What is Carbapenem-resistant Acinetobacter baumannii (CRAB)?
Carbapenem-resistant Acinetobacter baumannii (CRAB), is an opportunistic pathogen primarily associated with hospital-acquired infections. Acinetobacterbaumannii can cause infections in the urinary tract, blood, lungs, and in wound. It can also live in a patient without causing infections or symptoms- this is especially common in open wounds and respiratory secretions.
According to the Centers for Disease Control and Prevention, CRAB is an urgent public health threat. In healthcare facilities, CRAB contaminates both the patient care environment and the hands of health care providers. The pathogen survives for long periods on dry surfaces and can be spread by asymptomatic people.
These factors make CRAB outbreaks in acute care hospitals quite difficult to control.
Carbapenem-resistant Acinetobacter baumannii and COVID-19
On May 28, 2020, an anonymous 500-bed New Jersey hospital reported a cluster of CRAB infections during a surge in patients hospitalized with coronavirus (COVID-19). This resulted in an investigation that identified 34 patients with hospital-acquired multidrug-resistant CRAB infection or colonization from February to July 2020. Twenty-one of those patients (62%) were admitted to intensive care units (ICUs).
In late March, 2020, COVID-19–related hospitalizations increased drastically, which led to shortages in personnel, disinfectant products, medical equipment and personal protective equipment (PPE). As a result, it was not possible for staff to follow conventional infection prevention and control practices.
However, in late May as COVID-19 hospitalizations decreased, the New Jersey hospital resumed normal operation and were able to follow standard infection prevention protocols. CRAB cases subsequently returned to pre–COVID-19 levels of 0-2 monthly cases.
The occurrence of this cluster highlights the possibility for any multidrug-resistant organism (MDRO) to spread during events, such as our current pandemic, where standard hospital practices might be disrupted. It is crucial that the infection control and PPE supply chain becomes more reliable, to relieve some of the pressure from hospital staff and help combat MDROs.