A epidemiological investigation of a nosocomial outbreak of multidrug-resistant Acinetobacter baumannii in a critical care center in Japan, 2011–2012

Hiroto Ushizawa, Yuichiro Yahata, Takeo Endo, Tomoko Iwashima, Michiyo Misawa, Makoto Sonobe, Takuya Yamagishi, Hajime Kamiya, Kazutoshi Nakashima, Tamano Matsui, Mari Matsui, Satowa Suzuki, Keigo Shibayama, Mikio Doi, Fujiko Irie, Shinichi Yamato, Yasuhiro Otomo, Kazunori Oishi

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

In 2011, a multidrug-resistant Acinetobacter baumannii (MDRAB) outbreak occurred at a Japanese critical care center (CCC) in a tertiary care hospital. Multidrug-resistance in Japan is defined as resistance to the antimicrobials amikacin, carbapenem, and fluoroquinolone. We conducted a retrospective epidemiological investigation of this outbreak to identify the risk factors for MDRAB respiratory tract acquisition in this hospital. Cases were defined as hospitalized patients with MDRAB-positive cultures at least 3 days post admission to the CCC between June 1, 2011 and April 20, 2012. Fifteen MDRAB cases were identified, including 3 with infection and 12 with colonization. This case-control study demonstrated that hypoalbuminemia along with carbapenem administration were associated with MDRAB respiratory tract acquisition. Pulsed-field gel electrophoresis analysis and multilocus sequence typing using MDRAB isolates suggested a clonal dissemination of MDRAB strains with sequence type 74 occurred primarily among patients admitted to the CCC. From April 16, 2012, a decreased isolation rate of MDRAB in the hospital occurred after the implementation of the following infection control measures: closing the emergency room, discontinuing admission to the CCC, isolating patients with MDRAB colonization or infection to single room status, and conducting environmental cleaning. No MDRAB cases were detected between March 23 and April 20, 2012.

Original languageEnglish
Pages (from-to)143-148
Number of pages6
JournalJapanese journal of infectious diseases
Volume69
Issue number2
DOIs
Publication statusPublished - 2016 Mar 23

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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