Successful management of an outbreak of Acinetobacter baumannii infection in a tertiary care burns unit
Rahul Gorka, Surbhi Dhar, Shalli, Sakshi Bhat
Acinetobacter baumannii has become a notable and worrisome pathogen in the hospitals world over, and nosocomial outbreaks in the intensive care units and the burn units have been reported. It poses high morbidity and mortality at hospitals throughout the world. The Acinetobacter Baumannii-calcoaceticus complex is responsible for most of these infections, mainly the multidrug-resistant strain. It accounts for 1-3% of hospital infections and predominantly affects immune compromised patients. Burn wounds provide favourable alcove for microbes to dwell. Patients with burn injury are at a high risk of infection as a result of the nature of the burn injury and the immuno-compromised status along with prolonged hospital stay and invasive diagnostic methods and treatment procedures. These outbreaks are mostly caused by MDRAB which pose greater threats in vulnerable patients. In the month of March 2020, four patients in the burn unit simultaneously started having fever with chills. Blood culture, wound swab culture and Urine cultures were sent. Meanwhile, all these patients were started empirically on injection Tigecycline, Netilmicin and Vancomycin along with antipyretics. They were kept on strict vitals, input-output monitoring. They were also administered high calorie high protein diet. Daily dressings were done with sterile gauze and paraffin coated tullegrass gauze, following hand hygiene and personal hygiene measures. Multi Drug Resistant bacteria are well recognised for causing most important current public health problems and an outbreak occurs due to lapses on part of both patient and administrative side. Here the outbreak appeared to be initiated from Dressings trays, ward doors and hands which was confirmed by similar sensitivity patterns on culture media. The study also showed that proper implementation of hand hygiene methods, disinfection of ward and more number of dressings decreased the incidence of bacteria thus bringing the outbreak under control.