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Patient-to-Patient Transmission of Acinetobacter baumannii Gastrointestinal Colonization in the Intensive Care Unit

Anthony D Harris1, J Kristie Johnson2,3, Lisa Pineles2

  • 1Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA aharris@som.umaryland.edu.

Antimicrobial Agents and Chemotherapy
|May 16, 2019
PubMed

Insights

Patient-to-patient transmission of Acinetobacter baumannii, a common hospital-acquired infection, was investigated. Molecular methods revealed that at least 17% of new Acinetobacter baumannii infections in intensive care units resulted from direct patient contact.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Acinetobacter baumannii is a significant cause of hospital-acquired infections, particularly in intensive care units (ICUs).
  • Understanding transmission routes is crucial for implementing effective infection control strategies.

Purpose of the Study:

  • To determine the proportion of Acinetobacter baumannii infections resulting from patient-to-patient transmission.
  • To analyze the molecular epidemiology of Acinetobacter baumannii acquisition in an ICU setting.

Main Methods:

  • Prospective cohort study involving 3,452 patients in medical and surgical ICUs over two years (2011-2013).
  • Perianal surveillance cultures collected at admission, weekly, and discharge.
  • Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) for molecular characterization.
  • Analysis combined with hospital stay overlap to identify transmission events.

Main Results:

  • 196 out of 3,452 patients were colonized with Acinetobacter baumannii.
  • 66 patients acquired the pathogen during their ICU stay.
  • Of the 66 acquired cases, 31 (50%) were genetically related.
  • 11 cases (17%) were identified as patient-to-patient transmission based on genetic relatedness and overlapping hospital stays.

Conclusions:

  • At least 17% of Acinetobacter baumannii acquisitions in this ICU cohort were attributed to patient-to-patient transmission.
  • Molecular epidemiology combined with clinical data is effective in elucidating transmission dynamics.
  • Findings highlight the importance of infection control measures to prevent transmission within ICUs.
Keywords:
Acinetobacter baumanniicohort studyimipenem resistantpatient-to-patient transmissionpulsed-field gel electrophoresis

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