Clonal Spread of Carbapenem Resistant Acinetobacter baumannii in the Patients and their Environment at BMA Medical College and Vajira Hospital
Uraporn Phumisantiphong MSc*,**, Pornphan Diraphat PhD*, Fuangfa Utrarachkij MSc*, Somchai Uaratanawong MD**, Kanokrat Siripanichgon MD*
Affiliation : * Department of Microbiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand ** Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, Thailand
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 cup-
boards (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
