Nosocomial outbreak of carbapenem-resistant Acinetobacter baumannii in intensive care units and successful outbreak control program.
Nosocomial outbreak of carbapenem-resistant Acinetobacter baumannii in intensive care units and successful outbreak control program.
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DOI：
10.3346/jkms.2010.25.7.999
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发表时间：
2010-07
影响因子：
4.5
通讯作者：
Park DW
中科院分区：
文献类型：
--
作者：
Choi WS;Kim SH;Jeon EG;Son MH;Yoon YK;Kim JY;Kim MJ;Sohn JW;Kim MJ;Park DW
鲍曼不动杆菌是引起医院感染的重要病原菌。在这里，我们描述了一个爆发的碳青霉烯耐药A。沿着一个成功的爆发控制项目，从2007年10月到2008年7月，从57名ICU患者中分离出CRAB。19名患者被诊断为真正感染了CRAB，其中4人被推测死于CRAB感染，病死率为21.1%。在对环境和医务人员的监测中，从135份环境样品中分离出24份（17.9%），从65份医务人员中分离出7份（10.9%）。脉冲场凝胶电泳图谱显示，从病人、HCW和环境中分离的菌株具有遗传相关性。通过加强接触预防措施、通过大规模清洁减少环境污染和使用封闭式抽吸系统，控制了疫情。到2008年8月，ICU中没有新的CRAB病例。本研究表明，CRAB的广泛传播可以通过HCWs和环境污染发生，并且适当的策略，包括严格的接触预防措施，大规模的环境净化和封闭的抽吸系统可以有效地控制CRAB的爆发。
Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe an outbreak of carbapenem-resistant A. baumannii (CRAB) in the ICUs of a Korean university hospital, along with a successful outbreak control program. From October 2007 through July 2008, CRAB was isolated from 57 ICU patients. Nineteen patients were diagnosed as being truly infected with CRAB, four of whom were presumed to have died due to CRAB infection, producing a case-fatality rate of 21.1%. In surveillance of the environment and the healthcare workers (HCWs), CRAB was isolated from 24 (17.9%) of 135 environmental samples and seven (10.9%) of 65 HCWs. The pulsed field gel electrophoresis patterns showed that the isolates from patients, HCWs, and the environment were genetically related. Control of the outbreak was achieved by enforcing contact precautions, reducing environmental contamination through massive cleaning, and use of a closed-suctioning system. By August 2008 there were no new cases of CRAB in the ICUs. This study shows that the extensive spread of CRAB can happen through HCWs and the environmental contamination, and that proper strategies including strict contact precautions, massive environmental decontamination, and a closed-suctioning system can be effective for controlling CRAB outbreaks.
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影响因子：
9.4
作者：
TENOVER, FC;ARBEIT, RD;SWAMINATHAN, B
通讯作者：
SWAMINATHAN, B
影响因子：
4.5
作者：
D'Agata, EMC;Thayer, V;Schaffner, W
通讯作者：
Schaffner, W
影响因子：
4.5
作者：
Marchaim, Dror;Navon-Venezia, Shiri;Carmeli, Yehuda
通讯作者：
Carmeli, Yehuda
影响因子：
4.5
作者：
Yang JA;Park DW;Sohn JW;Yang IS;Kim KH;Kim MJ
通讯作者：
Kim MJ
DOI：
10.1590/s0074-02762004000800010
发表时间：
2004-12-01
期刊：
Memórias do Instituto Oswaldo Cruz
影响因子：
--
作者：
Braun, Graziela;Vidotto, Marilda Carlos
通讯作者：
Vidotto, Marilda Carlos