J Med Assoc Thai 2009; 92 (12):173

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Clonal Spread of Carbapenem Resistant Acinetobacter baumannii in the Patients and their Environment at BMA Medical College and Vajira Hospital
Phumisantiphong U Mail, Diraphat P , Utrarachkij F , Uaratanawong S , Siripanichgon K

Objective: To determine the clonal spread of carbapenem-resistant Acinetobacter baumannii (CRAB) in the
patients and their environment at BMA Medical College and Vajira Hospital.

Material and Method:
A prospective study on CRAB isolated from the clinical specimens of 30 patients and
300 from their environmental samples were carried out from September 1-15, 2008. The CRAB isolates were
genotyped using PCR-based typing method.

Results:
Twenty-six (86.7%) and 20 (66.7%) cases of 30 patients had their environment contaminated with A.
baumannii and CRAB, respectively Environmental contamination rates of A. baumannii and CRAB were
18.0%(54/300) and 13.0%(39/300), respectively. The most contaminated sites with CRAB were bedside cupboards
(26.7%), followed by bedrails and bed sheets (20%), BP cuffs (16.7%), over bed tables and nurse
station counters (13.3% each) and push carts (10%). Four molecular types were classified among 65 CRAB
isolates. Molecular type 1 was the most prevalent (90.7%) and found in all kinds of environmental samples
except patient record folder and computer keyboard/mouse. About 37% of the patients had at least one of their
environmental samples contaminated with CRAB clonally related with their own types.

Conclusion:
Clonal spread of CRAB was demonstrated to emphasize the important of hand hygiene, contact
precaution and patient’s environmental decontamination in controlling the spread of CRAB in the hospital.

Keywords: Carbapenem resistant A. baumannii, Clonal spread, PCR-based typing method, REP, M13

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