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Institutional Outbreak and Control of a Multidrug-Resistant Clone of Acinetobacter baumannii

Gross, Joseph W. MD*; Keiser, John F. MD, PhD†; Klouj, Afifa MS‡; Parenti, David M. MD*; Simon, Gary L. MD, PhD*

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e31819e308f
Original Articles
Abstract

Multidrug-resistant Acinetobacter baumannii has been recently recognized as a major cause of nosocomial infections. During an outbreak of a multidrug-resistant strain, all isolates of A. baumannii were analyzed by pulsed-field gel electrophoresis, and a retrospective review was conducted to identify risk factors for acquisition. Of the 65 patients, the unique outbreak clone (clone I) was isolated from 43 (group A), whereas 19 different strains were grown from 22 other patients (group B). Clone I was predominantly isolated from pleuropulmonary sources (63%; P < 0.0001). Imipenem resistance was nearly universal in clone I, and amikacin resistance was common. In univariate analysis, admission to the medical/surgical intensive care unit and use of mechanical ventilation and fluoroquinolone antibiotics were associated with clone I. Only admission to the medical/surgical intensive care unit was significant by multivariate analysis. The institution of an infection control program controlled but did not eliminate the outbreak.

Author Information

From the *Division of Infectious Diseases, †Department of Pathology, and ‡Department of Epidemiology and Biostatistics, The George Washington University Medical Center, Washington, DC.

Reprints: Gary L. Simon, MD, PhD, Division of Infectious Diseases, The George Washington University Medical Center, 2150 Pennsylvania Ave NW, Ste 5-411, Washington, DC 20037. E-mail: gsimon@mfa.gwu.edu.

© 2009 Lippincott Williams & Wilkins, Inc.