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J Hosp Infect. 2012 Aug;81(4):239-45. doi: 10.1016/j.jhin.2012.05.010. Epub 2012 Jun 22.

Control of an outbreak of Acinetobacter baumannii infections using vaporized hydrogen peroxide.

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  • 1Jagiellonian University Medical College, 18 Czysta Street, Krakow, Poland. achmiel@cm-uj.krakow.pl

Abstract

BACKGROUND:

Multidrug-resistant Acinetobacter baumannii (MRAB) is a serious nosocomial pathogen characterized by its survival on inanimate surfaces for long periods, making control of outbreaks difficult.

AIM:

To analyse two hospital outbreaks caused by MRAB, determine their epidemiology, carbapenem-resistance mechanisms and assess the effectiveness of surface disinfection by vaporized hydrogen peroxide (VHP).

METHODS:

MRAB strains were isolated from patients in two intensive care units (ICUs). Antimicrobial susceptibility testing was performed by E-test. Polymerase chain reaction (PCR) was used to detect the presence of the most common A. baumannii carbapenemases. Epidemiological typing was performed by rep-PCR (DiversiLab) and pulsed-field gel electrophoresis. VHP was used to decontaminate the affected ICUs.

FINDINGS:

MRAB was isolated from 28 patients between January 2009 and September 2010. All isolates were resistant to ciprofloxacin and gentamicin. Twenty-one were also resistant to carbapenems. Carbapenem resistance was associated primarily with the acquired OXA-23-like enzyme. Genotyping revealed three clones; the predominant clone corresponded to the international clone (IC) 2. Typing of the isolates pointed to a multifocal outbreak without a single source of infection, with horizontal spread of the dominating clone among ICU patients. A combination of rigorous infection control measures including strict isolation, education of staff, hand hygiene and surface decontamination using VHP halted the outbreak.

CONCLUSION:

The results of this study confirm the importance of rigorous infection prevention and control measures, combined with VHP decontamination in controlling an outbreak of MRAB.

Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

PMID:
22727825
[PubMed - indexed for MEDLINE]
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