@article{mbs:/content/journal/jmm/10.1099/jmm.0.012302-0, author = "Kohlenberg, Anke and Brümmer, Sophie and Higgins, Paul G. and Sohr, Dorit and Piening, Brar C. and de Grahl, Clemens and Halle, Elke and Rüden, Henning and Seifert, Harald", title = "Outbreak of carbapenem-resistant Acinetobacter baumannii carrying the carbapenemase OXA-23 in a German university medical centre", journal= "Journal of Medical Microbiology", year = "2009", volume = "58", number = "11", pages = "1499-1507", doi = "https://doi.org/10.1099/jmm.0.012302-0", url = "https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.012302-0", publisher = "Microbiology Society", issn = "1473-5644", type = "Journal Article", keywords = "OR, odds ratio", keywords = "ICU, intensive care unit", keywords = "CI, confidence interval", keywords = "CLSI, Clinical and Laboratory Standards Institute", keywords = "rep-PCR, repetitive-sequence-based PCR", keywords = "MSICU, medical–surgical intensive care unit", keywords = "SAPS, simplified acute physiology score", keywords = "TISS, therapeutic intervention scoring system", abstract = "A prolonged outbreak of carbapenem-resistant Acinetobacter baumannii in a German university medical centre in 2006 was investigated; the investigation included a descriptive epidemiological analysis, a case–control study, environmental sampling, molecular typing of A. baumannii isolates using PFGE and repetitive-sequence-based PCR (rep-PCR) typing, and detection of OXA-type carbapenemases by multiplex PCR. Thirty-two patients acquired the outbreak strain in five intensive care units (ICUs) and two regular wards at a tertiary care hospital within 10 months. The outbreak strain was resistant to penicillins, cephalosporins, ciprofloxacin, gentamicin, tobramycin, imipenem and meropenem, and carried the bla OXA-23-like gene. Based on PFGE and rep-PCR typing, it was shown to be related to the pan-European A. baumannii clone II. The most likely mode of transmission was cross-transmission from colonized or infected patients via the hands of health-care workers, with the severity of disease and intensity of care (therapeutic intervention scoring system 28 score >median) being independently associated with acquisition of the outbreak strain (odds ratio 6.67, 95 % confidence interval 1.55–36.56). Control of the outbreak was achieved by enforcement of standard precautions, education of personnel, screening of ICU patients for carbapenem-resistant A. baumannii and cohorting of patients. This is believed to be the first report of an outbreak of A. baumannii carrying the carbapenemase OXA-23 in Germany.", }