Protracted Outbreak of Multidrug-Resistant<i>Acinetobacter baumannii</i>after Intercontinental Transfer of Colonized Patients

Landelle, Caroline; Legrand, Patrick; Lesprit, Philippe; Cizeau, Florence; Ducellier, David; Gouot, Cyril; Brehaut, P; Soing-Altrach, Sophan; Girou, Emmanuelle; Brun‐Buisson, Christian

doi:10.1086/669093

Cited by 56 publications

(33 citation statements)

References 28 publications

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“…Intensive-care units are particularly susceptible to outbreaks associated with MDR-AB: it is sometimes difficult for them to adhere strictly to infection control measures when patients require a high and persistent care-load. Four years ago, the same hospital faced a hospital-wide outbreak of MDR-AB colonisations and infections due to the importation of an index case from Tahiti [11]. Despite this experience and the implementation in 2010 at the national and local level of strict measures on hospital admission to detect, screen and place under contactisolation precautions repatriated patients, another outbreak linked to the admission of a patient previously hospitalised abroad again occurred [12].…”

Section: Discussionmentioning

confidence: 99%

Outbreak of NDM-1-producing Acinetobacter baumannii in France, January to May 2013

et al. 2013

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We report the first outbreak of carbapenem-resistant NDM-1-producing Acinetobacter baumannii in Europe, in a French intensive-care unit in January to May 2013. The index patient was transferred from Algeria and led to the infection/colonisation of five additional patients. Concurrently, another imported case from Algeria was identified. The seven isolates were genetically indistinguishable, belonging to ST85. The blaNDM-1 carbapenemase gene was part of the chromosomally located composite transposon Tn125. This report underscores the growing concern about the spread of NDM-1-producing A. baumannii in Europe.

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Section: Discussionmentioning

confidence: 99%

Outbreak of NDM-1-producing Acinetobacter baumannii in France, January to May 2013

et al. 2013

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“…No touch room disinfection devices have been used as a component to control health care-associated outbreaks. 6,50,51,55,56,58,[75][76][77] The outbreaks involved S aureus, multidrug-resistant gram-negative bacilli, C difficile, and A baumannii plus MRSA. The device used in most cases was a HPV system (Bioquell).…”

Section: Clinical Trials Using Hpv Room Decontamination Devicesmentioning

confidence: 99%

Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: Focus on clinical trials

Weber

Rutala

Anderson

et al. 2016

American Journal of Infection Control

164

148

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Over the last decade, substantial scientific evidence has accumulated that indicates contamination of environmental surfaces in hospital rooms plays an important role in the transmission of key health care-associated pathogens (eg, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, Acinetobacter spp). For example, a patient admitted to a room previously occupied by a patient colonized or infected with one of these pathogens has a higher risk for acquiring one of these pathogens than a patient admitted to a room whose previous occupant was not colonized or infected. This risk is not surprising because multiple studies have demonstrated that surfaces in hospital rooms are poorly cleaned during terminal cleaning. To reduce surface contamination after terminal cleaning, no touch methods of room disinfection have been developed. This article will review the no touch methods, ultraviolet light devices, and hydrogen peroxide systems, with a focus on clinical trials which have used patient colonization or infection as an outcome. Multiple studies have demonstrated that ultraviolet light devices and hydrogen peroxide systems have been shown to inactivate microbes experimentally plated on carrier materials and placed in hospital rooms and to decontaminate surfaces in hospital rooms naturally contaminated with multidrug-resistant pathogens. A growing number of clinical studies have demonstrated that ultraviolet devices and hydrogen peroxide systems when used for terminal disinfection can reduce colonization or health care-associated infections in patients admitted to these hospital rooms.

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“…Successful outbreak containment was reported in the vast majority of the studies. This outcome was attributed to multiple measures in five of the studies [70,73,92,103,104], multiple measures, excluding ward closure in one study [77], and to all the measures used in 13 of the studies [71,75,80,81,84,88,89,95,[99][100][101][102]105]. Other studies attributed outbreak control specifically to the closure of the affected ward(s) [69,78,82,85,109,110], provision of dedicated and disposable equipment [72], disinfection of equipment [94,97], construction of a cohort isolation ward outside of the affected hospital [108], disinfection of the affected clinical area(s) during closure [76,87,90,98,106], cohorting enabled by ward closure [79], and treatment of healthcare workers for carriage [93], as well as death of the infected inpatients [86].…”

Section: Respiratory System (Table 2)mentioning

confidence: 99%

Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review

Wong

Eso

et al. 2015

Syst Rev

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BackgroundThough often used to control outbreaks, the efficacy of ward closure is unclear. This systematic review sought to identify studies defining and describing ward closure in outbreak control and to determine impact of ward closure as an intervention on outbreak containment.MethodsWe searched these databases with no language restrictions: MEDLINE, 1946 to 7 July 2014; EMBASE, 1974 to 7 July 2014; CINAHL, 1937 to 8 July 2014; and Cochrane Database of Systematic Reviews, 2005 to May 2014. We also searched the following: IndMED; LILACS; reference lists from retrieved articles; conference proceedings; and websites of the CDCP, the ICID, and the WHO. We included studies of patients hospitalized in acute care facilities; used ward closure as a control measure; used other control measures; and discussed control of the outbreak(s) under investigation. A component approach was used to assess study quality.ResultsWe included 97 English and non-English observational studies. None included a controlled comparison between ward closure and other interventions. We found that ward closure was often used as part of a bundle of interventions but could not determine its direct impact separate from all the other interventions whether used in parallel or in sequence with other interventions. We also found no universal definition of ward closure which was widely accepted.ConclusionsWith no published controlled studies identified, ward closure for control of outbreaks remains an intervention that is not evidence based and healthcare personnel will need to continue to balance the competing risks associated with its use, taking into consideration the nature of the outbreak, the type of pathogen and its virulence, mode of transmission, and the setting in which it occurs. Our review has identified a major research gap in this area.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0131-2) contains supplementary material, which is available to authorized users.

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Protracted Outbreak of Multidrug-ResistantAcinetobacter baumanniiafter Intercontinental Transfer of Colonized Patients

Cited by 56 publications

References 28 publications

Outbreak of NDM-1-producing Acinetobacter baumannii in France, January to May 2013

Outbreak of NDM-1-producing Acinetobacter baumannii in France, January to May 2013

Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: Focus on clinical trials

Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review

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