Chest Infections: Chest Infections: Bacterial |

Homology Analysis and Nosocomial Infection Control on Outbreak of ICU Acinetobacter baumannii Pneumonia FREE TO VIEW

Jianping Gao; Kejing Ying
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Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A93. doi:10.1016/j.chest.2016.02.098
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SESSION TITLE: Chest Infections: Bacterial

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To investigate an outbreak of Acinetobacter baumannii (A. baumannii) pneumonia with pulsed field gel electrophoresis (PFGE) homology analysis, and nosocomial infection control in an intensive care unit (ICU).

METHODS:A. baumannii was isolated in respiratory specimens from eight patients with mechanical ventilation in ICU. Appropriate anti-infective therapy was implemented. Bacterial clone typing using PFGE was done on the eight A. baumannii strains from patients and 31 A. baumannii strains from 50 environmental specimens. Clinical data was retrospectively collected, including sex, age, principal diagnosis, APACHE Ⅱ score, clinical pulmonary infection score, length of ICU stay, clinical outcome, et al.

RESULTS: Five patients recovered and discharged, 3 died. The most patients presented old age, relatively long ICU stay and severe clinical condition. Five different clones were separated among 8 patients, with 3 patients belonging to type A and 2 to type E. Positive rate of A. baumannii in environmental samples was 62% (31/50), while the most strain clones showed type C (12/31) and A (9/31). Type C clone strain was not discovered in any patient; meanwhile, the strains from the 4 patients were also not separated in environmental samples. Multidrug-resistance A. baumannii was ubiquitous in the ICU environment. Although the current prevalence did not owe to certain clone strain dissemination, comprehensive measures were taken to prevent the nosocomial infection spreading, including rigorous environmental cleaning and hand hygiene.

CONCLUSIONS: PFGE, mainly employed in bacteria genotyping, played an important role in surveillance, tracing and control of nosocomial infection.

CLINICAL IMPLICATIONS: Infection source and transmission route must be investigated when multidrug-resistance A. baumannii prevalence in ICU. Effective measures should be taken to prevent the dissemination.

DISCLOSURE: The following authors have nothing to disclose: Jianping Gao, Kejing Ying





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