2014 Volume 29 Issue 2 Pages 93-99
The spread of multidrug-resistant Acinetobacter baumannii (MDRA) has become a global concern, but detection of MDRA is comparatively rare in Japan. However, the presence of MDRA was confirmed in our hospital, after isolation from the sputum of a patient who had received treatment for cerebral infarction at a hospital in a neighboring country, and then was admitted to our hospital after return to Japan. No signs of infection were found, and the patient was in the carrier stage. Unfortunately, MDRA was subsequently detected in other patients. Typically, a patient suspected of MDRA infection is placed under supervision in a private room and zoning is carried out. We also performed genomic analysis using pulsed field gel electrophoresis (PFGE) to assess whether all cases of MDRA detected inside the hospital were the same strain. The PFGE results showed that the same strain had propagated inside the hospital. Further, the detected MDRA was identified as the IC–2 strain, which has the blaOXA–23–like gene and has propagated worldwide. We publicized the fact that the IC–2 MDRA strain had spread inside the hospital and conducted a workshop to instruct the staff on the importance of hand hygiene. As a result, although six patients were infected with MDRA, we were able to prevent further nosocomial spread. We recommend that detection of MDRA or any other new drug-resistant bacterium should trigger the implementation of the following infection-control policies to prevent the spread of in-hospital infection: emphasize early isolation precautions even the infection is only suspected, instead of placing too much importance on examination results; supply information regarding the situation to all personnel in the hospital; ensure that staff and patients are informed about regular hand hygiene; and improve compliance with infection countermeasures.
