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Control of hospital endemicity of multiple-drug-resistant Acinetobacter baumannii ST457 with directly observed hand hygiene

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Abstract

An increasing endemicity of multiple-drug-resistant Acinetobacter baumannii (MRAB) ST457 was noted in Hong Kong. The epidemiology, risk factors, and infection control measures to prevent nosocomial transmission of this epidemic clone were analyzed. A total of 5,058 patients cultured positive with A. baumannii between 1 January 2004 and 30 June 2014 were included, of which 297 (5.9 %) had bacteremia. The first case of MRAB bacteremia emerged in 2009, with an incidence that increased from 0.27 (one case) in 2009 to 1.86 (14 cases) per 100,000 patient-days in 2013 (p < 0.001). With the implementation of strict contact precautions and directly observed hand hygiene in conscious patients immediately before receiving meals and medications in July 2013, the incidence of MRAB bacteremia reduced from its peak to 0.77 (one case) per 100,000 patient-days in the first 6 months of 2014 (p < 0.001). Patients from long-term care facilities for the elderly [odds ratio (OR) 18.6, confidence interval (CI) 2.1–162.4, p = 0.008] and history of carbapenem (OR 7.0, CI 1.7–28.0, p = 0.006) and beta-lactam/beta-lactamase use (OR 5.6, CI 1.1–28.7, p = 0.038) 90 days prior to admission were independent risk factors for MRAB bacteremia by logistic regression when compared with carbapenem-susceptible A. baumannii bacteremia.

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Funding source

This work was supported by the commissioned research grant from the Health and Medical Research Fund of the Food and Health Bureau, HKSAR.

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None declared.

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Authors and Affiliations

  1. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China

    V. C. C. Cheng, J. H. K. Chen, R. W. S. Poon, S. Y. C. So, S. C. Y. Wong, C. C. Y. Yip, S. S. Y. Wong, J. F. W. Chan, P. L. Ho & K. Y. Yuen

  2. Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China

    V. C. C. Cheng & W. M. Lee

  3. School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China

    P. H. Chau

  4. Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China

    I. F. N. Hung

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  1. V. C. C. Cheng
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  2. J. H. K. Chen
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  3. R. W. S. Poon
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  4. W. M. Lee
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  5. S. Y. C. So
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  6. S. C. Y. Wong
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  7. P. H. Chau
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  8. C. C. Y. Yip
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  11. I. F. N. Hung
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  12. P. L. Ho
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  13. K. Y. Yuen
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Correspondence to K. Y. Yuen.

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Cheng, V.C.C., Chen, J.H.K., Poon, R.W.S. et al. Control of hospital endemicity of multiple-drug-resistant Acinetobacter baumannii ST457 with directly observed hand hygiene. Eur J Clin Microbiol Infect Dis 34, 713–718 (2015). https://doi.org/10.1007/s10096-014-2281-x

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  • DOI: https://doi.org/10.1007/s10096-014-2281-x

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