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Outbreak of Acinetobacter baumannii in an intensive care unit associated with tracheostomy

M W Mah1, Z A Memish, G Cunningham

  • 1Department of Infection Prevention and Control and Pathology, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.

American Journal of Infection Control
|October 5, 2001
PubMed

Insights

Tracheostomy significantly increases the risk of acquiring epidemic Acinetobacter baumannii in intensive care units. Enhanced infection control measures, including handwashing and staff education, resolved the outbreak.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Intensive care units (ICUs) are prone to healthcare-associated infections.
  • Acinetobacter baumannii is a significant pathogen in ICUs, often exhibiting multidrug resistance.
  • Epidemic strains necessitate rapid identification of risk factors and control strategies.

Purpose of the Study:

  • To identify risk factors for the acquisition of an epidemic strain of Acinetobacter baumannii in an ICU.
  • To investigate the association between specific procedures and Acinetobacter sp. acquisition.
  • To evaluate the effectiveness of infection control interventions.

Main Methods:

  • A case-control study design was employed.
  • Pulsed-field gel electrophoresis (PFGE) was used for strain identification.
  • Logistic regression analysis was performed to determine independent risk factors.

Main Results:

  • The epidemic strain was isolated from 87% of patients studied.
  • Tracheostomy was identified as an independent risk factor for Acinetobacter sp. acquisition (OR, 421; 95% CI, 13.8-12925; P = .001).
  • The risk was inversely related to the duration of mechanical ventilation; the outbreak coincided with early percutaneous tracheostomy policy.

Conclusions:

  • Tracheostomy is a major risk factor for Acinetobacter baumannii acquisition in the ICU.
  • Inadequate infection control during respiratory care likely contributed to the outbreak.
  • Contact precautions, enhanced handwashing, and staff education were effective in controlling the outbreak.

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