Department of Surgical Sciences, Plastic Surgery, Uppsala University, Sweden; Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Sweden.
Department of Women´s and Children´s Health, International Maternal and Child Health, Uppsala University, Sweden.
Burns. 2022 Dec;48(8):1940-1949. doi: 10.1016/j.burns.2022.01.018. Epub 2022 Jan 29.
To describe the course of the outbreak and infection control measures to stop the spread of sequence type 15 OXA-23-producing Acinetobacter baumannii in the Burn Center of Uppsala University Hospital, between November 2014 and the end of April 2015.
Compliance with hand hygiene, dress code, and cleaning routines were reviewed, the ward's environment was systematically investigated to identify potential environmental sources. Sampling routines for A. baumannii, from patients and environment, were established, and the epidemiological relationship was analysed for all carbapenem-resistant A. baumannii isolates using arbitrarily primed polymerase chain reaction (AP-PCR) and pulsed-field gel electrophoresis (PFGE).
A total of 54 patients were treated at the burn intensive care unit during the studied, approximately five months period, and an OXA-23-producing A. baumannii was isolated from nine patients (9/54, 17%), whereof two died (2/9, 22.2%). All isolates shared identical PFGE-genotype patterns and belonged to sequence type 15; AP-PCR was eligible for prompt epidemiological investigations.
Higher awareness and increased compliance with hand hygiene and dress code as well as intensified cleaning protocols of the environment and equipment were successfully established and likely to have led to stop the spread of sequence type 15 OXA-23-producing Acinetobacter baumannii.
描述 2014 年 11 月至 2015 年 4 月底期间，在乌普萨拉大学医院烧伤中心发生的 1 型 5 种 OXA-23 型碳青霉烯酶产生鲍曼不动杆菌爆发的过程和感染控制措施，以阻止其传播。
回顾了手卫生、着装规范和清洁程序的执行情况，系统调查了病房环境，以确定潜在的环境来源。建立了针对患者和环境中鲍曼不动杆菌的采样程序，并使用任意引物聚合酶链反应（AP-PCR）和脉冲场凝胶电泳（PFGE）分析所有耐碳青霉烯鲍曼不动杆菌分离株的流行病学关系。
在所研究的大约五个月期间，共有 54 名患者在烧伤重症监护病房接受治疗，9 名患者（9/54，17%）分离出 1 型 5 种 OXA-23 型碳青霉烯酶产生鲍曼不动杆菌，其中 2 例死亡（2/9，22.2%）。所有分离株具有相同的 PFGE 基因型模式，属于 1 型 5 种；AP-PCR 适合于及时进行流行病学调查。
提高对手卫生和着装规范的认识和执行，并加强环境和设备的清洁方案，成功地阻止了 1 型 5 种 OXA-23 型碳青霉烯酶产生鲍曼不动杆菌的传播。
