Acinetobacter baumanii and IPC guidelines

1. Assessment of Hospital Disinfectants and Antiseptics
Effectiveness on Emerging Carbapenem-Resistant
Acinetobacter baumannii Isolated from Hospital
Critical Devices and Clinical Samples at Muhimbili
National Hospital. Dar es Salaam, Tanzania.
INVESTIGATOR: Daniel Mwandu
SUPERVISOR: Dr. Joel Manyahi
16/05/2022

2. BACKGROUD
• Acinetobacter baumannii has emerged as a
significant multidrug-resistant (MDR) nosocomial
pathogen.
• Most of Multidrug-resistant A. baumannii has
developed resistance to most of the available
antibiotics including carbapenems, which are the
drugs of choice in the treatment of severe infections
[Yadav SK et al].

3. • carbapenem-resistant Acinetobacter baumannii, has
listed by WHO and CDC as one of the high priority
critical upcoming multidrug-resistant pathogen
bacteria which deserves close attention[WHO]
• A routinely used Antiseptics and disinfectants,
including alcohols, Lysol, phenols, povidone- iodine,
cetrimide and chlorine are very crucial on prevetion
and control of nosocomial infection. [ McDonnell G]

4. PROBLEM STATEMENT
• Despite adopting several strategies on IPC such use
of antiseptics and disinfectants.
• CRAB has emerged as a nosocomial pathogen
worldwide.
• This brings both health care costs and mortality
• However, there limited data on Effectiveness of
Hospital disinfectants and antiseptics against MDR-
Resistant Acinetobacter baumannii isolated from
hospital critical devices and clinical samples.

5. RATIONALE OF THE STUDY
• The finding from this study will establish the MIC,
MBC and killing time of Antiseptics and disinfectants
which will be useful at MNH.
• Also, the finding from this study will provide useful
information to the MoH and other stakeholders to
strengthen IPC strategies so as to fight against
nasocomia multidrug- resistant bacteria like CRAB.

6. RESEARCH QUESTIONS
• What is the magnitude of CRAB isolated from hospital
critical device and clinical samples
• What is the killing concentration and time of
disinfectants/antiseptics against carbapenem -Resistant
Acinetobacter baumanni
• What is MIC and MBC of antiseptics and disinfectants
(bleaching agents, povidone-iodine, cetrimide and
ethanol) against carbapenem-Resistant Acinetobacter
baumanni isolated from hospital critical device and
clinical samples?

7. OBJECTIVE
Broad objective
• To examine the susceptibility pattern of antiseptics and disinfectants
against carbapenem-Resistant Acinetobacter baumanni isolated from
hospital critical device and clinical samples
Specific objectives
• To assess the magnitude of carbapenem-Resistant Acinetobacter
baumanni isolated from hospital critical device and clinical samples
• To investigate the killing concentration and time for disinfectant/antiseptic
to carbapenem-Resistant Acinetobacter baumanni
• To determine MIC and MBC of disinfectants/antiseptics on carbapenem-
Resistant Acinetobacter baumanni

8. METHODOLOGY
Study design
• A laboratory-based, Quasi- experimental study will be
conducted at Muhimbili National Hospital (MNH)
between March and August 2024
Study population:
• Will be Acinetobacter baumanni isolated from hospital
critical devices and clinical samples at MNH
Sample size:
• The study will include 100 isolates from Hospital critical
devices and 40 from clinical samples.

9. Laboratory procedures:
• For Carbapenemases Production detection , the
double-disk synergy test (DDST) by disc diffusion
agar methods (Kirby Bauer method) will be used
in Accordance to CLSI guideline by Anwar et al.
• To Determine of MIC and MBC for
disinfectants/antiseptics will be done by using
broth macro-dilution suspension tests followed
by a serial of experimental tests, the
susceptibility cutoff of bleaching agents,
povidone-iodine, cetrimide and ethanol

10. Reference
• Yadav SK et al: Burden of Multidrug-Resistant Acinetobacter baumannii
Infection in Hospitalized Patients in a Tertiary Care Hospital of Nepal:
Infect Drug Resist. 2020; 13: 725–732.Published online 2020 Mar
3. doi: 10.2147/IDR.S239514
• WHO publishes list of bacteria for which new antibiotics are urgently
needed 27 February 2017.
• McDonnell G et al: Antiseptics and Disinfectants: Activity, Action, and
Resistance
• Anwar et al: Expressed and Silent Carbapenemase Genes Detected by
Multiplex PCR in both Carbapenem- Resistant and Phenotypically-
Susceptible Gram Negative Bacilli,2020
• CDC: Chemical Disinfectants
• Urška Rozman et al:Hygiene of Medical Devices and Minimum Inhibitory
Concentrations for Alcohol-Based and QAC Disinfectants among Isolates
from Physical Therapy Departments. Public Health 2022, 19,14690.
https://doi.org/10.3390/ijerph192214690