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Epidemiological significance of cutaneous, pharyngeal, and digestive tract colonization by multiresistant Acinetobacter baumannii in ICU patients
- Source :
- The Journal of hospital infection. 37(4)
- Publication Year :
- 1998
-
Abstract
- The aim of this prospective study was to assess the relative epidemiological role of digestive tract colonization by Acinetobacter baumannii , in comparison with other body site colonizations, in patients admitted to intensive care units (ICUs). From January to May 1995, axillary, pharyngeal and rectal swabs were taken together within the first 48 h of admission, and then weekly during ICU stay. Seventy-three patients were included, 48 of them (66%) had axillary, pharyngeal, or rectal colonization with A. baumannii , nine (19%) of these 48 during the first 48 h and the remaining 28 (77%) during the first week. Twenty-one (29%) had clinical samples positive for A. baumannii and axillary, pharyngeal, or rectal colonization. In 15 of these 21 (71%), colonization on body sites occurred prior to isolation from clinical samples (mean seven days, range 1–20). Throughout admission, rates of detection of A. baumannii were 75% (3648) for axillary or pharyngeal swabs and 77% (3748) for rectal swabs. Combination of two body site swabs yielded culture positive rates of 90% (4348) for axillary-pharyngeal or axillary-rectal sites, and 96% (4648) for pharyngeal-rectal. Two epidemic clones were defined by antibiotype and pulsed-field gel electrophoresis (PFGE) of Sma I DNA digests in 43 isolates from 11 patients. We conclude that body sites of patients were a major reservoir for A. baumannii infections in the outbreak. This finding casts doubt on the value of selective decontamination of the digestive tract as an additional infection control measure in this kind of outbreak. The weekly performance of pharyngeal and rectal swabs appears to detect A. baumannii colonization early among ICU patients and enables barrier methods to be applied rapidly.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
Digestive System Diseases
Colony Count, Microbial
Skin Diseases
law.invention
law
Intensive care
Internal medicine
Pulsed-field gel electrophoresis
Medicine
Infection control
Humans
Colonization
Prospective Studies
Antibacterial agent
Cross Infection
biology
business.industry
Outbreak
General Medicine
Pharyngeal Diseases
biology.organism_classification
Intensive care unit
Drug Resistance, Multiple
Acinetobacter baumannii
Surgery
Intensive Care Units
Infectious Diseases
Spain
business
Acinetobacter Infections
Subjects
Details
- ISSN :
- 01956701
- Volume :
- 37
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Journal of hospital infection
- Accession number :
- edsair.doi.dedup.....f9a7ad96e3738a4a3e0575f28ed248a6