VHP, Infection Control Measures Fight Resistant Acinetobacter baumannii

Environmental decontamination using vaporized hydrogen peroxide (VHP) combined with comprehensive infection prevention and control measures interrupted nosocomial transmission of multidrug-resistant (MDR) Acinetobacter baumannii in a long-term acute-care hospital (LTACH), report researchers, who add that application of this novel approach to halt the transmission of MDR A. baumannii warrants further investigation.

Amy Ray, MD, MPH, from the Division of Infectious Diseases and HIV Medicine at the University Hospitals Case Medical Center in Cleveland, and colleagues, sought to study VHP as an adjuvant in the control of MDR) Acinetobacter baumannii infection in an LTACH and to describe the risk factors for acquisition of MDR A. baumannii infection in the LTACH population. They conducted an utbreak investigation, a case-control study, and before-after intervention trial in a 54-bed LTACH affiliated with a tertiary-care center in northeastern Ohio; their results were published in the December issue of Infection Control & Hospital Epidemiology.

The researchers report that 13 patients infected or colonized with MDR A. baumannii were identified from January 2008 through June 2008. By susceptibility testing, 10 (77 percent) of the 13 isolates were carbapenem-resistant. MDR A. baumannii was found in wound samples, blood, sputum and urine. Wounds were identified as a risk factor for MDR A. baumannii colonization. Ventilatorassociated pneumonia was the most common clinical syndrome caused by the pathogen, and the associated mortality was 14 percent (two of the 13 case patients died). MDR A. baumannii was found in eight of 93 environmental samples, including patient rooms and a wound-care cart; environmental and clinical cultures were genetically related. Environmental cultures were negative immediately after VHP decontamination and both 24 hours and one week after VHP decontamination. The researchers report that nosocomial acquisition of the pathogen in the LTACH ceased after VHP intervention, and add that when patients colonized with MDR A. baumannii reoccupied rooms, environmental contamination recurred.

Reference: Ray A, Perez F, Beltramini AM, Jakubowycz M, Dimick P, Jacobs MR, Roman K, Bonomo RA and Salata RA.Use of Vaporized Hydrogen Peroxide Decontamination during an Outbreak of Multidrug-Resistant Acinetobacter baumannii Infection at a LongTerm Acute Care Hospital. Infect Control Hosp Epidemiol 2010;31:1236-1241.