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Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii: an unexpected difference in epidemiologic behavior

Author: Bernards AT, Frenay HM, Lim BT, Hendriks WD, Dijkshoorn L, van Boven CP.

Journal: Am-J-Infect-Control. 1998 Dec; 26(6): 544-51

Year published: 1998

Pathogen: Acinetobacter baumannii, MRSA, Methicillin-Resistant Staphylococcus aureusDuration:

Dates of investigation: A) Dec. 1994; B) Jul 1995; C) Jul 1995

Country: Netherlands

No. of beds: A) 424; B) 380; C) 848

Hospital: A) community teaching hospital; B) community hospital; C) regional referral center, university hospital

Mode of Transmission: airborne?; contaminated, environment is a possibility

Infection sites: bacteremia, BSI, pneumonia

Attack Rate: A) 22; B) 6; C) 1

No. deaths: A) 1

Methods: 1) laboratory studies (sedimentation plates, PCR fingerprinting); 2) evaluation of control measures (private rooms with anteroom in all three hosp, contact isolation in A, strict isolation in B and C, negative air pressure in C)

Results: 1) 3 index cases were transferred from Greece or Spain; 2) isolation of A baumannii on sedimentation plates; 3) lack of evidence of human carriage; 3) no spread occurred in hospital C, the only hospital with negative air pressure in the patient's anteroom; considering all 3 factors, airborne transmission is most likely ; 5) notes: in hospital C, infected patient underwent skin disinfection through daily washing with povidone-iodine solution for MRSA carriage

Discussions: Contamination of the environment remains a possibility, especially in hospital A where a significant lag time of 3 weeks occurred between the index case and the next cases; 2) no environmental cultures