Infection control response to an outbreak of OXA-23 carbapenemase-producing carbapenem-resistant Acinetobacter baumannii in a skilled nursing facility in Utah

Details

• Alternative Title:
  Am J Infect Control
• Personal Author:
  Smith, Amanda R. ; Vowles, Maureen ; Horth, Roberta Z. ; Smith, Lori ; Rider, Linda ; Wagner, Jennifer M. ; Sangster, Anna ; Young, Erin L. ; Schuckel, Hailey ; Stewart, James ; Gruninger, Randon J. ; Rossi, Alessandro ; Oakeson, Kelly F. ; Nakashima, Allyn K.
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• Description:
  Background: ; Antibiotic-resistant Acinetobacter species are a growing public health threat, yet are not nationally notifiable, and most states do not mandate reporting. Additionally, there are no standardized methods to detect Acinetobacter species colonization. ; Methods: ; An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) was identified at a Utah ventilator unit in a skilled nursing facility. An investigation was conducted to identify transmission modes in order to control spread of CRAB. Culture-based methods were used to identify patient colonization and environmental contamination in the facility. ; Results: ; Of the 47 patients screened, OXA-23-producing CRAB were detected in 10 patients (21%), with 7 patients (15%) having been transferred from out-of-state facilities. Of patients who screened positive, 60% did not exhibit any signs or symptoms of active infection by chart review. A total of 38 environmental samples were collected and CRAB was recovered from 37% of those samples. Whole genome sequencing analyses of patient and environmental isolates suggested repeated CRAB introduction into the facility and highlighted the role of shared equipment in transmission. ; Conclusions: ; The investigation demonstrated this ventilated skilled nursing facility was an important reservoir for CRAB in the community and highlights the need for improved surveillance, strengthened infection control and inter-facility communication within and across states.
• Subjects:
  • Article
  • Acinetobacter
  • Carbapenem-resistant
  • Outbreak
  • Skilled nursing facility
  • Infection control
  • Acinetobacter Infections
  • Acinetobacter baumannii
  • Anti-Bacterial Agents
  • Bacterial Proteins
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• Source:
  Am J Infect Control. 49(6):792-799
• Pubmed ID:
  33217512
• Pubmed Central ID:
  PMC8803644
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  49
• Issue:
  6
• Download URL:
  https://stacks.cdc.gov/view/cdc/113982/cdc_113982_DS1.pdf
• File Type:
  [PDF - 809.09 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:076609fc2450227e38589729d08ddd3cf1e1f089ba412c0fe916594bc784c291