1206 - Carbapenem-resistant Acinetobacter Baumannii Outbreak on a Burn Unit

Session Description: Carbapenem-resistant Acinetobacter baumannii infections are concerning in healthcare not only due to difficulty treating, but also for challenges with containment within a healthcare facility. Swift identification and implementation of infection control measures are necessary to prevent transmission.
An 11 bed dedicated Burn Unit identified a patient with a Carbapenem-resistant Acinetobacter baumannii infection in a wound culture after 17 days of being admitted to the unit. The patient had been transferred from a facility outside of the country where treatment had begun for the injury received while traveling. Immediate implementation of infection control measures was necessary to ensure spread of this organism was halted. Surveillance/Clinical cultures revealed that transmission had occurred when the same organism was recovered from two other burn patients on the unit.
Review of literature and discussion with other professional epidemiologists from the state health department revealed that Carbapenem-resistant Acinetobacter baumannii can be very pervasive in the healthcare environment. This organism can live in wet environments or very dry environments such as dust. The Infection Prevention team met with unit leadership to escalate concerns and take quick action. All patients on the burn unit had surveillance cultures collected to see if additional patients were colonized, microbiology lab was alerted to save Carbapenem-resistant Acinetobacter baumannii isolates from clinical cultures, all patients were placed on Enhanced Contact precautions requiring the use of gown and gloves for all patient care, and all disinfection on the unit required bleach wipes.
Surveillance cultures revealed no new patients with Carbapenem-resistant Acinetobacter baumannii colonization or infection. However, due to patients potentially acquiring this organism while in the hospital, concerns were raised for environmental contamination of the unit. Terminal bleach cleaning for all rooms upon discharge continued until positive patients were discharged. Additionally, vaporized hydrogen peroxide was used for disinfection of all areas of the unit.