[Spread of multidrug resistant acinetobacter baumannii in a teaching hospital]

ABSTRACT

A. baumannii is an important opportunistic pathogen widely distributed in the hospital environment and responsible for a variety of nosocomial infections especially in patients from intensive care units. We describe an outbreak of Acinetobacter baumannii [16 stains] in 3 intensive care units [I, II, III] at Charles Nicolle hospital of Tunis over a 5 month period [March to July 2005]. The antimicrobial susceptibility was determined by disc diffusion test and the genetic relatedness of isolates was done by Random Amplified Polymorphic DNA [RAPD] analysis. Two strains not related to the outbreak were used for the discrimination of the technique. Samples were collected from blood [44%], materials [31%], pus [6.5%], urines [6.5%] and respiratory tract [12.5%]. Antibiotic resistance pattern showed 2 different profiles. However, molecular typing of isolates revealed 3 distinct profiles [A, B, C] represented respectively by 8, 7 and one isolates. The major profile was the profile A found in 5 patients and in materials. It was appeared firstly in intensive care unit I. then in the 2 other units [II and Ill]. The profile B was observed also in the 3 units. However, the profile C was found in one patient in unit I. These data emphasize the need for active surveillance for multidrug-resistant Acinetobacter baumannii, and the value of molecular typing of strains in hospital settings to investigate spread of infection