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Interdisciplinary Perspectives on Infectious Diseases
Volume 2013, Article ID 582831, 9 pages
http://dx.doi.org/10.1155/2013/582831
Research Article

Control of a Clonal Outbreak of Multidrug-Resistant Acinetobacter baumannii in a Hospital of the Basque Country after the Introduction of Environmental Cleaning Led by the Systematic Sampling from Environmental Objects

1Service of Preventive Medicine, University Hospital of Cruces, Basque Health Service OSAKIDETZA, 48903 Barakaldo, Bizkaia, Spain
2Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country, 48940 Leioa, Bizkaia, Spain
3Laboratory of Microbiology, University Hospital of Cruces, Basque Health Service OSAKIDETZA, 48903 Barakaldo, Bizkaia, Spain
4Service of Anaesthesia and Reanimation, University Hospital of Cruces, Basque Health Service OSAKIDETZA, 48903 Barakaldo, Bizkaia, Spain

Received 29 May 2013; Revised 25 November 2013; Accepted 27 November 2013

Academic Editor: Albert Eid

Copyright © 2013 Jesús Delgado Naranjo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Between July 2009 and September 2010, an outbreak of multidrug-resistant (MDR) Acinetobacter baumannii was detected in one critical care unit of a tertiary hospital in the Basque Country, involving 49 infected and 16 colonized patients. The aim was to evaluate the impact of environmental cleaning and systematic sampling from environmental objects on the risk of infection by MDR A. baumannii. Methods. After systematic sampling from environmental objects and molecular typing of all new MDR A. baumannii strains from patients and environmental isolates, we analyzed the correlation (Pearson’s r) between new infected cases and positive environmental samples. The risk ratio (RR) of infection was estimated with Poisson regression. Results. The risk increased significantly with the number of positive samples in common areas (RR = 1.40; 95%CI = 0.99–1.94) and positive samples in boxes (RR = 1.19; 95%CI = 1.01–1.40). The number of cases also positively correlated with positive samples in boxes ( ; ) and common areas ( ; ). Conclusion. Once conventional measures have failed, environmental cleaning, guided by systematic sampling from environmental objects, provided the objective risk reduction of new cases and enabled the full control of the outbreak.