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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.

The Journal of Hospital Infection

|March 1, 1995

Summary

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.

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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.

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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.