Principles of investigation of an outbreak of a multi-drug resistant infection – role of AMS

In this video, Dr Souha Khanj discusses what an outbreak investigation is and the role of AMS.

She covers what an outbreak is, how it is assessed, the challenges of an outbreak and the components of an investigation.

The example of the Acinetobacter multi-drug resistant outbreak highlights the need for an efficient and rapid outbreak investigation procedure. The hospital was able to quickly:

• Establish the existence of an outbreak

• Verify the diagnosis

• Give it a case definition

• Review all patients that were infected by:

  • Looking at common sources

  • Taking environmental cultures

  • Looking at operating room procedures

  • Identifying diagnostic tests patients had received

  • Identify the antibiotics they had received

They were able to efficiently develop a hypothesis, identify a source, mode of transmission and predisposing factors. The intervention was multidisciplinary, with the AMS team playing a big role in the intervention. Rapid reporting of the MDR pathogen from the microbiology lab to the AMS team was vital in containing the outbreak.

Discuss the following in the comments below:

• Have you ever had an outbreak of resistant bacteria in your institution?

• Was an investigation done and if so were all of the key components carried out?