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.

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.

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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