Carbapenem-resistant Acinetobacter and role of curtains in an outbreak in intensive care units
Carbapenem-resistant Acinetobacter and role of curtains in an outbreak in intensive care units
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DOI：
10.1053/jhin.2001.1127
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发表时间：
2002-02-01
影响因子：
6.9
通讯作者：
Elliott, T
中科院分区：
文献类型：
--
作者：
Das, I;Lambert, P;Elliott, T
多重抗生素耐药鲍曼不动杆菌（包括美罗培南耐药）于1998年12月首次从伯明翰一家三级转诊大学教学医院的普通重症监护室的患者中分离出来。随后从其他12名患者中分离出类似的菌株，包括医院内另一个重症监护室的患者。在这两个单位使用美罗培南增加后爆发了疫情。环境筛查显示，重症监护室和床上用品的污染物表面存在多重耐药不动杆菌属。主要来源似乎是病人病床周围的窗帘。脉冲场凝胶电泳分型表明，患者的分离株和环境中的分离株无法区分。实施了严格的感染控制措施，包括增加使用次氯酸盐（1000 ppm）清洁环境的频率和每周两次更换窗帘，沿着限制在单位中使用美罗培南。多重耐药不动杆菌的分离。随后减少，并且在18个月的随访期内未检测到。据我们所知，这是首次报告的碳青霉烯类耐药不动杆菌属爆发。来自英国。这次暴发还突出了环境来源，特别是窗帘等干燥织物，是传播不动杆菌的重要储存库。(C)2002年，医院感染协会。
Multiple-antibiotic-resistant Acinetobacter baumanii, including meropenem resistance, was first isolated from a patient in the general intensive care unit of a tertiary-referral university teaching hospital in Birmingham in December 1998. Similar strains were subsequently isolated from 12 other patients, including those on another intensive care unit within the hospital. The outbreak followed an increase in the use of meropenem in both the units. Environmental screening revealed the presence of the multiple-resistant Acinetobacter species on fomite surfaces in the intensive care unit and bed linen. The major source appeared to be the curtains surrounding patients' beds. Typing by pulsed field gel electrophoresis demonstrated that the patients' isolates and those from the environment were indistinguishable. Rigorous infection control measures including increased frequency of cleaning of the environment with hypochlorite (1000 ppm) and twice-weekly changing of curtains were implemented, along with restriction of meropenem use in the units. Isolation of the multiple-resistant Acinetobacter spp. subsequently diminished and it was not detected over a follow-up period of 18 months. To our knowledge, this is the first reported outbreak of carbapenem-resistant Acinetobacter spp. from the UK. This outbreak also highlights environmental sources, particularly dry fabrics such as curtains, as an important reservoir for dissemination of acinetobacters. (C) 2002 The Hospital Infection Society.