Occupational transmission of Acinetobacter baumannii from a United States serviceman wounded in Iraq to a health care worker.
Occupational transmission of Acinetobacter baumannii from a United States serviceman wounded in Iraq to a health care worker.
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鲍曼不动杆菌从一名在伊拉克受伤的美国军人到一名医护人员的职业传播。
DOI：
10.1086/589247
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Bonomo,RobertA
中科院分区：
文献类型：
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作者：
Whitman,TimothyJ;Qasba,SoniaS;Timpone,JosephG;Babel,BrittaS;Kasper,MatthewR;English,JudithF;Sanders,JohnW;Hujer,KristineM;Hujer,AndreaM;Endimiani,Andrea;Eshoo,MarkW;Bonomo,RobertA
背景：鲍曼不动杆菌日益被认为是一种与民用和军用治疗设施的医院暴发有关的重要病原体。目前对这些暴发的分析经常描述患者之间的传播。到目前为止，职业性传播OFA。鲍曼从一名患者转变为一名卫生保健工作者(HCW)的报道尚未报道。我们启动了对一起具有复杂的FA病例的HCW的调查。鲍曼尼肺炎以确定她的疾病与达之间是否存在联系。方法：采用脉冲场凝胶电泳法和聚合酶链式反应/电喷雾电离质谱仪进行多位点测序分型，以确定克隆性。为了进一步确定这些分离株的特征，我们对耐药决定因素进行了遗传分析。结果和结论：回顾分析显示，多重耐药A。通过脉冲场凝胶电泳法无法区分从HCW中恢复的鲍曼尼和从她护理的患者中恢复的鲍曼尼。聚合酶链式反应/电喷雾电离质谱仪检测结果表明，分离株与OFA菌株相似。鲍曼尼来源于欧洲克隆II型(沃尔特里德陆军医疗中心11型毒株)。将HCW暴露于指标患者的时间仅为30分钟，并在不使用HCW面罩的情况下进行气管内吸痰。90A的考试。本次调查中收集的鲍曼分离株有2种主要克隆类型和多种次要克隆类型，其中来自HCW的分离株和来自指标患者的分离株是最流行的克隆类型。职业传播可能发生在医院；医务人员照顾感染a的患者。鲍曼尼应该意识到这种潜在的感染传播方式。
Background.Acinetobacter baumanniiis increasingly recognized as being a significant pathogen associated with nosocomial outbreaks in both civilian and military treatment facilities. Current analyses of these outbreaks frequently describe patient-to-patient transmission. To date, occupational transmission ofA. baumanniifrom a patient to a health care worker (HCW) has not been reported. We initiated an investigation of an HCW with a complicated case ofA. baumanniipneumonia to determine whether a link existed between her illness andA. baumannii-infected patients in a military treatment facility who had been entrusted to her care.Methods.Pulsed-field gel electrophoresis and polymerase chain reaction/electrospray ionization mass spectrometry, a form of multilocus sequencing typing, were done to determine clonality. To further characterize the isolates, we performed a genetic analysis of resistance determinants.Results and Conclusions.A “look-back” analysis revealed that the multidrug resistantA. baumanniirecovered from the HCW and from a patient in her care were indistinguishable by pulsed-field gel electrophoresis. In addition, polymerase chain reaction/electrospray ionization mass spectrometry indicated that the isolates were similar to strains ofA. baumanniiderived from European clone type II (Walter Reed Army Medical Center strain type 11). The exposure of the HCW to the index patient lasted for only 30 min and involved endotracheal suctioning without use of an HCW mask. An examination of 90A. baumanniiisolates collected during this investigation showed that 2 major and multiple minor clone types were present and that the isolates from the HCW and from the index patient were the most prevalent clone type. Occupational transmission likely occurred in the hospital; HCWs caring for patients infected withA. baumanniishould be aware of this potential mode of infection spread.