Characterization of the Multidrug-Resistant Acinetobacter species Causing a Nosocomial Outbreak at Intensive Care Units in a Korean Teaching Hospital: Suggesting the Correlations with the Clinical and Environmental Samples, Including Respiratory Tract-related Instrumentsopen access국내 한 대학병원의 중환자실에서 집단 발생한 다제내성 Acinetobacter species 성상 분석: 임상검체와 호흡기 관련 장비 등 환경 검체와의 연관
- Other Titles
- 국내 한 대학병원의 중환자실에서 집단 발생한 다제내성 Acinetobacter species 성상 분석: 임상검체와 호흡기 관련 장비 등 환경 검체와의 연관
- Authors
- Chung, Hae-Sun; Lee, Yang soon; Park, Eun Suk; Lee, Dong Suk; Ha, Eun Jin; Kim, Myungsook; Yong, Dongeun; Jeong, Seok Hoon; Lee, Kyungwon; Chong, Yunsop
- Issue Date
- Jun-2014
- Publisher
- 대한임상미생물학회
- Keywords
- Acinetobacter; Beta-lactamase OXA-23; Infe- ction control; Disease outbreaks
- Citation
- Annals of Clinical Microbiology, v.17, no.2, pp.29 - 34
- Indexed
- KCI
- Journal Title
- Annals of Clinical Microbiology
- Volume
- 17
- Number
- 2
- Start Page
- 29
- End Page
- 34
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/159692
- DOI
- 10.5145/ACM.2014.17.2.29
- ISSN
- 2288-0585
- Abstract
- Background: Acinetobacter spp. is an important no- socomial pathogen for which increasing resistance to multiple antimicrobial agents has been observed. Prevalence of multidrug-resistant (MDR) Acinetobacter spp. in the intensive care unit (ICU) at a teaching hospital in Korea started to increase in 2008. The aim of this study was to determine the source of pathogen spread and to characterize the emerging strains at an early stage of outbreak.
Methods: Samples from respiratory instruments and fomites in the ICUs, as well as from the healthcare workers, were cultured to identify the sources of MDR Acinetobacter spp. Antimicrobial susceptibility was determined by the CLSI disk diffusion method. Pulsed field gel electrophoresis (PFGE) was per- formed for clinical and environmental isolates in or- der to determine clonality. Carbapenemase genes were detected by multiplex PCR. Infection control measures including peer-monitoring of hand washing, environmental cleaning and standard precautions were enforced. Results: Among the samples from the ICU tools (105)and healthcare worker’s hands (44), 31 (30%) and 2 (5%) respective samples yielded MDR Acinetobacter spp. Among the environmental samples, 90% were from respiratory-related equipment. The majority of clinical and environmental MDR Acinetobacter spp. (44/55) belonged to the pulsotype A. baumannii and carried both blaOXA-51-like and blaOXA-23-like genes. Even though infection-control measures were enforced, prevalence of MDR Acinetobacter spp. continues to increase.
Conclusion: An outbreak of MDR Acinetobacter spp. in a Korean hospital was caused by A. baumannii carrying the blaOXA-23-gene and was correlated with contaminated respiratory-related instruments in the ICUs. More intensive measures for nosocomial in- fection control are needed for successful prevention of Acinetobacter spread in hospitals. (Ann Clin Microbiol 2014;17:29-34)
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