Nosocomial Transmission of Carbapenem-Resistant Acinetobacter baumannii (CRAb) among ICU Patients Detected by CRAb-LAMP
Methods: The study took place in medical ICU and surgical ICU of Faculty of Medicine Ramathibodi Hospital from Dec. 2013 to Feb. 2014. All the patients who stayed more than 2 days were included and screened for CRAb with LAMP by rectal swab and/or sputum (intubated patient only) on admission, day7 and discharge. If the either sample showed positive, we defined patient as positive.
Results: Throughout the research period, 794 samples were collected and the sensitivity of LAMP was 100% and its specificity was 88.9%, using the culture method as the gold standard. 334 patients were admitted to the either ICU and 155 (medical ICU: 108, surgical ICU: 47) were eligible in this study. The average length of stay in ICU was 8.9 days. The rate of CRAb-positive on admission was 12.3% (medical ICU: 13.9, surgical ICU: 8.5). The rate of CRAb acquisition was 26.8 per 1000 patient days (medical ICU: 31.0, surgical ICU: 17.2) and 24.3% (medical ICU: 29.0, surgical ICU: 14.0) of the patients was transmitted during ICU stay.
Conclusion: Active surveillance is important for identifying hidden reservoirs. Our research confirmed that CRAb-LAMP with its high sensitivity and rapidity enabled us to find positive patients early and to investigate the incidence of nosocomial transmission easily. We have started to make appropriate interventions for the CRAb-positive patients from the LAMP result and investigate the efficacy.
Y. Akeda, None
P. Santanirand, None
A. Kerdsin, None
M. Seki, None
W. Paveenkittiporn, None
K. Malathum, None
K. Oishi, None
K. Tomono, None
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