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Abstract - Successful control of outbreak caused by clonally related extensively-resistant Acinetobacter baumannii in an intensive care unit
Bushra Sultan, Aamer Ikram, Bruno Lopes, Ziaullah Jarral, Gohar Zaman, Parvez Asghar, Muhammad Yasir Rafiq, Muhammad Ayyub

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

Bushra Sultan1, Aamer Ikram1, Bruno Lopes2, Ziaullah Jarral1, Muhammad Yasir Rafiq1, Gohar Zaman1, Parvez Asghar3, Muhammad Ayyub1

1Department of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan

2Department of Microbiology, University of Aberdeen, United Kingdom

3Medical Intensive Care Unit, Military Hospital, Rawalpindi, Pakistan

 

ABSTRACT

Objective: Worldwide drug resistance in Acinetobacter baumannii is on the rise. We report outbreak of extensively-resistant (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, ampicillin-sulbactam, 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

Volume 07, Number 01 (2017)