Carbapenem-Resistant Acinetobacter baumannii: Concomitant Contamination of Air and Environmental Surfaces

OBJECTIVE. To concomitantly determine the differential degrees of air and environmental contamination by Acinetobacter baumannii based on anatomic source of colonization and type of ICU layout (single-occupancy vs open layout). DESIGN. Longitudinal prospective surveillance study of air and environmental surfaces in patient rooms. SETTING. A 1,500-bed public teaching hospital in Miami, Florida. PATIENTS. Consecutive A. baumannii colonized patients admitted to our ICUs between October 2013 and February 2014. METHODS. Air and environmental surfaces of the rooms of A. baumannii colonized patients were sampled daily for up to 10 days. Pulsed field gel electrophoresis (PFGE) was used to type and match the matching air, environmental, and clinical A. baumannii isolates. RESULTS. A total of 25 A. baumannii colonized patients were identified during the study period; 17 were colonized in the respiratory tract and 8 were colonized in the rectum. In rooms with rectally colonized patients, 38.3% of air samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 13.1% of air samples were positive (P = .0001). In rooms with rectally colonized patients, 15.5% of environmental samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 9.5% of environmental samples were positive (P = .02). The rates of air contamination in the open-layout and single-occupancy ICUs were 17.9% and 21,8%, respectively (P = .5). Environmental surfaces were positive in 9.5% of instances in open-layout ICUs versus 13.4% in single-occupancy ICUs (P = .09). CONCLUSIONS. Air and environmental surface contaminations were significantly greater among rectally colonized patients; however, ICU layout did not influence the rate of contamination.