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Pediatr Infect Dis J. 2012 Mar 29. [Epub ahead of print]
Investigation and Control of an Outbreak of Imipenem-Resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit.
Hong KB, Oh HS, Song JS, Lim JH, Kang DK, Son IS, Park JD, Kim EC, Lee HJ, Choi EH.
Sourcea Department of Pediatrics, Seoul National University Hospital, Seoul, South Korea b Infection Control Services, Seoul National University Hospital, Seoul, South Korea c Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea d Department of Laboratory Medicine, Seoul National University Hospital, Seoul, South Korea.
Abstract
BACKGROUND: This study investigated clinical details and epidemiology of the imipenem-resistant Acinetobacter baumannii (IRAB) outbreak which occurred at a pediatric intensive care unit (PICU), and describes successful outcome of the implemented infection control measures.
METHODS: With the recognition of three 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 Apr 2001 to June 2011. Multi locus sequence typing (MLST) was also performed.
RESULTS: 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%) of IRAB-infected patient died probably due to IRAB infection. IRAB grew from four samples obtained from sinks and water taps from 38 environmental samples. MLST analysis revealed two 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.
CONCLUSIONS: This study identifies the environmental source of an IRAB outbreak in a PICU and describes successful control of the outbreak with a multicomponent intervention program.
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发表于 2012-4-4 22:28
发表于 2012-4-4 23:48