A Epidemiological Investigation of a Nosocomial Outbreak of Multidrug-Resistant Acinetobacter baumannii in a Critical Care Center in Japan, 2011-2012

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  • Ushizawa Hiroto
    Field Epidemiology Training Program, National Institute of Infectious Diseases Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University
  • Yahata Yuichiro
    Infectious Diseases Surveillance Center, National Institute of Infectious Diseases
  • Endo Takeo
    Infection Control Team, National Hospital Organization Mito Medical Center
  • Iwashima Tomoko
    Infection Control Team, National Hospital Organization Mito Medical Center
  • Misawa Michiyo
    Infection Control Team, National Hospital Organization Mito Medical Center
  • Sonobe Makoto
    Infection Control Team, National Hospital Organization Mito Medical Center
  • Yamagishi Takuya
    Infectious Diseases Surveillance Center, National Institute of Infectious Diseases
  • Kamiya Hajime
    Infectious Diseases Surveillance Center, National Institute of Infectious Diseases
  • Nakashima Kazutoshi
    Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine
  • Matsui Tamano
    Infectious Diseases Surveillance Center, National Institute of Infectious Diseases
  • Matsui Mari
    Department of Bacteriology II, National Institute of Infectious Diseases
  • Suzuki Satowa
    Department of Bacteriology II, National Institute of Infectious Diseases
  • Shibayama Keigo
    Department of Bacteriology II, National Institute of Infectious Diseases
  • Doi Mikio
    Department of Public Health and Welfare
  • Irie Fujiko
    Department of Public Health and Welfare
  • Yamato Shinichi
    Mito Public Health Center
  • Otomo Yasuhiro
    Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University
  • Oishi Kazunori
    Infectious Diseases Surveillance Center, National Institute of Infectious Diseases

書誌事項

タイトル別名
  • A Epidemiological Investigation of a Nosocomial Outbreak of Multidrug-Resistant <i>Acinetobacter baumannii</i> in a Critical Care Center in Japan, 2011–2012
  • A Epidemiological Investigation of a Nosocomial Outbreak of Multidrug-Resistant <i>Acinetobacter baumannii</i> in a Critical Care Center in Japan, 2011&ndash;2012
  • An Epidemiological Investigation of a Nosocomial Outbreak of Multidrug-Resistant <italic>Acinetobacter baumannii</italic> in a Critical Care Center in Japan, 2011–2012
  • An epidemiological investigation of a nosocomial outbreak of multidrug-resistant Acinetobacter baumannii in a critical care center in Japan, 2011-2012

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抄録

In 2011, a multidrug-resistant Acinetobacter baumannii (MDRAB) outbreak occurred at a Japanese critical care center (CCC) in a tertiary care hospital. Multidrug-resistance in Japan is defined as resistance to the antimicrobials amikacin, carbapenem, and fluoroquinolone. We conducted a retrospective epidemiological investigation of this outbreak to identify the risk factors for MDRAB respiratory tract acquisition in this hospital. Cases were defined as hospitalized patients with MDRAB-positive cultures at least 3 days post admission to the CCC between June 1, 2011 and April 20, 2012. Fifteen MDRAB cases were identified, including 3 with infection and 12 with colonization. This case-control study demonstrated that hypoalbuminemia along with carbapenem administration were associated with MDRAB respiratory tract acquisition. Pulsed-field gel electrophoresis analysis and multilocus sequence typing using MDRAB isolates suggested a clonal dissemination of MDRAB strains with sequence type 74 occurred primarily among patients admitted to the CCC. From April 16, 2012, a decreased isolation rate of MDRAB in the hospital occurred after the implementation of the following infection control measures: closing the emergency room, discontinuing admission to the CCC, isolating patients with MDRAB colonization or infection to single room status, and conducting environmental cleaning. No MDRAB cases were detected between March 23 and April 20, 2012.

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