Different strains of Acinetobacter baumannii spreading in an intensive care unit

Background: An outbreak of Acinetobacter baumannii in neurological intensive care unit was detected, causing nosocomial infection on 6 cases and colonization on 5 cases.Methods: Five major clones of A baumannii circulating in the intensive care unit were detected by pulse-field gel electrophoresis (PFGE). The outbreak was controlled by aggressive intervention with disinfection of equipments and environment, and audit of hand-washing practice by the staff in this intensive care unit.Results: The A baumannii could be isolated from equipments and the environment, including the chart folders 5/8 (62.5%), work trolley 1/2 (50.0%), ambulance bag of patient 1/3 (33.3%), hands of healthcare-workers 7/22 (31.8%), surfaces of monitors 1/4 (25.0%), bottle of suction fluid 1/4 (25.0%); but not isolated from the hands of healthcare-workers after disinfection with wash practice.Conclusions: Different strains of A baumannii may cause infection, exist in medical environment, and colonize the patients at the same time. It may develop into true infection anytime. We conclude that hand hygiene as well as disinfection of equipments and the environment are the two most important factors to control and prevent the outbreak of A baumannii. Copyright (C) 2011, Taiwan Society of Emergency Medicine. Published by Elsevier Taiwan LLC. All rights reserved.