Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T19:58:49.079Z Has data issue: false hasContentIssue false

Colonization by Acinetobacter baumanii in Intensive–Care–Unit Patients

Published online by Cambridge University Press:  02 January 2015

Abstract

We prospectively studied the value of systematic rectal swabs performed for the detection of colonization and the prediction of infections by Acinetobacter baumanii in 751 consecutive patients admitted to five intensive-care units (ICUs) over an 8-month period. Gastrointestinal tract colonization was found in 8.7% of ICU admissions. The positive and negative predictive values of rectal swabs for the detection of subsequent infection were 17% and 99%, respectively. Sensitivity and specificity were 55% and 93%, respectively. We also determined the comparative values of rectal or nasal swabs and skin cultures for the detection of A baumanii colonization in 25 patients already colonized or infected with A baumanii. The combination of rectal and nasal swabs was positive in 20 (80%) of 25. The results of the present study suggest that detection of gastrointestinal tract A baumanii colonization is not an accurate predictor of subsequent A baumanii infection and that combined rectal and nasal swabs might be used for the detection of A baumanii colonization in ICU patients.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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. Bergogne-Berezin, E, Joly-Guillou, ML, Vieu, JF. Epidemiology of nosocomial infections due to Acinetobacter calcoaceticus . J Hosp Infect 1987;10:105ߝ113.CrossRefGoogle ScholarPubMed
2. Beck-Sague, CM, Jarvis, WR, Brook, JH, Culver, DH, Potts, A, Gay, E, et al. Epidemic bacteremia due to Acinetobacter baumanii in five intensive care units. Am J Epidemiol 1990;132:723ߝ733.CrossRefGoogle Scholar
3. Hartstein, AI, Rashad, AL, Liebler, JM, Actis, LA, Freeman, J, Rourke, JW, et al. Multiple intensive care unit outbreak of Acinetobacter calcoaceticus subspecies anitratus respiratory infection and colonization associated with contaminated, reusable ventilator circuits and resuscitation bags. Am J Med 1988;85:624ߝ631.CrossRefGoogle ScholarPubMed
4. Lortholary, O, Fagon, JY, Buu Hoi, A, Slama, MA, Pierre, J, Giral, P, et al. Nosocomial acquisition of multiresistant Acinetobacter baumanii: risk factors and prognosis. Clin Infect Dis 1995;20:790ߝ796.CrossRefGoogle Scholar
5. Fujita, K, Lilly, HA, Aycliffe, GAJ. Spread of resistant gram-negative bacilli in a burns unit. J Hosp Infect 1982;3:29ߝ37.CrossRefGoogle Scholar
6. Timsit, JF, Garrait, V, Misset, B, Goldstein, FW, Renaud, B, Carlet, J. The digestive tract is a major site for Acinetobacter baumanii colonization in intensive care unit patients. J Infect Dis 1993;168:1336ߝ1337.CrossRefGoogle Scholar
7. Allen, KD, Green, HT. Hospital outbreak of multi-resistant Acinetobacter anitratus: an airborne mode of spread? J Hosp Infect 1987;9:110ߝ119.CrossRefGoogle ScholarPubMed
8. Sakata, H, Fujita, K, Maruyama, S, Kakehashi, H, Mori, Y, Yoshioka, H. Acinetobacter calcoaceticus biovar anitratus septicaemia in a neonatal intensive care unit: epidemiology and control. J Hosp Infect 1989;14:15ߝ22.CrossRefGoogle Scholar
9. Wise, KA, Tosolini, FA. Epidemiological surveillance of Acinetobacter species. J Hosp Infect 1990;16:319ߝ329.CrossRefGoogle ScholarPubMed
10. Corbella, X, Pujol, M, Ayats, J, Sendra, M, Ardanuy, C, Dominguez, MA, et al. Relevance of digestive tract colonization in the epidemiology of nosocomial infections due to multiresistant Acinetobacter baumanii . Clin Infect Dis 1996;23:329ߝ334.CrossRefGoogle Scholar
11. French, GL, Casewell, MW, Roncoroni, AJ, Knight, S, Phillips, I. A hospital outbreak of antibiotic-resistant Acinetobacter anitratus: epidemiology and control. J Hosp Infect 1980;1:125ߝ131.CrossRefGoogle ScholarPubMed