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Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii: an unexpected difference in epidemiologic

A T Bernards1, H M Frénay, B T Lim

  • 1Department of Medical Microbiology, Leiden University Medical Centre, Leiden, The Netherlands.

American Journal of Infection Control
|December 4, 1998
PubMed
Summary

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Strict isolation prevented methicillin-resistant Staphylococcus aureus (MRSA) spread, but multiresistant Acinetobacter spread occurred in two hospitals. Current guidelines for gram-negative organisms may be insufficient, necessitating airborne precautions.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Microbiology

Background:

  • Dutch guidelines mandate strict isolation for patients transferred from abroad to prevent methicillin-resistant Staphylococcus aureus (MRSA) spread.
  • Three patients colonized with MRSA and multiresistant Acinetobacter were transferred to Dutch hospitals.
  • Acinetobacter spread occurred in two of three hospitals despite isolation, while MRSA did not spread.

Observation:

  • Despite isolation, Acinetobacter spread in two hospitals, while MRSA did not spread in any.
  • The hospital with no Acinetobacter outbreak implemented airborne transmission precautions.

Findings:

  • Standard isolation measures, effective against MRSA, were insufficient to prevent Acinetobacter spread.
  • Epidemiologically related Acinetobacter isolates were indistinguishable from the index strains, indicating successful transmission.

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Implications:

  • Current guidelines for multiresistant gram-negative organisms may be inadequate for Acinetobacter.
  • Airborne transmission of Acinetobacter must be considered in hospital infection control strategies.
  • Hospital isolation guidelines require revision to include airborne precautions for Acinetobacter.