An outbreak investigation of extensively drug-resistant Acinetobacter baumannii cases in the intensive care unit of Al-Qatif Central Hospital, Saudi Arabia

Abstract

Background: Acinetobacter baumannii has emerged as an extremely disturbing pathogen for several institutions worldwide. It is common in hospital environments, and outbreaks of Acinetobacter infections classically arise in intensive care units (ICUs). This investigation aimed to describe the extensively drug-resistant Acinetobacter baumannii (XDRAB) outbreak, which occurred in the intensive care unit (ICU) of Al-Qatif central hospital, Saudi Arabia. Methodology: This is a cross-sectional study for all positive (XDRAB) reported cases in the ICU of Al-Qatif Central Hospital, Eastern region during August and September 2019. Investigation of cases was based on the patient’s files, charts, lab records, interviewing the infection prevention and control team of the hospital, and the directorate. Microbiological and environmental samples were collected and tested for XDRAB. Results: A total of nine patients tested positive. Eight of the cases were male, and only three of them were Non-Saudi. The age ranged from 21 to 82 years, the mean age was 48.6 ± 21.14 years, and the mean length of ICU stay was eight ± 5.75 days. The environmental samples and the swabs from the health care workers (HCW) hand results were negative for XDRAB. Eight of the nine affected patients were on a mechanical ventilator (OR 9.2, 95% CI:1.09-77.9, P = 0.029), and according to the control chart, there was a previous outbreak attack in early 2019. Conclusion: The ICU of Al-Qatif hospital experienced an XDRAB outbreak in August, and it continued till September 2019. There was a previous outbreak with the same organism early in the same year, which required a strong adherence to the control and prevention measures and further analytical studies to find out the reasons behind the recurrent XDRAB outbreak. Key Words: Acinetobacter baumannii, outbreak investigation, drug-resistance, Saudi Arabia.