AI Article Synopsis
- CRAB (Carbapenem-resistant Acinetobacter baumannii) is a major cause of difficult-to-treat infections in healthcare settings, particularly in burn medicine, due to its high antibiotic resistance and environmental resilience.
- A retrospective study at a burn and plastic surgery center in Germany over three years identified eight CRAB cases, primarily in the burn intensive care unit, with evidence of hospital-acquired infections linked to specific clusters.
- The research highlights the importance of molecular techniques in tracking CRAB transmission, emphasizing that understanding the bacteria's genetic diversity can improve infection control measures within healthcare facilities.
Article Abstract
Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) frequently causes both healthcare-associated infections and nosocomial outbreaks in burn medicine/plastic surgery and beyond. Owing to the high antibiotic resistance, infections are difficult to treat, and patient outcomes are often compromised. The environmental persistence capability of CRAB favors its transmission in hospitals. A comprehensive analysis and understanding of CRAB epidemiology and microbiology are essential for guiding management.
Methods: A three-year retrospective cohort study (2020-2022) was conducted in a German tertiary burn and plastic surgery center. In addition to epidemiological analyses, microbiological and molecular techniques, including whole-genome sequencing, were applied for the comprehensive examination of isolates from CRAB-positive patients.
Results: During the study period, eight CRAB cases were found, corresponding to an overall incidence of 0.2 CRAB cases per 100 cases and an incidence density of 0.35 CRAB cases per 1000 patient-days. Six cases (75%) were treated in the burn intensive care unit, and four cases (50%) acquired CRAB in the hospital. Molecular analyses comprising 74 isolates supported the epidemiologic assumption that hospital acquisitions occurred within two separate clusters. In one of these clusters, environmental CRAB contamination of anesthesia equipment may have enabled transmission. Furthermore, molecular diversity of CRAB isolates within patients was observed.
Conclusions: CRAB can pose a challenge in terms of infection prevention and control, especially if cases are clustered in time and space on a ward. Our study demonstrates that high-resolution phylogenetic analysis of several bacterial isolates from single patients can greatly aid in understanding transmission chains and helps to take precision control measures.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378564 | PMC |
| http://dx.doi.org/10.1186/s13756-024-01459-5 | DOI Listing |
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