among medical staff and administration equipment. Routine and aggressive environmental and equipment disinfection is essential for preventing recurrent outbreaks of nosocomial infection with MDR A. baumannii.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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