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Carbapenem-Resistant Acinetobacter baumannii: Concomitant Contamination of Air and Environmental Surfaces

Published online by Cambridge University Press:  05 April 2016

Luis A. Shimose ,
Eriko Masuda ,
Maroun Sfeir ,
Ana Berbel Caban ,
Maria X. Bueno ,
Dennise dePascale ,
Caressa N. Spychala ,
Timothy Cleary ,
Nicholas Namias  and
Daniel H. Kett
...Show all authors
Luis A. Shimose
Affiliation:
Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
Eriko Masuda
Affiliation:
Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
Maroun Sfeir
Affiliation:
Department of Medicine, Weill Cornell Medical College, New York, New York
Ana Berbel Caban
Affiliation:
Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
Maria X. Bueno
Affiliation:
Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
Dennise dePascale
Affiliation:
Department of Pathology, Miller School of Medicine, University of Miami, Miami, Florida
Caressa N. Spychala
Affiliation:
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Timothy Cleary
Affiliation:
Department of Pathology, Miller School of Medicine, University of Miami, Miami, Florida
Nicholas Namias
Affiliation:
Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida
Daniel H. Kett
Affiliation:
Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
Yohei Doi
Affiliation:
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
L. Silvia Munoz-Price*
Affiliation:
Department of Medicine, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin
*
Address correspondence to L. Silvia Munoz-Price, MD, PhD, Human Research Building Suite #2100 (Office H2250), 8701 Watertown Plank Road, PO Box 26509, Milwaukee, WI 53226 ([email protected]).
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Abstract

OBJECTIVE

To concomitantly determine the differential degrees of air and environmental contamination by Acinetobacter baumannii based on anatomic source of colonization and type of ICU layout (single-occupancy vs open layout).

DESIGN

Longitudinal prospective surveillance study of air and environmental surfaces in patient rooms.

SETTING

A 1,500-bed public teaching hospital in Miami, Florida.

PATIENTS

Consecutive A. baumannii–colonized patients admitted to our ICUs between October 2013 and February 2014.

METHODS

Air and environmental surfaces of the rooms of A. baumannii–colonized patients were sampled daily for up to 10 days. Pulsed-field gel electrophoresis (PFGE) was used to type and match the matching air, environmental, and clinical A. baumannii isolates.

RESULTS

A total of 25 A. baumannii–colonized patients were identified during the study period; 17 were colonized in the respiratory tract and 8 were colonized in the rectum. In rooms with rectally colonized patients, 38.3% of air samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 13.1% of air samples were positive (P=.0001). In rooms with rectally colonized patients, 15.5% of environmental samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 9.5% of environmental samples were positive (P=.02). The rates of air contamination in the open-layout and single-occupancy ICUs were 17.9% and 21.8%, respectively (P=.5). Environmental surfaces were positive in 9.5% of instances in open-layout ICUs versus 13.4% in single-occupancy ICUs (P=.09).

CONCLUSIONS

Air and environmental surface contaminations were significantly greater among rectally colonized patients; however, ICU layout did not influence the rate of contamination.

Infect Control Hosp Epidemiol 2016;37:777–781

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 7 , July 2016 , pp. 777 - 781
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. The results of this project were presented in part in Abstract #1803 at ID Week 2014 in Philadelphia, Pennsylvania, on October 11, 2014.

References

REFERENCES

1. Munoz-Price, LS, Weinstein, RA. Acinetobacter infection. N Engl J Med 2008;358:1271–1281.Google Scholar
2. Antibiotic resistance threats in the United States, 2013. Centers for Disease Control and Prevention website. http://www.cdc.gov/drugresistance/pdf/ ar-threats-2013-508.pdf. Published 2013. Accessed September 19, 2015.Google Scholar
3. Munoz-Price, LS, Namias, N, Cleary, T, et al. Acinetobacter baumannii: association between environmental contamination of patient rooms and occupant status. Infect Control Hosp Epidemiol 2013;34:517–520.Google Scholar
4. Hess, AS, Shardell, M, Johnson, JK, et al. A randomized controlled trial of enhanced cleaning to reduce contamination of healthcare worker gowns and gloves with multidrug-resistant bacteria. Infect Control Hosp Epidemiol 2013;34:487–493.CrossRefGoogle ScholarPubMed
5. Rosa, R, Arheart, KL, Depascale, D, et al. Environmental exposure to carbapenem-resistant Acinetobacter baumannii as a risk factor for patient acquisition of A. baumannii. Infect Control Hosp Epidemiol 2014;35:430–433.Google Scholar
6. Latibeaudiere, R, Rosa, R, Laowansiri, P, Arheart, K, Namias, N, Munoz-Price, LS. Surveillance cultures growing carbapenem-resistant Acinetobacter baumannii predict the development of clinical infections: a retrospective cohort study. Clin Infect Dis 2015;60:415–422.Google Scholar
7. Munoz-Price, LS. Controlling multidrug-resistant Gram-negative bacilli in your hospital: a transformational journey. J Hosp Infect 2015;89:254–258.CrossRefGoogle Scholar
8. Munoz-Price, LS, Arheart, K, Nordmann, P, et al. Eighteen years of experience with Acinetobacter baumannii in a tertiary care hospital. Crit Care Med 2013;41:2733–2742.Google Scholar
9. Munoz-Price, LS, Carling, P, Cleary, T, et al. Control of a two-decade endemic situation with carbapenem-resistant Acinetobacter baumannii: electronic dissemination of a bundle of interventions. Am J Infect Control 2014;42:466–471.Google Scholar
10. Munoz-Price, LS, Fajardo-Aquino, Y, Arheart, KL, et al. Aerosolization of Acinetobacter baumannii in a trauma ICU. Crit Care Med 2013;41:1915–1918.Google Scholar
11. Shimose, LA, Doi, Y, Bonomo, RA, et al. Contamination of ambient air with Acinetobacter baumannii on consecutive inpatient days. J Clin Microbiol 2015;53:2346–2348.Google Scholar
12. Rosa, R, Depascale, D, Cleary, T, Fajardo-Aquino, Y, Kett, DH, Munoz-Price, LS. Differential environmental contamination with Acinetobacter baumannii based on the anatomic source of colonization. Am J Infect Control 2014;42:755–757.CrossRefGoogle ScholarPubMed
13. Huslage, K, Rutala, WA, Sickbert-Bennett, E, Weber, DJ. A quantitative approach to defining “high-touch” surfaces in hospitals. Infect Control Hosp Epidemiol 2010;31:850–853.Google Scholar
14. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-Fourth Informational Supplement M100-S24. Wayne, PA: CLSI, 2014.Google Scholar
15. Qureshi, ZA, Hittle, LE, O’Hara, JA, et al. Colistin-resistant Acinetobacter baumannii: beyond carbapenem resistance. Clin Infect Dis 2015;60:1295–1303.Google Scholar
16. Towner, KJ, Levi, K, Vlassiadi, M. Genetic diversity of carbapenem-resistant isolates of Acinetobacter baumannii in Europe. Clin Microbiol Infect 2008;14:161–167.Google Scholar
17. McCracken, M, Mataseje, LF, Loo, V, et al. Characterization of Acinetobacter baumannii and meropenem-resistant Pseudomonas aeruginosa in Canada: results of the CANWARD 2007–2009 study. Diagn Microbiol Infect Dis 2011;69:335–341.Google Scholar
18. Vali, L, Dashti, K, Opazo-Capurro, AF, Dashti, AA, Al Obaid, K, Evans, BA. Diversity of multi-drug resistant Acinetobacter baumannii population in a major hospital in Kuwait. Front Microbiol 2015;6:743.Google Scholar
19. Gerner-Smidt, P. Endemic occurrence of Acinetobacter calcoaceticus biovar anitratus in an intensive care unit. J Hosp Infect 1987;10:265–272.Google Scholar
20. Allen, KD, Green, HT. Hospital outbreak of multi-resistant Acinetobacter anitratus: an airborne mode of spread? J Hosp Infect 1987;9:110–119.Google Scholar
21. Crombach, WH, Dijkshoorn, L, van Noort-Klaassen, M, Niessen, J, van Knippenberg-Gordebeke, G. Control of an epidemic spread of a multi-resistant strain of Acinetobacter calcoaceticus in a hospital. Intensive Care Med 1989;15:166–170.Google Scholar
22. Rock, C, Harris, AD, Johnson, JK, Bischoff, WE, Thom, KA. Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients. Infect Control Hosp Epidemiol 2015;36:830–832.Google Scholar
23. Apisarnthanarak, A, Tantajina, P, Laovachirasuwan, P, Singh, N. Is aerosalization a problem with carbapenem-resistant Acinetobacter baumannii in Thailand Hospital? In: Program and Abstracts of the Annual Scientific Meeting of the Infectious Diseases Society of America (IDWeek); October 7–11, 2015; San Diego, CA. Abstract 1770.Google Scholar
24. Shimose, LA, Greissman, S, Berbel-Caban, A, DePascale, D, Cleary, T, Munoz-Price, LS. A comparison of two methods for sampling air: settle plates versus impactor. In: Program and Abstracts of the Annual Scientific Meeting of the Infectious Diseases Society of America (IDWeek); October 7–11, 2015; San Diego, CA. Abstract 1774.Google Scholar
25. Munoz-Price, LS. Acinetobacter in the air: did Maryland get it wrong? Infect Control Hosp Epidemiol 2015;36:833–834.Google Scholar
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