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Volume 12, Number 8—August 2006

Research

VEB-1 Extended-Spectrum β-lactamase–producing Acinetobacter baumannii, France1

Thierry Naas*2Comments to Author , Bruno Coignard†2, Anne Carbonne‡, Karine Blanckaert‡, Odile Bajolet§, Claude Bernet¶, Xavier Verdeil#, Pascal Astagneau‡, Jean-Claude Desenclos†, Patrice Nordmann*, and on behalf ofthe French Nosocomial Infection Early Warning, Investigation and Surveillance Network
Author affiliations: *Hôpital de Bicêtre, Le Kremlin-Bicêtre, France; †Institut de Veille Sanitaire, Saint-Maurice, France; ‡Centre de Coordination de Lutte contre les Infections Nosocomiales Paris Nord, Paris, France; §Réseau Bactéries Multi-Résistantes Champagne-Ardennes, Centre Hospitalier et Universitaire, Reims, France; ¶Centre de Coordination de Lutte contre les Infections Nosocomiales Sud-Est, Lyon, France; #Centre de Coordination de Lutte Contre les Infections Nosocomiales Sud-Ouest et Centre Hospitalier et Universitaire, Toulouse, France

Main Article

Table 2

Recommendations for hospitals*†

Type Recommendation
Notification Report any case of infection or colonization with Acinetobacter baumannii strain showing resistance profile similar to that of 2001 outbreak strain (16) to CCLIN and local health department; attach copy of antibiogram.
Laboratory guidelines Establish identification criteria based on antibiogram
Store strains and contact central laboratory for microbiologic investigation
Medical wards Inform all medical teams and paramedics of presence of bacterial strain
Ensure appropriate use of antimicrobial drugs in high-risk wards
Infection control team Set up systematic screening of patients in high-risk wards
Reinforce isolation protocols and standard hygiene precautions throughout hospital
Reinforce surface cleaning procedures in wards where infected or colonized patients have been
Patient transfer Limit internal and external patient transfers
Inform receiving hospitals of status of patients colonized or infected with ESBL-producing A. baumannii

*CCLIN, regional infection control coordinating centers; ESBL, extended-spectrum β-lactamase.
†At the national level, recommendations were disseminated by the National Institute of Public Health (Institut de Veille Sanitaire) and the French Nosocomial Infection Early Warning, Investigation and Surveillance Network (Réseau d'Alerte, d'Investigation et de Surveillance des Infections Nosocomiales) through its website (http://www.invs.sante.fr/raisin, "alerte" section). At the regional level, they were disseminated to all hospital laboratories and infection control units by CCLIN through email notifications and their respective websites. In each hospital, they were implemented in the wards by infection control units assisted by CCLIN, when necessary.

Main Article

1This study was presented in part at the 2004 Annual Conference on Antimicrobial Resistance: Science • Prevention • Control, June 28–30, 2004, Bethesda, Maryland, USA.

2These authors contributed equally to this work.

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