Simultaneous Outbreaks of Extensively Drug Resistant Acinetobacter baumannii and Carbapenemase Producing Enterobacteriaceae in an Intensive Care Unit: Interruption of Epidemic but not Endemic Transmission (original) (raw)

Abstract

Background: Carbapenemase-producing Enterobacteriaceae (CPE) and multidrug-resistant Acinetobacter baumannii (AB) have emerged as vexing problems in infection control. Our objective was to describe concurrent outbreaks of CPE and extensively drug resistant (XDR) AB in an intensive care unit (ICU) and interventions to control their spread. Methods: We investigated concurrent clusters of CPE and XDR AB in a surgical ICU that occurred 1/10-3/10. Polymerase chain reaction was used to detect the presence of blaKPC and resistance plasmids in carbapenemase phenotype-positive Enterobacteriaceae. Pulsed-field gel electrophoresis was performed to assess clonality of XDR AB (defined as resistance to all FDA approved antibiotics, including colistin and tigecycline). Enhanced infection control measures (staff education, room/personnel cohorting, and enhanced environmental cleaning with validation using ATP testing) were implemented 1/28/10. Efficacy of the interventions was evaluated by interrup...

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