The Acinetobacter Threat

As I reported today at epiNewswire, a once-rare hospital infection is quickly becoming a major public health challenge in health care and nursing home facilities.

Antibiotic-resistant Acinetobacter infections are deadlier and more readily spread than other hospital infections, contaminating health care workers’ hands and gloves up to four times as frequently as other drug-resistant bacteria, according to a new study in the journal Infection Control and Hospital Epidemiology.

The study found that a third of health care worker contacts with Acinetobacter-colonized patients led to contamination of workers’ gloves or hands. And that is very likely a gross underestimate of what’s going on at other hospitals, because the authors of the study reported 100 percent compliance with hand hygiene practices and patient contact rules — even though they acknowledge in the study that even 70 percent compliance with hand washing rules is unheard of at most U.S. hospitals.

In an essay introducing epiNewswire’s continuing coverage of Acinetobacter research news, I describe how this once-rare hospital infection, rates of which were declining until the late 1990s, emerged as a major new hospital infection starting in 2003, with wounded soldiers and contractors returning to hospitals in Germany, England and the U.S.

While the British military and researchers quickly identified cross-contamination between patients as a “particular problem,” U.S. military officials downplayed that risk.

Conversations with Walter Reed and Bethesda Naval Hospital workers convinced me several years ago that hand hygiene and Acinetobacter infection control to prevent cross-contamination were not being taken seriously.

That, combined with Acinetobacter’s superior ability to survive on environmental surfaces like doorknobs and clothing, has doubtlessly contributed to this infection’s rapid spread throughout U.S. and western European hospitals …and now, nursing homes… since 2003.

I’ve been speaking with family members and patients contending with Acinetobacter infections for several years, thanks largely to introductions made by Acinetobacter activist Marcie Hascall Clark.

I also observed this disturbing incident in 2008, at the VA long-term polytrauma unit in Tampa: a severely brain-injured Navy corpsman’s son was celebrating his third birthday party at the polytrauma unit with his mother, his essentially unconscious father, and the other patients and their family members. A bright red sign warned at both his door and the door one room down that strict infection control practices must be observed, and a nurse told meboth patients had drug-resistant Acinetobacter infections.

Nobody was wearing gloves or gowns. At one point, the little boy, who was sitting on his father’s lap, smeared cake on his daddy’s face and a nurse stepped into the other infection-control-notice patient’s room for a towel, which she used to clean up the corpsman’s face and then handed to his wife, who used it to clean her son’s face.

No hand hygiene or infection control practices were observed during my visit to that unit. And these were obviously dedicated, caring health care professionals.

The tragedy of oft-neglected “moderate” brain trauma was also on display that day, when a young soldier asked a man if he was the doctor and he said, “No, I’m your father.”