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Antimicrob Agents Chemother. 2019 May 13. pii: AAC.00392-19. doi: 10.1128/AAC.00392-19. [Epub ahead of print]

Patient-to-Patient Transmission of Acinetobacter baumannii Gastrointestinal Colonization in the Intensive Care Unit.

Author information

1
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA aharris@som.umaryland.edu.
2
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
3
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
4
Medical Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA.
5
Departments of Medicine, Pharmacology, Molecular Biology and Microbiology, Biochemistry, Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
6
CWRU Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA.

Abstract

Objective: Acinetobacter baumannii is an important nosocomial pathogen. The objective of this study was to determine the proportion of A. baumannii due to patient-to-patient transmission by analyzing the molecular epidemiology of patients who acquired A. baumannii using peri-anal surveillance cultures in a large 2-year intensive care unit population.Design: Prospective cohort studyMethods: Patients who were admitted to the medical and surgical intensive care units (ICUs) at the University of Maryland Medical Center from 2011 to 2013 underwent admission, weekly and discharge peri-anal cultures collected. Using multilocus sequence typing (MLST) with subsequent pulsed-field gel electrophoresis (PFGE) for increased discrimination, and hospital overlap, the number of patients that acquired A. baumannii due to patient-to-patient transmission was determined.Results: Our cohort consisted of 3452 patients. In total, 196 cohort patients were colonized with A. baumannii; 130 patients were positive at ICU admission and 66 patients acquired A. baumannii during their stay. Among the 196 A. baumannii patient isolates, there were 91 unique MLST types. Among the 66 patients who acquired A. baumannii, 31 (50%) were considered genetically related by MLST and/or PFGE type and 11 (17%) were considered patient-to-patient transmission by genetic-relatedness and overlapping hospital stay.Conclusions: Our data shows that, of those cases of A. baumannii acquisition, at least 17% were cases of patient-to-patient transmission.

PMID:
31085518
DOI:
10.1128/AAC.00392-19

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