S Alfandari1, J Gois2, P-Y Delannoy2, H Georges2, N Boussekey2, A Chiche2, A Meybeck2, P Patoz3, N Blondiaux3, E Senneville4, H Melliez4, O Leroy2. 1. Service de réanimation et des maladies infectieuses, centre hospitalier de Tourcoing, 155, rue du Président-Coty, 59208 Tourcoing cedex, France. Electronic address: alfandari.s@gmail.com. 2. Service de réanimation et des maladies infectieuses, centre hospitalier de Tourcoing, 155, rue du Président-Coty, 59208 Tourcoing cedex, France. 3. Laboratoire de biologie, centre hospitalier de Tourcoing, 59208 Tourcoing, France. 4. Service universitaire des maladies infectieuses et du voyageur, centre hospitalier de Tourcoing, 59208 Tourcoing, France.
Abstract
OBJECTIVE: We had for aim to describe the identification and management of a 14-clonal carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak, following admission of a known CRAB-infected patient in an ICU. METHODS: We reviewed the carriers' files and outbreak management procedures. RESULTS: The index patient was admitted with strict isolation precautions. The outbreak started 2 months after his discharge. It persisted despite reinforcement of strict isolation precautions, staff and patient cohorting, and extensive environmental decontamination including 2 rounds of routine terminal cleaning and disinfection or 1 round of cleaning and disinfection followed by hydrogen peroxide treatment. A second epidemic peak, after 4 weeks without any case, led to another wide environmental sampling and decontamination rounds. The source of the CRAB outbreak was suspected to be the blood pressure cuffs Velcro. Switching to cuffs submersible in a disinfectant stopped the outbreak. CONCLUSIONS: CRAB outbreaks are difficult to manage and sources of persistent colonization can be unexpected.
OBJECTIVE: We had for aim to describe the identification and management of a 14-clonal carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak, following admission of a known CRAB-infectedpatient in an ICU. METHODS: We reviewed the carriers' files and outbreak management procedures. RESULTS: The index patient was admitted with strict isolation precautions. The outbreak started 2 months after his discharge. It persisted despite reinforcement of strict isolation precautions, staff and patient cohorting, and extensive environmental decontamination including 2 rounds of routine terminal cleaning and disinfection or 1 round of cleaning and disinfection followed by hydrogen peroxide treatment. A second epidemic peak, after 4 weeks without any case, led to another wide environmental sampling and decontamination rounds. The source of the CRAB outbreak was suspected to be the blood pressure cuffs Velcro. Switching to cuffs submersible in a disinfectant stopped the outbreak. CONCLUSIONS: CRAB outbreaks are difficult to manage and sources of persistent colonization can be unexpected.
Authors: Holly Wong; Katherine Eso; Ada Ip; Jessica Jones; Yoojin Kwon; Susan Powelson; Jill de Grood; Rose Geransar; Maria Santana; A Mark Joffe; Geoffrey Taylor; Bayan Missaghi; Craig Pearce; William A Ghali; John Conly Journal: Syst Rev Date: 2015-11-07