Acinetobacter Baumanni - Case Study Example

Name : xxxxxx Tutor : xxxxxxx Title : xxxxxxx Institution : xxxxxxx @2010 Acinetobacter baumanni-Case Study Introduction Acinetobacter baumanni has been shown to have emerged as the most prominent organism in the genus Acinetobacter. This organism has been shown to have become such a threat in various institutions around the globe. The implicated clinical significance of this organism has greatly been fostered by its implicated ability to develop a number of drug resistance determinants. This is thus an organism that stands to greatly threaten the antibiotic industry. The reports from the Neonatal Intensive Care Unit (NICU) point to a serious situation that calls for an immediate investigation. The strain of drug resistant A.baumanni has been reported in this hospital. This paper examines a longitudinal intervention approach geared at identifying the microbiological and clinical epidemiology of a likely outbreak alongside the use of a multicomponent disease control strategy. Examining the Situation For all the neonates in the ICU found to be infected with the organism, the isolated strain need to be verified further with the use of other techniques including the restriction analysis of the associated ribosomal genes. This can further be perfected by the use of various molecular typing techniques including Pulse Field Electrophoresis and the use of various models of the Polymerase Chain Reaction. The main objective of this investigatory approach is to establish the implicated risk factors responsible for the various infections associated with the A.baumannii. This would possibly lead in to the stringent characterization of the various strains of the organism that are responsible for the infection and further evaluate the suitability of the multicomponent intervention strategy. The intervention approach is meant to be a technical investigation with focus on the Neonatal Intensive Care Unit. In order to effectively investigate the route cause of the infection, the mechanisms implicated in the spread of the infection and how a number of isolates are able to dominate alongside the use of a wide range of biological techniques should be applied. This is highly related to the possibility that determining an outbreak may be relatively difficult if at all ideal distinction is not made with the various strains of the organism. The use of one line of technique alone may not be effective in elucidating all the implicated aspects of any particular infection with any strain of this organism (Bergonie-Berezin 2008).The use of various genotypic typing methods should thus be recommended in facilitating the detection of an outbreak with this organism. With regard to this particular case, the infection is such that is circumscribed to the Neonatal ICU unit and it could be possible that a certain pathological object within the environment of the ward is solely responsible for the infection. Since the emergence of the associated infections in previous times have been counteracted by the use of various antibiotics. It could be possible that the reemergence of the infections is as a result of the various mechanisms of drug resistance that the organisms have acquired. The use of molecular typing techniques in the detection of any infection in such a case can help in the identification of any form of evolutionary mechanism adopted by the organism in resisting the use of drugs. The proper use of antibiotics in this regard is an aspect that needs to be reconsidered to ensure that the antibiotics are appropriately administered in an effort to help in reducing chances of the organism gaining resistance mechanisms towards them. To help in the control of the spread of infection, it is important that the various risk factors cited in line with the occurrence of the infections are guarded against (Bergonie-Berezin 2008). The proper use of implicated antibiotics for this particular case could be the main approach to defining a preventive mechanism. The mode of carriage implicated in the spread of the infections is an aspect that should be given much consideration. It could be possible that the reoccurrence of A.baumannii infections in this particular ICU unit is associated with the prevalence of inadequate prevention mechanisms to guard against the infection of neonates with the organism especially on admission in to the ICU unit. Why the Occurrence of A.Baumanii infections in the Neonatal ICU Unit has been Persistent The persistence of the A.Baumanni infection among infants in the neonatal ICU unit could possibly be as a result of three major causes related to the prevailing environment. The three major causes of the reoccurrence of the infections could be related to the development of resistance to the use of antibiotics, the development of resistance to desiccation and the use of disinfectants. The type of resistance acquired by the strain of A.baumanii in this case could be as a result of the use of antibiotics to which the organisms have managed to acquire a selective advantage. The extensive exposure to the use of antimicrobials in the ICU unit could be the main cause of the development of this type of resistance .The selection advantage implicated in the development of the resistance to the use of the various antibiotics could be as a result of the indiscriminate use of the implicated antibiotics in the neonatal ICU unit. With regard to the resistance of these organisms to the process of desiccation, it should be understood that unlike other organisms, the A.baumannii have the ability to survive for relatively long periods of times on surfaces. This is an aspect that fosters their spread of infection. These organisms have the ability to withstand desiccation more than any other member of the same genus. This could be an aspect that highly fosters their ability to re-infect the infants (Bergonie-Berezin 2008). This type of resistance coupled with their possible resistance to the use of various antimicrobial agents in the ICU could be a possible cause for their prevalence The testing of Multi-drug resistance in infants infected with the A.baumanni It is important to constantly monitor infants that exhibit signs of multi-drug resistance for the purpose of controlling any further spread of the infection. It is equally important to constantly examine cultures derived from the skin, nostrils or the pharynx especially in infants that have shown signs of poor sensitivity. The determination of the main cause or the mode of transmission in the hospital unit is an aspect that would greatly help in reducing the rate of infection. Control measures that can be adopted in the prevention of subsequent outbreaks in the Neonatal ICU Unit To help in controlling subsequent reemergence of infections with this strain of bacteria, it is advisable to conduct a number of molecular epidemiological studies. This would help in determining the presence of any possible clonal outbreak. The use of environmental cultures should also be upheld in an effort to determine the presence of any possible environmental cause of the infection. In the event that any environmental related source of infection is established, there is need to quickly have it removed from the surrounding of the infants. Advocating for effective and enhanced cleaning of the entire environment within the ICU unit need to be communicated to the responsible personnel. This will possibly help in the elimination of the organisms from the environs of the ICU Unit. There need to isolation mechanisms geared at the overall optimization of contact isolation through the use of various protective gear (Bergonie-Berezin 2008). This can be done when the nurses in charge of the neonatal intensive care unit are encouraged to put on gloves and aprons when attending to the their patients. Efforts geared at improving sanitation with regard to the use of hand washing facilities needs to be upheld. The use of antibiotics should be moderated in an effort to ensure that the antibiotics are not excessively used in a manner that may foster the development of a selective advantage in the A.baumannii strains. There need to be a control study that can help in determining the particular antibiotics that are responsible for initiating the development of resistance in the A.baumanii strains (Bergonie-Berezin 2008). The mechanisms used to monitor the adoption and adherence to the identified intervention measures should also be constantly upheld. Owing to the increased emergency of various mechanisms of antibiotic resistance among the A.baumanii strains, there is need to conduct adequate antimicrobial susceptibility testing before using any antibiotics. This is because the selection of antibiotics for therapeutic use in the even of an infection with these organisms is very tricky. The use of various inhibitors that can counteract both enzymatic and membrane based resistance mechanisms in the A.baumanni should be considered especially in the event that they are not very many readily available antibiotics to circumvent the resistance. Prior to the use of any antibiotic in the management of A.baumannii related infections, there is need to conduct susceptibility testing to check for any possible drug resistance. Conclusion The Acinetobacter baumanii is an organism that has been shown to be responsible for the causation of a number of pneumonia related infections in the ICU. This calls for the need to adopt the identified intervention measures in an attempt to reduce the rate of the reemergence of infection. The effectiveness with which the identified measures can work towards the reduction of the rate of occurrence of infection highly depends on the collaboration and strict adherence to the identified measures by the responsible personnel working in this unit. Reference Bergonie-Berezin, E 2008, Acinetobacter Biology and Pathogenesis, Springer, New Jersey. Read More

he use of various genotypic typing methods should thus be recommended in facilitating the detection of an outbreak with this organism. With regard to this particular case, the infection is such that is circumscribed to the Neonatal ICU unit and it could be possible that a certain pathological object within the environment of the ward is solely responsible for the infection. Since the emergence of the associated infections in previous times have been counteracted by the use of various antibiotics.

It could be possible that the reemergence of the infections is as a result of the various mechanisms of drug resistance that the organisms have acquired. The use of molecular typing techniques in the detection of any infection in such a case can help in the identification of any form of evolutionary mechanism adopted by the organism in resisting the use of drugs. The proper use of antibiotics in this regard is an aspect that needs to be reconsidered to ensure that the antibiotics are appropriately administered in an effort to help in reducing chances of the organism gaining resistance mechanisms towards them.

To help in the control of the spread of infection, it is important that the various risk factors cited in line with the occurrence of the infections are guarded against (Bergonie-Berezin 2008). The proper use of implicated antibiotics for this particular case could be the main approach to defining a preventive mechanism. The mode of carriage implicated in the spread of the infections is an aspect that should be given much consideration. It could be possible that the reoccurrence of A.baumannii infections in this particular ICU unit is associated with the prevalence of inadequate prevention mechanisms to guard against the infection of neonates with the organism especially on admission in to the ICU unit.

Why the Occurrence of A.Baumanii infections in the Neonatal ICU Unit has been Persistent The persistence of the A.Baumanni infection among infants in the neonatal ICU unit could possibly be as a result of three major causes related to the prevailing environment. The three major causes of the reoccurrence of the infections could be related to the development of resistance to the use of antibiotics, the development of resistance to desiccation and the use of disinfectants. The type of resistance acquired by the strain of A.

baumanii in this case could be as a result of the use of antibiotics to which the organisms have managed to acquire a selective advantage. The extensive exposure to the use of antimicrobials in the ICU unit could be the main cause of the development of this type of resistance .The selection advantage implicated in the development of the resistance to the use of the various antibiotics could be as a result of the indiscriminate use of the implicated antibiotics in the neonatal ICU unit. With regard to the resistance of these organisms to the process of desiccation, it should be understood that unlike other organisms, the A.

baumannii have the ability to survive for relatively long periods of times on surfaces. This is an aspect that fosters their spread of infection. These organisms have the ability to withstand desiccation more than any other member of the same genus. This could be an aspect that highly fosters their ability to re-infect the infants (Bergonie-Berezin 2008). This type of resistance coupled with their possible resistance to the use of various antimicrobial agents in the ICU could be a possible cause for their prevalence The testing of Multi-drug resistance in infants infected with the A.

baumanni It is important to constantly monitor infants that exhibit signs of multi-drug resistance for the purpose of controlling any further spread of the infection. It is equally important to constantly examine cultures derived from the skin, nostrils or the pharynx especially in infants that have shown signs of poor sensitivity. The determination of the main cause or the mode of transmission in the hospital unit is an aspect that would greatly help in reducing the rate of infection.

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