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Am J Infect Control. 2018 Jan;46(1):60-66. doi: 10.1016/j.ajic.2017.07.010. Epub 2017 Sep 8.

Control of multidrug-resistant Acinetobacter baumannii in Hong Kong: Role of environmental surveillance in communal areas after a hospital outbreak.

Author information

1
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.
2
Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China; Infection Control Team, Tung Wah Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.
3
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
4
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China. Electronic address: kyyuen@hku.hk.

Abstract

BACKGROUND:

Environmental reservoir is an important source of multidrug-resistant Acinetobacter baumannii (MRAB) outbreaks. The role of postoutbreak environmental surveillance for guiding sustained infection control effort has not been examined.

METHODS:

Enhanced environmental disinfection and regular environmental surveillance of ward communal areas after an outbreak were performed in a university-affiliated hospital. To assess the usefulness of environmental culture in predicting patients with MRAB, weekly surveillance of communal areas was continued for 3 months after the outbreak in intervention wards. The incidence of MRAB in intervention and nonintervention wards (control) was compared, whereas the other infection control measures remained identical.

RESULTS:

Postoutbreak weekly surveillance of communal areas showed that identification of newly diagnosed MRAB patients was significantly correlated with preceding environmental contamination with MRAB (P = .001). The incidence of nosocomial MRAB infection was significantly lower in the intervention compared with nonintervention wards (0.55 vs 2.28 per 1,000 patient days, respectively; P = .04). All MRAB isolated from the environmental and patients' samples belonged to multilocus sequence typing ST457 and were blaOXA23-like positive.

CONCLUSIONS:

Environmental surveillance may serve as a surrogate marker for the presence of MRAB carriers. Implementation of timely infection control measures should be guided by environmental culture for MRAB to minimize the risk of MRAB outbreak.

KEYWORDS:

Environmental surveillance; Multidrug-resistant Acinetobacter baumannii; Outbreak

PMID:
28893447
DOI:
10.1016/j.ajic.2017.07.010
[Indexed for MEDLINE]

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