Korean J Nosocomial Infect Control.  1996 Jun;1(1):49-61.

Outbreak of Multi-resistant Acinetobecter baumannii in Intensive Care Unit of a Newly Opened Hospital

• Pai HJ
• Yoo SM
• Seong YS
• Sonh SH
• Cho YK
• Song JH
• Cho JH
• Lee HC

Abstract

BACKGROUND
A sustained outbreak of multi-resistant Acinetobacter baumannii has been noticed in intensive care unit (ICU) of a newly opened hospital.
METHODS
We retrospectively studied 72 patients in the ICU whose specimen grew A. baumannii from March to December 1995. To identify risk factors for infection, a case control study was conducted. Comparing clinical characteristics of 19 infected patients with those of 53 colonized cases. Environmental culture was performed in January 1996 to identify the source of infection. We analyzed antibiotic susceptibility of the isolates, and ribotyping was performed with 52 isolates.
RESULTS
Nineteen out of 72 patients developed disease: primary sepsis 2, catheter related infection 2, catheter related infection and pneumonia 2, wound infection 5, wound infection and sepsis 2, pneumonia 6. On comparison of clinical characteristics between the infected and colonized groups, central venous catheterization was a significant risk factor for development of disease by A. baumannii (P<0.05) and duration of lCU stay was a factor independently associated with A. baumannii infection by logistic regression analysis. An epidemiologic investigation failed to identify the source of infection, but we found 2 of 3 sinks in lCU were heavily contaminated by the organism. Antibiogram of the isolates showed a multi-drug resistance including amikacin, which was found to increase gradually during the course of the outbreak. Ribotyping showed 3 major subtypes: 2A (18 isolates) 2B (16) 2B'(13) and other types (5).
CONCLUSION
The findings from this study support the reports from many parts of the world that A. baumannii plays an increasingly important role as one of the major nosocomial pathogens.

Keyword

Acinetobacter baumannli; Nosocomial outbreak; Multi-drug resistance; Ribotyping

MeSH Terms

Acinetobacter baumannii
Amikacin
Case-Control Studies
Catheterization, Central Venous
Catheters
Central Venous Catheters
Colon
Drug Resistance, Multiple
Humans
Intensive Care Units*
Critical Care*
Logistic Models
Microbial Sensitivity Tests
Pneumonia
Retrospective Studies
Ribotyping
Risk Factors
Sepsis
Wound Infection
Amikacin