Department of Health Sciences, University of Genoa, Italy.
Am J Infect Control. 2011 Nov;39(9):790-4. doi: 10.1016/j.ajic.2011.01.016. Epub 2011 Jun 25.
Multidrug-resistant Acinetobacter baumannii (MDRAB) is an important cause of hospital acquired infection. We describe a 7-month outbreak of a MDRAB infection involving various wards of an Italian hospital and an investigation of the possible source of the infection was conducted.
A baumannii was isolated from various biological samples from 22 colonized or infected patients, and was identified and characterized for its antibiotic sensitivity. Typing of A baumannii was performed by multilocus sequence typing (MLST). Investigation of the outbreak involved extensive microbiological sampling of the environment.
In 50% of cases the infection occurred in the ICU. Invasive procedures were performed in 63.6% of patients. The strain isolated proved to be resistant to all the antibiotics tested, including carbapenems, and displayed the same allelic profile in all patients. None of the 141 samples taken during environmental monitoring showed positivity for A baumannii.
The results of the present study reveal the importance of strict adherence to control measures by all health care personnel and highlight the fact that regular staff training and frequent revision of control measures are essential to the successful management of an outbreak.
多重耐药鲍曼不动杆菌（MDRAB）是医院获得性感染的重要原因。我们描述了一起涉及意大利一家医院多个病房的 MDRAB 感染暴发，并对感染的可能来源进行了调查。
从 22 例定植或感染的患者的各种生物样本中分离出鲍曼不动杆菌，并对其抗生素敏感性进行了鉴定和特征分析。采用多位点序列分型（MLST）对鲍曼不动杆菌进行分型。对暴发的调查涉及对环境进行广泛的微生物采样。
50%的感染发生在 ICU。63.6%的患者进行了侵入性操作。分离出的菌株对所有测试的抗生素均有耐药性，包括碳青霉烯类，并在所有患者中具有相同的等位基因谱。在环境监测期间采集的 141 个样本中，均未检出鲍曼不动杆菌阳性。
本研究结果表明，所有医护人员严格遵守控制措施非常重要，并强调定期对员工进行培训和频繁修订控制措施对于成功管理暴发至关重要。
