BIRMINGHAM, United Kingdom — The intensive care unit of a hospital is often where the most vulnerable patients go for treatment. While you might think this is a secure location, away from disease and infection, a new study finds that antibiotic-resistant bacteria can still make its way into the ICU. Researchers say an ICU in Hangzhou, China was entirely contaminated with a virulent strain that infected one in three patients — creating a nightmare for healthcare professionals.
Carbapenem-resistant Acinetobacter baumannii (CRAB) made its way into this ICU through multiple patient admissions and continued to spread through airflow, staff, shared equipment, and plumbing, a team from the United Kingdom explains.
“CRAB poses a serious risk to hospitalized patients and can cause severe disease including pneumonia, urinary tract infection, bacteremia, meningitis, and soft tissue infections – all of which can be very difficult to treat due to the bacteria’s multidrug-resistance,” explains study co-author Professor Alan McNally from the University of Birmingham.
The researchers sampled the entire ICU and found 35 CRAB-positive patients, 14 of which contracted it during their ICU stay. Not only did patients test positive, but their beds and hospital equipment were contaminated as well. In fact, researchers found the bacteria covering bed units (54.6%) more often than they found it infecting patients (24.1%). Overall, ventilators and dispensing trolleys were the most likely objects to test positive for CRAB.
“The quantity of CRAB found in this ICU highlights the urgent need for targeted infection prevention and control measures in healthcare facilities where such large accumulations of the bacteria are likely, so that we can stem the global spread of this pathogen,” adds Prof. McNally in a university release.
Antibiotic resistance is a public health threat that rightfully worries scientists, researchers, and the general public. While patients should have confidence that antibiotic therapies will work against the bacteria they’re created to fight, more and more strains are defeating the drugs designed to destroy them. CRAB can stay on surfaces and equipment for extended periods of time and spread to patients within just 48 hours of admission. Such outbreaks require widespread changes on an infrastructural level that can be detrimental to clinical care, logistical functions, and financial planning, according to the study authors.
To ward off infection as much as possible, these findings emphasize the need for deep and regular cleaning of surfaces which both patients and staff touch often, isolation of CRAB-positive patients, minimal relocation between beds to slow its spread, and enhanced hand washing protocols among staff.
CRAB is an antibiotic-resistant strain that doctors are encountering all over the world, and McNally urges officials to create organizations that make efforts for mitigating the spread of it with therapeutics a top priority. Given the unexpected nature of this and all other antibiotic-resistant bacteria, this is imperative.
“In the absence of new therapeutic agents, effective CRAB IPC strategies are vital, if we are to limit the morbidity and mortality caused by the bacteria in hospitals. We must develop a thorough understanding of the persistence, transmission, and evolution of CRAB populations in such environments,” concludes McNally.
The findings are published in The Lancet.
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