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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
Summary
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.
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.