gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Extensive outbreak with a pandrug-resistant Acinetobacter baumannii on an ICU for burn patients

Ausbruch: Panresistenter Acinetobacter baumannii auf einer Schwerstverbranntenstation

Meeting Abstract

  • E. Ott - Hannover Medical School, Institute for Medical Microbiology and Hospital Epidemiology, Hannover, Germany
  • F.-C. Bange - Hannover Medical School, Institute for Medical Microbiology and Hospital Epidemiology, Hannover, Germany
  • H.-O. Rennekampff - Hannover Medical School, Department of Plastic, Hand- and Reconstructive Surgery, Hannover, Germany
  • I. F. Chaberny - Hannover Medical School, Institute for Medical Microbiology and Hospital Epidemiology, Hannover, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocINF 10-6

DOI: 10.3205/10kit022, URN: urn:nbn:de:0183-10kit0221

Veröffentlicht: 2. Juni 2010

© 2010 Ott et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Between August 2008 and April 2009 an outbreak of pandrug-resistant Acinetobacter baumannii occurred in an intensive care unit (ICU) for burn patients. The outbreak strain was identified by pulsed-field gel electrophoresis (PFGE). 20 of 23 culture-positive cases were acquired nosocomially. Patients were 60 years on average, the majority were female (65%), and suffered second- and third-degree burns (61%). According to CDC-criteria, six patients had wound infections, and two patients had pneumonia. Of the 23 cases, 6 died during the hospital stay. Sampling of the environment showed a heavy contamination throughout the ICU. Yet were not able to identify a focal source for which the outbreak had originated. However, during the outbreak, a lack of proper hand hygiene, and an inadequate number of staff facilitated the transmission. In addition, structural problems such as a bath tub, which was difficult to clean properly, became evident. Despite the broad contamination of the ward with the pandrug-resistant Acinetobacter baumannii, we aimed at controlling the outbreak without closing down the unit. While the unit remained fully operational, we implemented multicomponent interventions including extensive environmental decontamination, educational programs for the staff, strict isolation, 1:1 patient care, additional hand desinfectant dispenser, improvement of the technique for surgical dressing, and usage of a suitable bath tub. Even so we failed to identify the origin for this outbreak, the implementation of a bundle of measures finally led to the termination of the outbreak.