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Delayed Detection of an Increase in Resistant Acinetobacter at a Detroit Hospital

Published online by Cambridge University Press:  21 June 2016

David R. Johnson ,
Melinda A. Love-Dixon ,
William J. Brown ,
Donald P. Levine ,
Frances P. Downes  and
William N. Hall
David R. Johnson*
Affiliation:
Centers for Disease Control, Division of Field Epidemiology, Atlanta, Georgia Michigan Department of Public Health, Lansing, Michigan
Melinda A. Love-Dixon
Affiliation:
City of Detroit Health Department, Wayne State University Medical School, Detroit, Michigan
William J. Brown
Affiliation:
Detroit Medical Center, Wayne State University Medical School, Detroit, Michigan Wayne State University Medical School, Detroit, Michigan
Donald P. Levine
Affiliation:
Wayne State University Medical School, Detroit, Michigan
Frances P. Downes
Affiliation:
Michigan Department of Public Health, Lansing, Michigan
William N. Hall
Affiliation:
Michigan Department of Public Health, Lansing, Michigan
*
Michigan Dept. of Public Health, Bureau of Infectious Disease Control, 3500 North Logan, PO Box 30035, Lansing, MI 48909
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Abstract

Objective:

To study an increase of antimicrobial-resistant Acinetobacter baumannii and to assess reasons for the delayed detection of this increase.

Design:

Review of medical, laboratory, and infection control records. Plasmid profile analysis of available A baumannii isolates.

Setting:

A 340-bed trauma and intensive care hospital in Detroit, Michigan.

Results:

The number of hospitalized patients with resistant A baumannii increased during late 1989 and early 1990: 4 in September, 10 in October, 12 in November, 18 in December, and 23 in January (chi square for trend = 14.6, p= .0001). Forty-four (66%) of the 67 patients culture-positive for resistant A baumannii had respiratory tract colonization or infection. Of 11 resistant isolates, 6 had a similar plasmid profile and 5 had no plasmids. Under the hospital's targeted surveillance system, only positive cultures from blood or wounds were investigated; this largely respiratory increase of resistant A baumannii went unrecognized until January 1990.

Conclusions:

Antimicrobial resistance in A baumannii is an important concern. Such resistance is not necessarily plasmid mediated. Tar geted surveillance for this and other agents of nosocomial infection should be used with caution, particularly in hospitals with many debilitated patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 7 , July 1992 , pp. 394 - 398
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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