[Management of a 4MRGN Acinetobacter baumanii outbreak in a burn unit]
F Siemers1, S Fanghänel2, P A Bergmann1
1Plastische- und Handchirurgie/Brandverletztenzentrum, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale).
Abstract:
Patients with 4MRGN Acinetobacter baumanii infections in a burn unit represent great challenge. The structured management with 7 involved patients in such a situation is presented. After discovering the infectious trigger a management team is established. An immediate stop for further admissions was announced and all infected room areas and medical equipment were analysed for infection foci. The infected patients were transferred to regional hospitals or a rehabiltation hospital after finishing all surgical procedures. In one case, for whom further operations were needed, a transfer to a separated area of the intermediate care unit (IMC) within the hospital was arranged. The performed analysis of infection foci indicated a bronchoscopy tower to be the infection source. The outbreak was terminated after transferring all patients, final disinfection and subsequent nebulisation with 5-6% hydrogen peroxide within 18 days.
Insights
Managing multidrug-resistant Acinetobacter baumannii (4MRGN) infections in burn patients is challenging. A structured approach involving patient transfer, infection source identification, and environmental disinfection successfully terminated an 18-day outbreak.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Burn Management
Background:
- Multidrug-resistant Acinetobacter baumannii (MDR A. baumannii) poses a significant threat, particularly in intensive care settings like burn units.
- Effective management strategies for 4MRGN A. baumannii outbreaks are crucial to prevent patient-to-patient transmission and mortality.
Observation:
- A challenging outbreak involving 7 patients with 4MRGN A. baumannii infections occurred in a specialized burn unit.
- An infection control team was rapidly assembled to manage the outbreak.
- Environmental and equipment assessments were conducted to pinpoint infection sources.
Findings:
- The outbreak was traced to a contaminated bronchoscopy tower.
- A comprehensive management plan included immediate cessation of new admissions, patient transfers to appropriate facilities, and isolation of affected areas.
- Terminal disinfection and hydrogen peroxide nebulization were key interventions.
Implications:
- This case highlights the importance of a structured, multidisciplinary response to multidrug-resistant organism outbreaks in critical care.
- Prompt identification and elimination of the environmental reservoir (bronchoscopy tower) were critical for outbreak termination.
- The successful containment within 18 days demonstrates the efficacy of combined infection control measures, including patient isolation and environmental decontamination.
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