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학술저널
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대한임상미생물학회 Annals of Clinical Microbiology Annals of Clinical Microbiology 제17권 제2호
발행연도
2014.1
수록면
29 - 34 (6page)

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Background: Acinetobacter spp. is an important no- socomial pathogen for which increasing resistance to multiple antimicrobial agents has been observed. Prevalence of multidrug-resistant (MDR) Acinetobacter spp. in the intensive care unit (ICU) at a teaching hospital in Korea started to increase in 2008. The aim of this study was to determine the source of pathogen spread and to characterize the emerging strains at an early stage of outbreak. Methods: Samples from respiratory instruments and fomites in the ICUs, as well as from the healthcare workers, were cultured to identify the sources of MDR Acinetobacter spp. Antimicrobial susceptibility was determined by the CLSI disk diffusion method. Pulsed field gel electrophoresis (PFGE) was per- formed for clinical and environmental isolates in or- der to determine clonality. Carbapenemase genes were detected by multiplex PCR. Infection control measures including peer-monitoring of hand washing, environmental cleaning and standard precautions were enforced. Results: Among the samples from the ICU tools (105)and healthcare worker’s hands (44), 31 (30%) and 2 (5%) respective samples yielded MDR Acinetobacter spp. Among the environmental samples, 90% were from respiratory-related equipment. The majority of clinical and environmental MDR Acinetobacter spp. (44/55) belonged to the pulsotype A. baumannii and carried both blaOXA-51-like and blaOXA-23-like genes. Even though infection-control measures were enforced, prevalence of MDR Acinetobacter spp. continues to increase. Conclusion: An outbreak of MDR Acinetobacter spp. in a Korean hospital was caused by A. baumannii carrying the blaOXA-23-gene and was correlated with contaminated respiratory-related instruments in the ICUs. More intensive measures for nosocomial in- fection control are needed for successful prevention of Acinetobacter spread in hospitals. (Ann Clin Microbiol 2014;17:29-34)
#Acinetobacter #Beta-lactamase OXA-23 #Infe- ction control #Disease outbreaks

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참고문헌 (13)

참고문헌 신청
Clinical and Laboratory Standards Institute / 2008 / Performance Standards for Antimicrobial Susceptibility Testing; Eighteenth Informational Supplement / Clinical and Laboratory Standar google schola Fournier PE / 2006 / Comparative genomics of multidrug resistance in Acinetobacter baumannii / PLoS Genet 2 : e7 ~ google schola Kim CK / 2010 / Prevalence and diversity of carbapenemases among imipenemnonsusceptible Acinetobacter isolates in Korea: emergence of a novel OXA-182 / Diagn Microbiol Infec google schola Lee K / 2001 / Modified Hodge and EDTA-disk synergy tests to screen metallo-betalactamase-producing strains of Pseudomonas and Acinetobacter species / Clin Microbiol Infect 7 google schola Lee K / 2003 / Evaluation of the Hodge test and the imipenem-EDTA double-disk synergy test for differentiating metallo-beta-lactamase-producing isolates of Pseudomonas spp. a google schola

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