RELEVANCE OF DIGESTIVE-TRACT COLONIZATION IN THE EPIDEMIOLOGY OF NOSOCOMIAL INFECTIONS DUE TO MULTIRESISTANT ACINETOBACTER-BAUMANNII

Fecal colonization with multiresistant Acinetobacter baumannii was eva luated in 189 consecutive patients in intensive care units (ICUs) duri ng two different 2-month periods (October-November 1993 and May-June 1 994). Rectal swabs were obtained weekly from admission to discharge fr om the ICU. Overall, 77 patients (41%) had multiresistant A. baumannii fecal colonization; colonization was detected in 55 (71%) of the pati ents within the first week of their ICU stay, Clinical infections due to multiresistant A. baumannii occurred more frequently in patients wi th fecal colonization than in those without fecal colonization (26% vs , 5%, respectively; P < .001). The reinforcement of isolation measures between study periods reduced both the number of fecal carriers of mu ltiresistant A. baumannii (from 52% to 31%; P < .01) and the number of patients with multiresistant A. baumannii infections (from 17% to 11% ; no statistical significance), The digestive tract of ICU patients co uld be an important epidemiologic reservoir for multiresistant A. baum annii infections in hospital outbreaks, Further prospective studies sh ould be undertaken to define the relative significance of digestive tr act colonization compared with other body site colonizations.