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Ann Ist Super Sanita ; 43(1): 83-8, 2007.
Article in English | MEDLINE | ID: mdl-17536158

ABSTRACT

We investigated an outbreak of Acinetobacter baumannii in the intensive care unit (ICU) of a hospital in Rome, Italy. The outbreak involved 14 patients whose isolates were most frequently recovered from bronchoalveolar lavage. All isolates were multidrug-resistant and showed diminished susceptibility or resistance to carbapenems. A. baumannii strains with a similar antibiotic susceptibility pattern were isolated from the environment. Pulsed-field gel electrophoresis identified a single clone from both the patients' and environmental isolates. Because of the lack of a single source of infection, the eradication of the epidemic required a broad approach, including contact isolation and cohorting, aggressive environmental disinfection, and close monitoring of the ward staff's performance. Infected patients were successfully treated with combined therapy. Although considered of low virulence, A. baumannii can be particularly aggressive and difficult to treat in ICU patients.


Subject(s)
Acinetobacter Infections/microbiology , Acinetobacter baumannii/isolation & purification , Cross Infection/microbiology , Disease Outbreaks , Drug Resistance, Multiple, Bacterial , Intensive Care Units , Acinetobacter Infections/drug therapy , Acinetobacter Infections/epidemiology , Acinetobacter baumannii/drug effects , Adult , Aged , Aged, 80 and over , Ampicillin/administration & dosage , Ampicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Bronchoalveolar Lavage Fluid/microbiology , Carbapenems/pharmacology , Colistin/administration & dosage , Colistin/therapeutic use , Cross Infection/drug therapy , Cross Infection/epidemiology , Disinfection , Electrophoresis, Gel, Pulsed-Field , Female , Humans , Male , Middle Aged , Patient Isolation , Rifampin/administration & dosage , Rifampin/therapeutic use , Rome/epidemiology , Sulbactam/administration & dosage , Sulbactam/therapeutic use
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