The application of root cause analysis management in multidrug resistant Acinetobacter baumannii infection in ICU ward

Objective To apply root cause analysis management in multidrug resistant Acinetobacter baumannii infection in ICU ward. Methods Six patients infected with multi-drug resistant Acinetobacter baumannii in ICU ward of our hospital were selected as the study object in February 2018. The instrument and equipment in ICU ward, the surface of bed unit, the diagnosis and treatment instrument, the sanitary ware, hands of medical staff and so on, were sampled. The root cause analysis method was used to find the source of infection and the route of transmission. The root causes of the outbreak of multi-drug resistant Acinetobacter baumannii were summarized and analyzed, and the intervention measures were taken. Results A total of 48 ICU environmental specimens were collected from 6 patients, of which 30 samples were positive showed by etiological examination, and the isolated strains were basically consistent with their drug resistance results (resistance to more than three types of antibiotics). It was inferred that the nosocomial infection of Acinetobacter baumannii in this outbreak was caused by the same pathogen contamination. At the same time, the detection results of Acinetobacter baumannii in ICU environment showed that the contamination of bed units and most of the surface of objects in the ward (the detection rate was 66%-75%), the disinfection and isolation measures not in place, and the non-standard hand hygiene of the staff were the main causes of the outbreak of nosocomial infection. Conclusions The main causes of the spread of multi-drug resistant Acinetobacter baumannii infection of ICU were found by root cause analysis, and the standard manual hygiene and contact isolation standards should be formulated and strictly implemented. It is an effective way to reduce the incidence of nosocomial infection of MDRAB by disinfection and sterilization measures on the surface of objects and the environment in the ward. There were no cases of multidrug resistant Acinetobacter baumannii infection in April 2018. Key words: Root cause analysis; ICU; Multidrug resistance; Acinetobacter baumannii; Nosocomial infection