Investigation and management of an imipenem-resistant oxa-23 Acinetobacter baumannii outbreak in an intensive care unit
| Autor: | Anne Renault, Michèle Virmaux, Gwenaël Prat, Jean-Marie Tonnelier, I. Le Du, D. Tande, Ronan Garlantézec, Raoul Baron, B. Lejeune, S. Jourdain, M. Cosse, L. Daniel, G. Lelay, Jean-Michel Boles, C. Bourigault, Montaine Lefèvre |
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| Rok vydání: | 2011 |
| Předmět: |
Acinetobacter baumannii
Adult Male medicine.medical_specialty Imipenem Adolescent Shutdown Drug resistance Asymptomatic Disease Outbreaks law.invention Young Adult 03 medical and health sciences 0302 clinical medicine law Drug Resistance Bacterial medicine Humans 030212 general & internal medicine Intensive care medicine Aged Aged 80 and over Cross Infection 0303 health sciences biology 030306 microbiology business.industry Outbreak Middle Aged biology.organism_classification medicine.disease Intensive care unit Anti-Bacterial Agents 3. Good health Intensive Care Units Pneumonia Infectious Diseases Case-Control Studies Female medicine.symptom business Acinetobacter Infections medicine.drug |
| Zdroj: | Médecine et Maladies Infectieuses. 41:430-436 |
| ISSN: | 0399-077X |
| DOI: | 10.1016/j.medmal.2011.01.013 |
| Popis: | Objectives The study objectives were to describe the investigation and management of an imipenem-resistant Acinetobacter baumannii outbreak that occurred in the 15-bed ICU of a tertiary care teaching hospital (Brest, France), during the summer 2008. Patients and methods Patients harboring an imipenem-resistant A. baumannii strain were defined as case patients. We described case occurrence and steps taken to control the outbreak: contact isolation, reinforcement of hygiene procedures, unit shutdown decision, unit disinfection, and reopening. We also made a case control study and a cost analysis of the outbreak management. Results During a 10-day period, five patients were positive for a single clone of imipenem-resistant oxa-23 A. baumannii. Four patients presented with ventilation-acquired pneumonia and one was asymptomatic. The first two patients died one day after the first swab which led to the identification of A. baumannii. No additional case was noted in the ICU or in other hospital units after deciding to close the ICU. The cost of outbreak management was estimated at 264,553 euros. The case control study identified several factors associated with infection or colonization: length of stay in the ICU, chronic respiratory disease, number of previous antibiotic classes used, duration of ventilation, prone position, echocardiography, and presence of a nasogastric tube. Conclusion This outbreak occurred during the summer period requiring the shutdown of the ICU and inducing a considerable cost. Rapid reactions of the ICU staff during the outbreak enabled to limit the epidemic. |
| Databáze: | OpenAIRE |
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