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Outbreak of multiresistant Acinetobacter baumannii in a polyvalent intensive care unit: clinical, epidemiological analysis and PFGE-printing evolution

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Abstract

An outbreak of multidrug-resistant Acinetobacter baumannii (MRAB) occurred over the course of a 27-week period in our adult polyvalent intensive care unit (ICU). Twenty-one patients were affected, and 72 strains were identified from different clinical samples. The strains were resistant to all antibiotics except for colistin and ampicillin/sulbactam. Forty-nine MRAB strains collected from 18 patients were analysed by pulsed-field gel electrophoresis (PFGE). This analysis revealed four highly-related PFGE types (genetic similarity index >90%) termed 1, 2, 3 and 4, that were isolated in 13, seven, one, and three patients, respectively. A single PFGE type was identified from five of ten patients with successive isolation of MRAB; in the other five patients, two or three PFGE types were detected. This suggested phased evolution of PFGE types 2, 3 and 4 from PFGE type 1. Global mortality was high (13 patients; 62%). Non-survivors had higher APACHE II scores than survivors on the date that MRAB was isolated (OR = 1.57; 95% CI [1.02, 2.44]). The outbreak was controlled after implementation of an extensive infection control program.

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Sources of funding

This research was supported by grant MPY 1116/07 from the Instituto de Salud Carlos III.

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The authors declare no conflicts of interests.

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Authors and Affiliations

  1. Intensive Care Unit, Hospital Don Benito-Villanueva, Health Service of Extremadura, 06400, Don Benito, Badajoz, Spain

    J. Monterrubio-Villar & A. Córdoba-López

  2. Microbiology Department, Hospital Don Benito-Villanueva, Health Service of Extremadura, 06400, Don Benito, Badajoz, Spain

    C. González-Velasco

  3. Bacteriology Department, National Centre of Microbiology, Carlos III Health Institute, 28220, Majadahonda, Madrid, Spain

    S. Valdezate-Ramos, P. Villalón-Panzano & J. A. Saéz-Nieto

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  1. J. Monterrubio-Villar
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  2. C. González-Velasco
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  3. S. Valdezate-Ramos
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  4. A. Córdoba-López
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  5. P. Villalón-Panzano
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  6. J. A. Saéz-Nieto
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Correspondence to J. Monterrubio-Villar.

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Monterrubio-Villar, J., González-Velasco, C., Valdezate-Ramos, S. et al. Outbreak of multiresistant Acinetobacter baumannii in a polyvalent intensive care unit: clinical, epidemiological analysis and PFGE-printing evolution. Eur J Clin Microbiol Infect Dis 28, 1281–1284 (2009). https://doi.org/10.1007/s10096-009-0777-6

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  • DOI: https://doi.org/10.1007/s10096-009-0777-6

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