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Aerosolization of Acinetobacter baumannii in a Trauma ICU*

Munoz-Price, L. Silvia MD1,2,4; Fajardo-Aquino, Yovanit MD4; Arheart, Kristopher L. EdD2,5; Cleary, Timothy PhD6; DePascale, Dennise MT4; Pizano, Louis MD3; Namias, Nicholas MD3; Rivera, Jesabel I. BS7; O’Hara, Jessica A. MPH7; Doi, Yohei MD, PhD7

doi: 10.1097/CCM.0b013e31828a39c0
Clinical Investigations

Objective: To establish the presence of air contamination with Acinetobacter baumannii in the trauma ICU.

Design: Point prevalence microbiological surveillances.

Settings: A 1,500-bed public teaching hospital in the Miami metro area.

Patients: Trauma ICU patients.

Measurements: Pulsed field electrophoresis was performed on environmental and clinical isolates to determine the association of any isolates from the air with clinical isolates.

Main Results: Out of 53 patient areas cultured, 12 (22.6%) had their air positive for A. baumannii. The presence of an A. baumannii–positive patient (underneath the plate) was associated with positive air cultures for A. baumannii (11 of 21 [52.4%] vs 0 of 25 [0%]; p < 0.0001). However, we were not able to find differences in air contamination based on the presence of A. baumannii in respiratory secretions versus absence (p = 1.0). Air and clinical isolates were found to be clonally related.

Conclusions: Aerosolization of A. baumannii in the ICUs is a concern, and its role in the transmission of this organism among patients should be further clarified.

1Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL.

2Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL.

3Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL.

4Jackson Memorial Hospital, Miami, FL.

5Division of Biostatistics, Miller School of Medicine, University of Miami, Miami, FL.

6Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL.

7Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA.

*See also p. 2042.

Supplemental digital content is available from this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal).

Dr. Doi has received grant support from Merck and has consulted for Pfizer. The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: smunozprice@med.miami.edu

© 2013 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins