PDF(Pubmed)
Abstract：
BACKGROUND: Even amid the coronavirus disease-19 (COVID-19) pandemic, the spread of multidrug-resistant bacteria and infection control are still important tasks. After recognizing the carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak that occurred in the isolation room for COVID-19, we would like to introduce what infection control measures were implemented to eradicate it.
METHODS: All COVID-19 patients with CRAB in any specimen admitted to the COVID-19 isolation ward of the tertiary hospital in Korea from October to November 2021 were analyzed.
RESULTS: During the outbreak, 23 patients with COVID-19 and CRAB infections were identified. The index case was an 85-year-old female referred from a long-term care facility. CRAB was identified in sputum culture in most patients (91.3%). The CRAB outbreak occurred mainly in the rooms around the index case. Environmental cultures on the floor, air inlet, air outlet, and window frame of the rooms were performed. The antimicrobial resistance patterns of CRAB from patients and the environment were identical; whole-genome sequencing analyses revealed isolated clonality. Infection control measures with enhanced environmental cleaning using 1,000 ppm sodium hypochlorite and phenolic compounds, enhanced hand hygiene, additional education, and mandatory additional gowning and gloving of COVID-19 personal protective equipment (PPE) were applied on 29 October. No CRAB infection cases occurred from 2 November for two weeks.
CONCLUSIONS: In addition to applying PPE and COVID-19 precautions in COVID-19 isolation wards, adhering to strict contact precautions along with environmental control can help prevent the spread of multidrug-resistant bacteria.
METHODS: All COVID-19 patients with CRAB in any specimen admitted to the COVID-19 isolation ward of the tertiary hospital in Korea from October to November 2021 were analyzed.
RESULTS: During the outbreak, 23 patients with COVID-19 and CRAB infections were identified. The index case was an 85-year-old female referred from a long-term care facility. CRAB was identified in sputum culture in most patients (91.3%). The CRAB outbreak occurred mainly in the rooms around the index case. Environmental cultures on the floor, air inlet, air outlet, and window frame of the rooms were performed. The antimicrobial resistance patterns of CRAB from patients and the environment were identical; whole-genome sequencing analyses revealed isolated clonality. Infection control measures with enhanced environmental cleaning using 1,000 ppm sodium hypochlorite and phenolic compounds, enhanced hand hygiene, additional education, and mandatory additional gowning and gloving of COVID-19 personal protective equipment (PPE) were applied on 29 October. No CRAB infection cases occurred from 2 November for two weeks.
CONCLUSIONS: In addition to applying PPE and COVID-19 precautions in COVID-19 isolation wards, adhering to strict contact precautions along with environmental control can help prevent the spread of multidrug-resistant bacteria.
摘要：
背景：即使在冠状病毒病-19（COVID-19）大流行期间，多重耐药细菌的传播和感染控制仍然是重要的任务。在认识到发生在COVID-19隔离室的碳青霉烯类耐药鲍曼不动杆菌（CRAB）暴发后，我们想介绍采取了哪些感染控制措施来根除它。
方法：对2021年10-11月韩国三级医院COVID-19隔离病房收治的所有CRAB患者进行分析。
结果：在爆发期间，确定了23例COVID-19和CRAB感染患者。该索引病例是一名从长期护理机构转诊的85岁女性。在大多数患者（91.3％）的痰培养中发现了CRAB。CRAB爆发主要发生在索引病例周围的房间。地板上的环境文化，进气口,出风口,和房间的窗框进行了表演。来自患者和环境的CRAB的抗菌素耐药性模式是相同的；全基因组测序分析显示分离的克隆性。感染控制措施，使用1,000ppm次氯酸钠和酚类化合物加强环境清洁，加强手部卫生，额外的教育，10月29日，对COVID-19个人防护装备（PPE）进行了强制性额外的礼服和手套。从11月2日起，两周内没有发生CRAB感染病例。
结论：除了在COVID-19隔离病房中应用PPE和COVID-19预防措施外，坚持严格的接触预防措施和环境控制可以帮助防止多重耐药细菌的传播。
方法：对2021年10-11月韩国三级医院COVID-19隔离病房收治的所有CRAB患者进行分析。
结果：在爆发期间，确定了23例COVID-19和CRAB感染患者。该索引病例是一名从长期护理机构转诊的85岁女性。在大多数患者（91.3％）的痰培养中发现了CRAB。CRAB爆发主要发生在索引病例周围的房间。地板上的环境文化，进气口,出风口,和房间的窗框进行了表演。来自患者和环境的CRAB的抗菌素耐药性模式是相同的；全基因组测序分析显示分离的克隆性。感染控制措施，使用1,000ppm次氯酸钠和酚类化合物加强环境清洁，加强手部卫生，额外的教育，10月29日，对COVID-19个人防护装备（PPE）进行了强制性额外的礼服和手套。从11月2日起，两周内没有发生CRAB感染病例。
结论：除了在COVID-19隔离病房中应用PPE和COVID-19预防措施外，坚持严格的接触预防措施和环境控制可以帮助防止多重耐药细菌的传播。
