Acinetobacter Pneumonia: A Review

Joshua D. Hartzell, MD, Andrew S. Kim, MD, Mark G. Kortepeter, MD, MPH, Kimberly A. Moran, MD

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In This Article

Prevention

The ability of Abc to survive for long periods in the hospital environment contributes to its ability to cause outbreaks. Jawad and colleagues demonstrated that under simulated hospital conditions, Abc can survive an average of 20 days.[98] Another study reported that it can survive on hospital surfaces for up to 4 months.[99] A study by Hujer and coworkers suggested that failure to completely disinfect treatment facilities contributed to nosocomial spread of Abc. In that study, 37% of isolates were acquired via nosocomial transmission.[46] At least 1 study has reported that hypochlorite solutions may be effective in disinfecting the hospital environment when other solutions have failed.[100]

The American Thoracic Society (ATS)/Infectious Disease Society of America (IDSA) guidelines provide an overview of available methods for preventing HAP and VAP.[68] These methods have proven efficacy in reducing these disorders, but less information is available about controlling outbreaks of Abc. Previous outbreaks have been controlled by education on hand washing, patient and staff cohorting, implementing contact precautions, minimizing use of broad-spectrum antibiotics, closing hospital units, discharging colonized patients, and decontaminating the environment.[11,29,101] However, these practices do not always control the outbreak. The authors of a recent review concluded that data on effectively controlling multidrug-resistant gram-negative bacteria are insufficient.[102] Consequently, each institution is responsible for individual decisions based on the most likely source of the outbreak. Regardless, strict adherence to infection control policies by physicians, nurses, ancillary support staff, patients, and their families is crucial to the success of any program.

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