Occupational transmission of Acinetobacter baumannii from a United States serviceman wounded in Iraq to a health care worker
| Autor: | Judith F. English, John W. Sanders, Matthew R. Kasper, Mark W. Eshoo, Sonia S. Qasba, Timothy J. Whitman, Andrea M. Hujer, Britta S. Babel, Robert A. Bonomo, Joseph Timpone, Kristine M. Hujer, Andrea Endimiani |
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| Rok vydání: | 2008 |
| Předmět: |
Microbiology (medical)
Acinetobacter baumannii Male medicine.medical_specialty Spectrometry Mass Electrospray Ionization Warfare Infectious Disease Transmission Patient-to-Professional Health Personnel Drug resistance Polymerase Chain Reaction Article law.invention law Drug Resistance Multiple Bacterial Occupational Exposure medicine Pneumonia Bacterial Humans Intensive care medicine biology business.industry Outbreak Middle Aged medicine.disease biology.organism_classification Intensive care unit United States Anti-Bacterial Agents Electrophoresis Gel Pulsed-Field Pneumonia Infectious Diseases Military Personnel Coccobacillus Bacteremia Emergency medicine Iraq Sputum Female medicine.symptom business Acinetobacter Infections |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 47(4) |
| ISSN: | 1537-6591 |
| Popis: | Acinetobacter baumannii is an aerobic gram-negative pleomorphic coccobacillus commonly found in soil, skin flora, and the hospital environment [1–3]. The ability of A. baumannii to survive on environmental surfaces for extended periods of time, along with its capacity to demonstrate antimicrobial resistance genes, make it exceptionally well suited to emerge as a successful nosocomial pathogen [4–8]. Generally speaking, this organism is responsible for pulmonary, urinary tract, bloodstream, or surgical wound infections in immunocompromised patients with multiple comorbidities [4, 9]. Numerous reports also describe A. baumannii outbreaks of bloodstream infections, osteomyelitis, and complicated skin and soft-tissue infections in US military and civilian personnel who were wounded while serving in Iraq and Afghanistan [10, 11]. Scott et al. [12] traced an outbreak of A. baumannii infection in wounded soldiers to the environmental contamination of field hospitals in Iraq and Kuwait. Transporting these injured personnel who are colonized or infected with A. baumannii back to the United States is also linked to the nosocomial transmission of these strains from wounded US service personnel to civilian patients in military treatment facilities (MTFs) [6]. Additionally, an analysis of the complex transmission dynamics of 1 major outbreak showed that multiple clones with multidrug-resistant phenotypes were circulating at the same time [6, 12]. A. baumannii rarely cause community-acquired pneumonia and sepsis. These uncommon manifestations of A. baumannii infection are found among patients who reside in tropical climates and who have chronic obstructive pulmonary disease and/or who abuse alcohol [13]. In June 2006, a 55-year-old woman presented to a teaching medical center with pneumonia, bacteremia, and sepsis due to A. baumannii. At the time of this illness, she was employed as an intensive care unit (ICU) health care worker (HCW) at an MTF for US service personnel wounded in Iraq and Afghanistan. Of further note, a nosocomial outbreak of A. baumannii infection was occurring in the MTF at the same time. We investigated the possibility that her infection was related to occupational exposure of patients infected or colonized with A. baumannii. We found that the strain of A. baumannii that infected her matched a strain from the sputum of a wounded US serviceman. We also discovered that this strain was the most common clone type isolated within the MTF at the time the HCW became infected, was related to previously described strains circulating in Europe, and was also present at another MTF, the Walter Reed Army Medical Center (WRAMC). |
| Databáze: | OpenAIRE |
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