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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/28710

    標題: The Impact of Inadequate Terminal Disinfection on an Outbreak of Imipenem-Resistant Acinetobacter baumannii in an Intensive Care Unit
    作者: Liu, Wei-Lun
    Liang, Hsueh-Wen
    Lee, Mei-Feng
    Lin, Hsin-Lan
    Lin, Yu-Hsiu
    Chen, Chi-Chung
    Chang, Ping-Chin
    Lai, Chih-Cheng
    Chuang, Yin-Ching
    Tang, Hung-Jen
    貢獻者: 保健營養系
    日期: 2014-09
    上傳時間: 2015-05-06 21:26:01 (UTC+8)
    出版者: Public Library Science
    摘要: Background: This study was conducted to investigate an outbreak caused by imipenem-resistant Acinetobacter baumannii (IRAB) in a medical intensive care unit (ICU) in a regional hospital. Methods: In response to an IRAB outbreak from October 2012 to February 2013, we developed several infection control measures, including an extensive review process of environmental cleaning and disinfection, and used molecular methods to identify each clinical and environmental IRAB isolate. Results: During this five-month period, 22 patients were colonized with IRAB and 18 patients had IRAB infections. The in-hospital mortality rate was significantly higher among patients with infections rather than colonizations (44.4% vs 9.1%, p = 0.028). Additionally, nine environmental specimens, including five specimens collected after terminal disinfection, were positive for IRAB. 12 environmental isolates and 28 of 36 available clinical isolates belonged to one unique pulsotype A, which was confirmed by molecular methods. We found the concentration of disinfectant, 0.08% sodium hypochlorite, was inadequate. After correcting the environmental cleansing methods, the surveillance study showed no further IRAB isolates on the control panel surfaces of the medical equipment or in patients in the ICU. Additionally, an in vitro study of IRAB immersed in different concentrations of sodium hypochlorite showed that 0.5% sodium hypochlorite eradicates IRAB after 30 seconds of inoculation, but 0.08% sodium hypochlorite only reduces the bacterial load. Conclusions: This study highlights the importance of the preparation of disinfectants to adequately achieve environmental disinfection in the control of IRAB outbreaks in the ICU.
    關聯: Plos One, v.9 n.9, e107975
    Appears in Collections:[保健營養系(所) ] 期刊論文

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