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[A hospital epidemic due to Achromobacter calcoaceticus]
Abstract:
35 patients were secondarily infected in our hospital with a strain of A. calcoaceticus resistant to the usual antibiotics and sulfonamides, but sensitive to colimycin. The epidemic lasted 118 days and is not yet finished. Each of the infected patients had a severe surgical or medical illness, underwent operations, trachetomy, etc. and was treated with antibiotics. A. calcoaceticus persisted alone or was associated with other bacteria from 1 to 46 days, in specimens (sputum, etc. or in blood) sometimes until death. It is not pathogenic for rabbits and mice; its pathogenicity in man is discussed in the text. The epidemic strain was not harboured by 15 doctors, students or nurses, nor present on 147 objects in the vicinity of the patients, but was found in a bottle of aqueous 1% eosin solution in the room of an infected child. Experiments show that A. calcoaceticus is not killed by a 1% eosin solution, and freely multiplies in broth containing 0,5% eosin. It is easy to identify the first case and chronology of the epidemic, but it is less easy to identify each time the means of propagation. Usually, infected patients seem to be the source of further infection. Does eosin paly more than an occasional role? Were the germs transported by dust? This not very disturbing epidemic suggests that less pathogenic germs may still cause unsuspected hospital epidemics.
Insights
A hospital epidemic of antibiotic-resistant Acinetobacter calcoaceticus (A. calcoaceticus) occurred over 118 days, primarily spreading between patients. The study identified eosin solution as a potential reservoir for this opportunistic pathogen.
Area of Science:
- Clinical Microbiology
- Hospital Epidemiology
- Infectious Diseases
Background:
- Secondary infections pose a significant challenge in hospital settings, particularly with antibiotic-resistant strains.
- Acinetobacter calcoaceticus (A. calcoaceticus) can cause persistent infections in vulnerable patients.
- Understanding transmission dynamics is crucial for controlling hospital-acquired infections.
Purpose of the Study:
- To investigate an 118-day hospital epidemic caused by a multidrug-resistant strain of Acinetobacter calcoaceticus (A. calcoaceticus).
- To identify the source and transmission routes of the A. calcoaceticus epidemic strain.
- To assess the role of environmental factors, such as eosin solutions, in the spread of A. calcoaceticus.
Main Methods:
- Clinical observation and microbiological analysis of 35 infected patients.
- Environmental sampling, including patient vicinity objects and solutions.
- Laboratory experiments to assess A. calcoaceticus viability and multiplication in eosin solutions.
Main Results:
- A. calcoaceticus, resistant to common antibiotics but sensitive to colimycin, infected 35 patients over 118 days.
- The epidemic strain was isolated from patients' specimens and found in a 1% eosin solution, where it survived and multiplied.
- Transmission appeared to be primarily patient-to-patient, but the eosin solution represented a potential environmental reservoir.
Conclusions:
- Acinetobacter calcoaceticus (A. calcoaceticus) can cause prolonged hospital epidemics, even with less pathogenic strains.
- Environmental contamination, specifically with eosin solutions, may play a role in the propagation of A. calcoaceticus.
- Vigilance for opportunistic pathogens and their environmental reservoirs is essential in healthcare settings.