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Rapid and Specific Detection of Acinetobacter baumannii Infections Using a Recombinase Polymerase Amplification/Cas12a-based System
Published on: April 25, 2025
Dissemination of Clinical Acinetobacter baumannii Isolate to Hospital Environment during the COVID-19 Pandemic
Emina Pustijanac1, Jasna Hrenović2, Mirna Vranić-Ladavac3
1Faculty of Natural Sciences, Juraj Dobrila University of Pula, 52100 Pula, Croatia.
Abstract:
The aim of this study was to find the source of Acinetobacter baumannii in the intensive care unit (ICU) after an outbreak during the coronavirus disease 2019 (COVID-19) pandemic, as there was no A. baumannii detected on usually screened susceptible surfaces. The screening of the ICU environment was done in April 2021 when eleven different samples were taken. One A. baumannii isolate was recovered from the air conditioner and was compared with four clinical A. baumannii isolates obtained from patients hospitalized in January 2021. Isolates were confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), minimum inhibitory concentrations (MICs) were determined, and the multilocus sequence typing (MLST) was performed. The molecular identification of A. baumannii isolates as ST208, the presence of the same blaOXA-23 carbapenemase gene, and the same antibiotic susceptibility profile suggest that the isolate recovered from the air conditioner is the same as the isolates recovered from hospitalized patients. The environmental isolate was recovered three months later than the clinical isolates, emphasizing the ability of A. baumannii to survive on dry abiotic surfaces. The air conditioner in the clinical environment is an important but undoubtedly neglected source of A. baumannii outbreaks, hence, frequent disinfection of hospital air conditioners with appropriate disinfectants is mandatory to mitigate the circulation of A. baumannii between patients and the hospital environment.
Insights
An air conditioner was identified as a hidden source of Acinetobacter baumannii outbreaks in an intensive care unit (ICU). This finding highlights the need for regular disinfection of hospital air conditioning systems to prevent patient infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Environmental Health
Background:
- Acinetobacter baumannii outbreaks pose a significant threat in intensive care units (ICUs), particularly following pandemics like COVID-19.
- Standard environmental screening failed to identify the source of A. baumannii following a recent ICU outbreak.
Purpose of the Study:
- To investigate the source of Acinetobacter baumannii in an ICU environment after an outbreak.
- To determine if environmental sources, specifically air conditioning systems, contributed to the A. baumannii outbreak.
Main Methods:
- Environmental screening of the ICU, including air conditioner sampling, was conducted.
- Acinetobacter baumannii isolates from the air conditioner and clinical samples were analyzed using MALDI-TOF MS, MIC determination, and MLST.
- Molecular typing (MLST) and genotypic analysis (blaOXA-23 gene) were performed to compare isolates.
Main Results:
- One Acinetobacter baumannii isolate was recovered from the air conditioner unit.
- Molecular analysis confirmed the air conditioner isolate (ST208) was identical to clinical isolates from patients, sharing the blaOXA-23 gene and antibiotic susceptibility profile.
- The environmental isolate was detected three months after clinical cases, demonstrating A. baumannii's survival on abiotic surfaces.
Conclusions:
- Hospital air conditioning systems represent a significant and often overlooked reservoir for Acinetobacter baumannii.
- The study underscores the importance of regular and thorough disinfection of air conditioners to prevent A. baumannii transmission in healthcare settings.
- Implementing stringent disinfection protocols for air conditioning units is crucial for mitigating A. baumannii outbreaks in ICUs.
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