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Successful Eradication of Multidrug Resistant Acinetobacter in the Helsinki Burn Centre
Andrew Lindford1, Valtteri Kiuru, Veli-Jukka Anttila
1From the *Helsinki Burn Centre, Helsinki University Central Hospitals, Finland; †Lohja Health Care Centre, Finland; and ‡Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital, Finland.
Abstract:
Multidrug-resistant (MDR) Acinetobacter is an important pathogen implicated in nosocomial infections in healthcare environments. Virulence factors, resistance mechanisms, and limited therapeutic options make this pathogen a major problem currently facing burn intensive care units (ICUs) worldwide. The purpose of this study was to assess the effect of infection control measures taken in Helsinki Burn Centre in 2001 on MDR Acinetobacter prevalence in ICU burn patients. Data were retrospectively collected from patient files from 1998 to 2012. ICU burn patients were defined as those with either over 30% of total body surface area burnt or requiring mechanical ventilation. Inclusion criteria consisted of patients who tested positive for Acinetobacter sp. in routine bacterial cultures or cultures taken because of a clinically suspected infection. Infection control interventions performed in 2001 consisted of various shower room renovations and changes in hospital hygiene and burn treatment regimes. Between 1998 and 2012, 75 patients were diagnosed with Acinetobacter sp. colonization. Following the infection control interventions the incidence of Acinetobacter sp. radically declined. Between 1998 and 2001, there were 31 cases of MDR Acinetobacter colonizations diagnosed, but from 2002 to 2012 no MDR strains were found. Changes to hospital hygiene and wound treatment protocols as well as structural changes to the hospital environment can have a major impact on preventing and treating Acinetobacter outbreaks in burn centers.
Insights
Implementing infection control measures significantly reduced multidrug-resistant Acinetobacter (MDR Acinetobacter) in burn intensive care unit (ICU) patients. Following interventions, MDR Acinetobacter prevalence declined dramatically, with no cases found post-2001.
Area of Science:
- Infectious Diseases
- Public Health
- Hospital Epidemiology
Background:
- Multidrug-resistant (MDR) Acinetobacter poses a significant threat in healthcare settings, particularly in burn intensive care units (ICUs).
- Limited treatment options and high virulence contribute to the challenge of managing Acinetobacter infections.
- Nosocomial infections caused by MDR Acinetobacter are a global concern in critical care environments.
Purpose of the Study:
- To evaluate the impact of infection control interventions implemented in 2001 at Helsinki Burn Centre.
- To assess the effect of these measures on the prevalence of MDR Acinetobacter among ICU burn patients.
- To analyze trends in Acinetobacter colonization before and after the intervention period.
Main Methods:
- Retrospective data collection from patient files between 1998 and 2012.
- Inclusion criteria: ICU burn patients (over 30% total body surface area burnt or mechanically ventilated) positive for Acinetobacter sp.
- Interventions included shower room renovations and modifications to hospital hygiene and burn treatment protocols.
Main Results:
- A total of 75 patients were diagnosed with Acinetobacter sp. colonization between 1998 and 2012.
- Prior to interventions (1998-2001), 31 cases of MDR Acinetobacter colonization were identified.
- Following interventions (2002-2012), no MDR Acinetobacter strains were detected, indicating a radical decline in incidence.
Conclusions:
- Changes in hospital hygiene and wound treatment protocols, alongside structural environmental modifications, were effective.
- These interventions significantly impacted the prevention and management of Acinetobacter outbreaks in burn centers.
- Implementing comprehensive infection control strategies is crucial for controlling MDR Acinetobacter in vulnerable patient populations.
