Published in:
Open Access
01-12-2012 | Research article
A bronchofiberoscopy-associated outbreak of multidrug-resistant Acinetobacter baumanniiin an intensive care unit in Beijing, China
Authors:
Yukun Xia, CuiLing Lu, Jingya Zhao, Gaige Han, Yong Chen, Fang Wang, Bin Yi, Guoqin Jiang, Xiaohua Hu, Xianfeng Du, Zheng Wang, Hong Lei, Xuelin Han, Li Han
Published in:
BMC Infectious Diseases
|
Issue 1/2012
Login to get access
Abstract
Background
Bronchofiberscopy, a widely used procedure for the diagnosis of various pulmonary diseases within intensive care units, has a history of association with nosocomial infections. Between September and November 2009, an outbreak caused by multidrug-resistant Acinetobacter baumannii (MDR-Ab) was observed in the intensive care unit of a tertiary care hospital in Beijing, China. This study is aimed to describe the course and control of this outbreak and investigate the related risk factors.
Methods
Clinical and environmental sampling, genotyping with repetitive extragenic palindromic polymerase chain reaction (REP-PCR), and case–control risk factor analysis were performed in the current study.
Results
During the epidemic period, 12 patients were infected or colonized with MDR-Ab. Sixteen (72.7%) of twenty-two MDR-Ab isolates from the 12 patients and 22 (84.6%) of 26 MDR-Ab isolates from the bronchofiberscope and the healthcare-associated environment were clustered significantly into a major clone (outbreak MDR-Ab strain) by REP-PCR typing. Seven patients carrying the outbreak MDR-Ab strain were defined as the cases. Six of the seven cases (83%) received bronchofiberscopy versus four of the 19 controls (21%) (odds ratio, 22.5; 95% confidence interval, 2.07–244.84; P = 0.005). Several potential administrative and technical problems existed in bronchofiberscope reprocessing.
Conclusions
Bronchofiberscopy was associated with this MDR-Ab outbreak. Infection control precautions including appropriate bronchofiberscope reprocessing and environmental decontamination should be strengthened.