caa a22 4500 60615700X CHVBK 20210128100611.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10096-014-2281-x doi (NATIONALLICENCE)springer-10.1007/s10096-014-2281-x Control of hospital endemicity of multiple-drug-resistant Acinetobacter baumannii ST457 with directly observed hand hygiene [Elektronische Daten] [V. Cheng, J. Chen, R. Poon, W. Lee, S. So, S. Wong, P. Chau, C. Yip, S. Wong, J. Chan, I. Hung, P. Ho, K. Yuen] An increasing endemicity of multiple-drug-resistant Acinetobacter baumannii (MRAB) ST457 was noted in Hong Kong. The epidemiology, risk factors, and infection control measures to prevent nosocomial transmission of this epidemic clone were analyzed. A total of 5,058 patients cultured positive with A. baumannii between 1 January 2004 and 30 June 2014 were included, of which 297 (5.9%) had bacteremia. The first case of MRAB bacteremia emerged in 2009, with an incidence that increased from 0.27 (one case) in 2009 to 1.86 (14 cases) per 100,000 patient-days in 2013 (p < 0.001). With the implementation of strict contact precautions and directly observed hand hygiene in conscious patients immediately before receiving meals and medications in July 2013, the incidence of MRAB bacteremia reduced from its peak to 0.77 (one case) per 100,000 patient-days in the first 6months of 2014 (p < 0.001). Patients from long-term care facilities for the elderly [odds ratio (OR) 18.6, confidence interval (CI) 2.1-162.4, p = 0.008] and history of carbapenem (OR 7.0, CI 1.7-28.0, p = 0.006) and beta-lactam/beta-lactamase use (OR 5.6, CI 1.1-28.7, p = 0.038) 90days prior to admission were independent risk factors for MRAB bacteremia by logistic regression when compared with carbapenem-susceptible A. baumannii bacteremia. Springer-Verlag Berlin Heidelberg, 2014 Cheng V. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Chen J. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Poon R. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Lee W. Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut So S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Wong S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Chau P. School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China aut Yip C. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Chan J. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Hung I. Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Ho P. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Yuen K. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 713-718 0934-9723 34:4<713 2015 34 10096 https://doi.org/10.1007/s10096-014-2281-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2281-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cheng V. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Chen J. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Poon R. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Lee W. Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- So S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Wong S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Chau P. School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Yip C. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Chan J. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Hung I. Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Ho P. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Yuen K. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 713-718 0934-9723 34:4<713 2015 34 10096