Korean J healthc assoc Infect Control Prev.  2019 Dec;24(2):81-87. 10.14192/kjicp.2019.24.2.81.

Colonization Prevalence and Risk Factor Analysis of Carbapenem-Resistant Acinetobacter baumannii in an Intensive Care Unit without Outbreaks

Affiliations
  • 1Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea. yakim@nhimc.or.kr
  • 2Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 3Infection Control Unit, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 4Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Acinetobacter baumannii is a well-known etiologic agent of a variety of nosocomial infections; the resistance rate to imipenem is surprisingly high in Korea. The colonization of carbapenem-resistant A. baumannii (CRAB) is known to be associated with increased mortality, hospital stay, and cost in intensive care unit (ICU)-admitted patients. In this study, the prevalence, molecular epidemiology, and risk factors of CRAB colonization were evaluated in ICU settings that did not have a current outbreak.
METHODS
Consecutive screening for the colonization of CRAB was performed with 291 patients admitted to the surgical or medical ICU within 48 hours for six months (from April to September 2017) in one general hospital (817 beds, Goyang-si, Gyeonggi-do province, Korea). An active surveillance culture (ASC) for CRAB was performed according to the Centers for Disease Control and Prevention protocols with a perirectal swab sample. After DNA extraction, multiplex PCR was performed to detect carbapenemase genes (bla(OXA-23-like), bla(OXA-24-like), bla(OXA-51-like), bla(OXA-58-like), ISAba1-bla(OXA-23-like), and ISAba1-bla(OXA-51-like gene)). A case-control study was performed to evaluate the risk factors.
RESULTS
Among the 291 patients, the colonization rate of CRAB at ICU admission was 5.2%. The carbapenem resistance mechanism of CRAB colonizers is mostly due to OXA-23-like enzyme production. A risk factor was found to be previous admission to long-term care facilities.
CONCLUSION
To perform ASC for detecting CRAB in ICU-admitted patients, the colonization rate of CRAB should be considered. Patients with a history of admission to a long-term care facility should be prioritized.

Keyword

Acinetobacter baumannii; Carbapenem resistance; Colonization; Infection control

MeSH Terms

Acinetobacter baumannii*
Acinetobacter*
Case-Control Studies
Centers for Disease Control and Prevention (U.S.)
Colon*
Critical Care*
Cross Infection
Disease Outbreaks*
DNA
Drug Resistance, Bacterial
Gyeonggi-do
Hospital Mortality
Hospitals, General
Humans
Imipenem
Infection Control
Intensive Care Units*
Korea
Long-Term Care
Mass Screening
Molecular Epidemiology
Multiplex Polymerase Chain Reaction
Prevalence*
Risk Factors*
DNA
Imipenem
Full Text Links
  • KJHAICP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr