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Ventilator-associated Acinetobacter baumannii pneumonia

Kala Ebenezer1, Ebor Jacob G James, Joy Sarojini Michael

  • 1Pediatric ICU, Christian Medical College and Hospital, Vellore, India. picu@cmcvellore.ac.in

Indian Pediatrics
|July 2, 2011
PubMed

Insights

An outbreak of ventilator-associated pneumonia caused by carbapenem-resistant Acinetobacter baumannii in infants was traced to contaminated humidifying chambers. Improved cleaning protocols successfully controlled the spread of this dangerous infection.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pediatric Critical Care

Background:

  • Ventilator-associated pneumonia (VAP) poses a significant threat to infants in intensive care.
  • Carbapenem-resistant Acinetobacter baumannii (CRAB) is a challenging pathogen, particularly in vulnerable populations.
  • Outbreaks of CRAB necessitate rapid identification of sources and effective control measures.

Purpose of the Study:

  • To investigate an outbreak of VAP caused by CRAB in a pediatric intensive care unit.
  • To identify the source of CRAB transmission among infants.
  • To implement and assess control strategies to manage the outbreak.

Main Methods:

  • Retrospective case review of infants diagnosed with VAP.
  • Microbiological analysis including non-bronchoscopic bronchoalveolar lavage (NBAL) for pathogen identification.
  • Environmental sampling and microbiological survey of the pediatric intensive care unit and wards.
  • Review of current cleaning and disinfection practices for respiratory equipment.

Main Results:

  • Six infants with acute lower respiratory tract infection developed VAP due to CRAB.
  • A. baumannii was isolated from NBAL samples of all affected infants.
  • Environmental surveys identified oxygen humidifying chambers as the likely source of CRAB contamination.
  • Implementation of revised cleaning and humidification protocols led to outbreak control.

Conclusions:

  • Oxygen humidifying chambers can serve as a reservoir for CRAB transmission in pediatric settings.
  • Strict adherence to updated cleaning and maintenance protocols for respiratory equipment is crucial for preventing CRAB outbreaks.
  • Prompt source identification and targeted interventions are effective in controlling CRAB VAP outbreaks in infants.

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