Outbreak of nosocomial meningitis caused by Acinetobacter baumannii in neurosurgical patients

J Hosp Infect. 2004 Aug;57(4):300-7. doi: 10.1016/j.jhin.2004.04.009.

Abstract

An outbreak of nosocomial meningitis caused by Acinetobacter baumannii, which developed postoperatively in seven neurosurgical patients is described. The clinical isolates of A. baumannii were typed by biochemical profiles and antibiogram patterns, and by random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR) and amplified fragment length polymorphism (AFLP) fingerprinting. The implicated strain was multi-drug resistant, however, susceptibility to imipenem and netilmicin was detected. An extensive search for the environmental source of the epidemic strain was carried out. Two of several isolates from hospital environment, corresponded to the A. baumannii outbreak strain, one being cultured from the suctioning equipment used in the care of these patients. The introduction of multiresistant epidemic A. baumannii into a neurosurgical unit is a severe risk factor for patients undergoing neurosurgical procedures. Genotypic typing methods are important for definitive identification of these strains in patients and their environment.

MeSH terms

  • Acinetobacter Infections / diagnosis
  • Acinetobacter Infections / epidemiology
  • Acinetobacter Infections / etiology*
  • Acinetobacter Infections / transmission
  • Acinetobacter baumannii* / genetics
  • Bacterial Typing Techniques
  • Cerebrospinal Fluid / microbiology
  • Cluster Analysis
  • Cross Infection / diagnosis
  • Cross Infection / epidemiology
  • Cross Infection / etiology*
  • Cross Infection / transmission
  • DNA Fingerprinting
  • DNA, Bacterial / analysis
  • DNA, Bacterial / genetics
  • Disease Outbreaks / prevention & control
  • Disease Outbreaks / statistics & numerical data*
  • Drug Resistance, Multiple, Bacterial
  • Environmental Monitoring
  • Epidemiological Monitoring
  • Equipment Contamination / prevention & control
  • Equipment Contamination / statistics & numerical data
  • Genotype
  • Hospital Mortality
  • Humans
  • Infection Control / methods
  • Meningitis, Bacterial / diagnosis
  • Meningitis, Bacterial / epidemiology
  • Meningitis, Bacterial / etiology*
  • Meningitis, Bacterial / transmission
  • Microbial Sensitivity Tests
  • Neurosurgical Procedures / adverse effects*
  • Polymorphism, Restriction Fragment Length
  • Random Amplified Polymorphic DNA Technique
  • Retrospective Studies
  • Risk Factors
  • Suction / instrumentation

Substances

  • DNA, Bacterial