Multidrug-resistant Acinetobacter baumannii outbreak in an intensive care unit.

Carbapenem-resistant Acinetobacter baumannii was isolated from 15 colonized or infected patients (carriers) between April-July 2004, in a teaching hospital ICU in Rome, Italy. All isolated strains were susceptible only to gentamicin, ampicillin-sulbactam and colistin and displayed the same Random Amplified Polymorphic DNA (RAPD) 1 pattern. Twelve out of 15 strains were susceptible to tigecycline, whereas the remaining three showed an intermediate susceptibility. Although infection control measures were reinforced and carriers isolated in separate rooms A. baumannii transmission continued. Therefore finally A. baumannii carriers were moved to another available sub-intensive unit, which was reequipped, and cared by dedicated personnel, whereas only the non infected/colonized patients remained in the ICU. The study showed that during an outbreak by multi-resistant A. baumannii it may be indispensable to isolate geographically not only patients but also dedicated staff.