Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/1672
Título : Nosocomial Outbreak of Infection With Pan-Drug-Resistant Acinetobacter baumannii in a Tertiary Care University Hospital
Autor : Valencia, Raquel
Arroyo, Luis A
Conde, Manuel
Aldana, Josefa M
Torres, María-José
Fernández-Cuenca, Felipe
Garnacho-Montero, José
Cisneros, José M
Ortíz, Carlos
Pachón, Jerónimo
Aznar, Javier
Filiación: [Valencia,R; Conde,M; Aldana,JM] Preventive Medicine and Public Health Service, [Arroyo,LA; Aznar,J] Clinical Microbiology Service, [Garnacho-MOntero,J; Ortíz,C] Intensive Care Servicem, [Cisneros,JM; Pachón,J] Infectious Diseases Service, Virgen del Rocío University Hospitals. Seville Spain. [Valencia,R; Conde,M] Department of Preventive Medicine, [Torres,MJ; Fernández-Cuenca,F; Aznar,J] Department of Microbiology, [Pachón,J] Department of Medicine, The University of Seville, Spain.
Palabras clave : Acinetobacter baumannii
Antibacterianos
Instituciones Oncológicas
Estudios de Casos y Controles
Infección Hospitalaria
Brotes de Enfermedades
Hospitales Universitarios
Humanos
Control de Infecciones
Factores de Riesgo
España
MeSH: Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Moraxellaceae::Acinetobacter::Acinetobacter baumannii
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospitals::Hospitals, Special::Cancer Care Facilities
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Disease Outbreaks
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Academic Medical Centers::Hospitals, Teaching::Hospitals, University
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Public Health Practice::Communicable Disease Control::Infection Control
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Moraxellaceae Infections::Acinetobacter Infections
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Fecha de publicación : Mar-2009
Editorial : University of Chicago Press
The Society for Healthcare Epidemiology of America
Cita Bibliográfica: Valencia R, Arroyo LA, Conde M, Aldana JM, Torres MJ, Fernández-Cuenca F, et al. Nosocomial outbreak of infection with pan-drug-resistant Acinetobacter baumannii in a tertiary care university hospital. Infect Control Hosp Epidemiol. 2009 ; 30(3):257-63
Abstract: OBJECTIVE To describe what is, to our knowledge, the first nosocomial outbreak of infection with pan-drug-resistant (including colistin-resistant) Acinetobacter baumannii, to determine the risk factors associated with these types of infections, and to determine their clinical impact. DESIGN Nested case-control cohort study and a clinical-microbiological study. SETTING A 1,521-bed tertiary care university hospital in Seville, Spain. PATIENTS Case patients were inpatients who had a pan-drug-resistant A. baumannii isolate recovered from a clinical or surveillance sample obtained at least 48 hours after admission to an intensive care unit (ICU) during the time of the epidemic outbreak. Control patients were patients who were admitted to any of the "boxes" (ie, rooms that partition off a distinct area for a patient's bed and the equipment needed to care for the patient) of an ICU for at least 48 hours during the time of the epidemic outbreak. RESULTS All the clinical isolates had similar antibiotic susceptibility patterns (ie, they were resistant to all the antibiotics tested, including colistin), and, on the basis of repetitive extragenic palindromic-polymerase chain reaction, it was determined that all of them were of the same clone. The previous use of quinolones and glycopeptides and an ICU stay were associated with the acquisition of infection or colonization with pan-drug-resistant A. baumannii. To control this outbreak, we implemented the following multicomponent intervention program: the performance of environmental decontamination of the ICUs involved, an environmental survey, a revision of cleaning protocols, active surveillance for colonization with pan-drug-resistant A. baumannii, educational programs for the staff, and the display of posters that illustrate contact isolation measures and antimicrobial use recommendations. CONCLUSIONS We were not able to identify the common source for these cases of infection, but the adopted measures have proven to be effective at controlling the outbreak.
Descripción : Journal Article;
URI: http://hdl.handle.net/10668/1672
Versión del editor : http://www.jstor.org/stable/10.1086/595977?__redirected
DOI: 10.1086/595977
ISSN : 1559-6834 (Online)
0899-823X (Print)
Appears in Collections:01- Artículos - Hospital Virgen del Rocío

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