Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-26T07:42:56.118Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessing the Burden of Acinetobacter baumannii in Maryland: A Statewide Cross-Sectional Period Prevalence Survey

Published online by Cambridge University Press:  02 January 2015

Kerri A. Thorn ,
Lisa L. Maragakis ,
Katie Richards ,
J. Kristie Johnson ,
Brenda Roup ,
Patricia Lawson ,
Anthony D. Harris ,
Elizabeth P. Fuss ,
Margaret A. Pass  and
David Blythe
...Show all authors
Kerri A. Thorn*
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Lisa L. Maragakis
Affiliation:
Johns Hopkins University, Baltimore, Maryland
Katie Richards
Affiliation:
Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
J. Kristie Johnson
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Brenda Roup
Affiliation:
Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
Patricia Lawson
Affiliation:
Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
Anthony D. Harris
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Elizabeth P. Fuss
Affiliation:
Carroll Hospital Center, Westminster, Maryland
Margaret A. Pass
Affiliation:
St. Agnes Hospital, Baltimore, Maryland
David Blythe
Affiliation:
Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
Eli N. Perencevich
Affiliation:
University of Iowa, Iowa City, Iowa
Lucy Wilson
Affiliation:
Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
*
Department of Epidemiology and Public Health, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF 334B, Baltimore, MD 21201 (kthom@epi.umaryland.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To determine the prevalence of Acinetobacter baumannii, an important healthcare-associated pathogen, among mechanically ventilated patients in Maryland.

Design.

The Maryland MDRO Prevention Collaborative performed a statewide cross-sectional active surveillance survey of mechanically ventilated patients residing in acute care and long-term care (LTC) facilities. Surveillance cultures (sputum and perianal) were obtained from all mechanically ventilated inpatients at participating facilities during a 2-week period.

Setting.

All healthcare facilities in Maryland that provide care for mechanically ventilated patients were invited to participate.

Patients.

Mechanically ventilated patients, known to be at high risk for colonization and infection with A. baumannii, were included.

Results.

Seventy percent (40/57) of all eligible healthcare facilities participated in the survey, representing both acute care (n = 30) and LTC (n = 10) facilities in all geographic regions of Maryland. Surveillance cultures were obtained from 92% (358/390) of eligible Patients. A. baumannii was identified in 34% of all mechanically ventilated patients in Maryland; multidrug-resistant A. baumannii was found in 27% of all Patients. A. baumannii was detected in at least 1 patient in 49% of participating facilities; 100% of LTC facilities had at least 1 patient with A. baumannii, compared with 31% of acute care facilities. A. baumannii was identified from all facilities in which 10 or more patients were sampled.

Conclusions.

A. baumannii is common among mechanically ventilated patients in both acute care and LTC facilities throughout Maryland, with a high proportion of isolates demonstrating multidrug resistance.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 9 , September 2012 , pp. 883 - 888
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Sengstock, DM, Thyagarajan, R, Apalara, J, Mira, A, Chopra, T, Kaye, KS. Multidrug-resistant Acinetobacter baumannii: an emerging pathogen among older adults in community hospitals and nursing homes. Clin Infect Dis 2010;50(12):1611–1616.10.1086/652759Google Scholar
2. Furuno, JP, Hebden, JN, Standiford, HC, et al. Prevalence of meth-icillin-resistant Staphylococcus aureus and Acinetobacter baumannii in a long-term acute care facility. Am J Infect Control 2008;36(7):468–471.10.1016/j.ajic.2008.01.003Google Scholar
3. Gaynes, R, Edwards, JR. Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis 2005;41(6): 848–854.Google Scholar
4. Dent, LL, Marshall, DR, Pratap, S, Hulette, RB. Multidrug resistant Acinetobacter baumannii: a descriptive study in a city hospital. BMC Infect Dis 2010;10:196.10.1186/1471-2334-10-196Google Scholar
5. Dizbay, M, Tunccan, OG, Sezer, BE, Hizel, K. Nosocomial imipenem-resistant Acinetobacter baumannii infections: epidemiology and risk factors. Scand J Infect Dis 2010;42(10):741–746.10.3109/00365548.2010.489568Google Scholar
6. Villegas, MV, Hartstein, AI. Acinetobacter outbreaks, 1977-2000. Infect Control Hosp Epidemiol 2003;24(4):284–295.10.1086/502205Google Scholar
7. Wright, MO. Multi-resistant gram-negative organisms in Maryland: a statewide survey of resistant Acinetobacter baumannii . Am J Infect Control 2005;33(7):419–421.10.1016/j.ajic.2005.01.009Google Scholar
8. Maragakis, LL, Tucker, MG, Miller, RG, Carroll, KC, Perl, TM. Incidence and prevalence of multidrug-resistant Acinetobacter using targeted active surveillance cultures. JAMA 2008;299(21):2513–2514.10.1001/jama.299.21.2513Google Scholar
9. Pass, MA, Kingsland, BE, Weiger, JM, Ross, RW. The use of pulsed-field gel electrophoresis (PFGE) to characterize an outbreak of Acinetobacter baumannii/haemolyticus in Baltimore, Maryland. Presented at: Society for Healthcare Epidemiology of America, Fifth Decennial International Conference on Healthcare-Associated Infections; 2010; Atlanta.Google Scholar
10. Ajao, AO, Robinson, G, Lee, MS, et al. Comparison of culture media for detection of Acinetobacter baumannii in surveillance cultures of critically-ill patients. Eur J Clin Microbiol Infect Dis 2011;30(11):1425–1430.10.1007/s10096-011-1237-7Google Scholar
11. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing, 16th Informational Supplement. Wayne, PA: CLSI, 2006. CLSI document M100-S16.Google Scholar
12. Magiorakos, AP, Srinivasan, A, Carey, RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Dis 2012;18(3): 268–281.10.1111/j.1469-0691.2011.03570.xGoogle Scholar
13. Tenover, FC, Arbeit, RD, Goering, RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33(9):2233–2239.10.1128/jcm.33.9.2233-2239.1995Google Scholar
14. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004;32(8):470–485.10.1016/j.ajic.2004.10.001Google Scholar
15. Denton, M, Wilcox, MH, Parnell, P, et al. Role of environmental cleaning in controlling an outbreak of Acinetobacter baumannii on a neurosurgical intensive care unit. Intensive Crit Care Nurs 2005;21(2):94–98.10.1016/j.iccn.2003.10.008Google Scholar
16. Simor, AE, Lee, M, Vearncombe, M, et al. An outbreak due to multiresistant Acinetobacter baumannii in a burn unit: risk factors for acquisition and management. Infect Control Hosp Epidemiol 2002;23(5):261–267.10.1086/502046Google Scholar
17. Palmore, TN, Michelin, AV, Bordner, M, et al. Use of adherence monitors as part of a team approach to control clonal spread of multidrug-resistant Acinetobacter baumannii in a research hospital. Infect Control Hosp Epidemiol 2011;32(12):1166–1172.10.1086/662710Google Scholar
18. Marchaim, D, Navon-Venezia, S, Schwartz, D, et al. Surveillance cultures and duration of carriage of multidrug-resistant Acinetobacter baumannii . J Clin Microbiol 2007;45(5):1551–1555.10.1128/JCM.02424-06Google Scholar
19. Perencevich, EN, McGregor, JC, Shardell, M, et al. Summer peaks in the incidences of gram-negative bacterial infection among hospitalized patients. Infect Control Hosp Epidemiol 2008;29(12):1124–1131.10.1086/592698Google Scholar