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Pillows, an unexpected source of Acinetobacter
A Weernink1, W P Severin, I Tjernberg
1Department of Hospital Hygiene, Regional Hospital Midden Twente, Hengelo, The Netherlands.
Abstract:
From 1989 until 1992 an increase in the number of isolations of Acinetobacter was observed in a community hospital in The Netherlands. The organisms were spread throughout the hospital and a common source was suspected. Feather pillows were found to harbour high numbers of acinetobacters. Replacement with synthetic pillows and correction of the laundry procedure resulted in a significant reduction of Acinetobacter isolations. A number of isolates from patients and from pillows were indistinguishable using biotyping, antibiogram typing and cell envelope protein typing. By the use of DNA-DNA hybridization most isolates were identified to A. baumannii and the unnamed closely related genomic species 13. A number of isolates, mostly from pillows, were identified as A. radioresistens. The outcome of cultivation, intervention and typing suggests that the feather pillows played an important role in the outbreak.
Insights
Feather pillows were identified as the source of an Acinetobacter outbreak in a Dutch hospital. Replacing them and improving laundry significantly reduced Acinetobacter infections, highlighting pillow hygiene importance.
Area of Science:
- Microbiology
- Hospital Epidemiology
- Infection Control
Background:
- An increase in Acinetobacter isolations was observed in a Dutch community hospital between 1989 and 1992.
- The widespread distribution of Acinetobacter suggested a common source within the hospital environment.
Purpose of the Study:
- To investigate the source of the Acinetobacter outbreak.
- To determine the role of environmental factors, specifically feather pillows, in the increased isolations.
Main Methods:
- Environmental sampling, focusing on feather pillows.
- Microbiological identification and typing of Acinetobacter isolates from patients and pillows (biotyping, antibiogram, cell envelope protein typing, DNA-DNA hybridization).
- Intervention study involving replacement of feather pillows and modification of laundry procedures.
Main Results:
- Feather pillows were found to harbor high numbers of Acinetobacter.
- Microbiological typing (including DNA-DNA hybridization) indicated that patient and pillow isolates were often indistinguishable, identifying species like A. baumannii and A. radioresistens.
- Replacement of feather pillows and laundry correction led to a significant reduction in Acinetobacter isolations.
Conclusions:
- Feather pillows were a significant reservoir and likely the source of the Acinetobacter outbreak.
- Environmental hygiene, particularly concerning bedding, is crucial for controlling Acinetobacter infections in healthcare settings.