Early detection and control of an Acinetobacter baumannii multi-resistant outbreak in a hospital in Quito, Ecuador

  • Monica Cartelle Gestal Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
  • Jeannete Zurita Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
  • Gabriela Gualpa Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
  • Cecibel Gonzalez Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
  • Ariane Paz y Mino Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
Keywords: outbreak, Acinetobacter baumannii, nosocomial infections, control, ABA

Abstract

Introduction: Acinetobacter baumannii (ABA) is an important opportunistic pathogen associated with high mortality rates in intensive care units (ICUs). An outbreak in the ICU of a secondary-level hospital in Quito, Ecuador, occurred during April and May 2015 and was successfully controlled.

Methodology: Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) and repetitive element palindromic (REP)-PCR was conducted on all isolates recovered from patients, as well as environmental samples, to confirm the presence of an outbreak. A case-control study was conducted by comparing the clinical histories of the affected patients and of control patients present in the ICU during the outbreak period who did not present a positive culture for ABA.

Results: Five patients were infected and two were colonized with the same clonal strain of ABA, which was also identified on the stethoscope and a monitor associated with an isolation room. Statistical analysis of case histories did not identify any additional risk factors, but the outbreak was initiated by one patient in the isolation room of the ICU who was infected with the outbreak strain. All patients who ocupied that room after the index case tested positive for at least one culture of ABA. The outbreak strain was found on the stethoscope, and a subclone was found on the monitor of that room.

Conclusion: Having access to basic equipment will enable well-trained professionals to rapidly detect and initiate the control process of an outbreak, saving lives and money spent on nosocomial infection treatments.

Author Biographies

Monica Cartelle Gestal, Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
Director and P.I. of the Biomedical Research Unit
Jeannete Zurita, Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
Director of the Microbiology
Gabriela Gualpa, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
Servicio de Laboratorio Clínico Northospital, Comité de Vigilancia y Control de Infecciones.
Cecibel Gonzalez, Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
Technician Microbiology Laboratory
Ariane Paz y Mino, Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador
Medical Student. Biomedical Research Unit
Published
2016-12-30
How to Cite
1.
Cartelle Gestal M, Zurita J, Gualpa G, Gonzalez C, Paz y Mino A (2016) Early detection and control of an Acinetobacter baumannii multi-resistant outbreak in a hospital in Quito, Ecuador. J Infect Dev Ctries 10:1294-1298. doi: 10.3855/jidc.7544
Section
Outbreak