The Gainesville Sun and First Coast News have reported that seven to eight patients in the UF Health Shands Hospital burn unit have tested positive for a bacterium that can lead to a fatal infection, according to the hospital’s chief medical officer, Dr. Timothy Flynn. The infections were documented between March and July 22.
The bacterium, acinetobacter baumannii, lives on surfaces and in soil and can spread through human contact or medical devices. Although the hospital has not yet determined the cause or date of when the bacterium was introduced to the hospital, molecular testing suggests the spread came from a single source. “While the bacterium does not usually cause illness in healthy people, it can cause infection in severely immune-compromised individuals, such as burn patients. Nationally and internationally, this organism is recognized as a major cause of infections in hospitalized patients,” said Rosanna Passaniti, Shands Media Relations Coordinator, UF Health Communications.
Flynn said that some of the infected patients were successfully treated and that the results depended on the health and degree of burns the patients had prior to the infection. He also said the hospital tried to avoid using the only antibiotic known to treat acinetobacter baumannii, called Colistin, because it can be toxic to the kidneys.
In early March, the first patient at UF Health Shands Hospital tested positive for the bacteria, and the other six tested positive in late May. Hospital personnel were aware of the bacteria, but the outbreak was not reported to the health department. “Once it was clear that this was not an isolated case, steps were taken to move (uninfected or newly admitted) patients off the (burn) unit,” representatives said, to prevent more patients becoming infected.
The hospital has now closed the burn unit for renovations, surveillance cultures have been conducted throughout the hospital, according to Flynn, and they are using the incident as an opportunity to reexamine their cleaning and infection-control procedures.
The outbreak of acinetobacter baumannii at Shands mirrors a growing trend across the country and world of antibiotic-resistant bacteria causing deadly infections in hospitals’ sickest patients. Dr. Brad Spellberg, an infectious disease expert at UCLA, estimates there are roughly 50,000 cases of this bacteria annually in the U.S., and 20 times that in the world. It is also common in returning troops from Afghanistan and Iraq, many of whom were contaminated through soil.
In hospitals, the bacteria often are transmitted from devices such as IVs, urine catheters and blood pressure cuffs, said Dr. Alex Kallen, an infectious disease specialist at the Centers for Disease Control and Prevention in Atlanta. Kallen said hospital and hygiene also play a role. For example, health care workers who change the dressings on two different patients without first washing their hands can transmit it. “Uncleaned medical equipment can play a huge role,” Kallen said. “Most places that have a problem with this require a reassessment of cleaning within the rooms. “It is a very hearty organism and can survive in an environment for a very long time,” he continued.