To ask the Secretary of State for Health what assessment she has made of the (a) impact and (b) spread of acinetobactor baumannii in hospitals; whether a new strain has been imported from Iraq; and if she will make a statement. (95324)

Microbiology laboratories in England, Wales and Northern Ireland voluntarily report bloodstream isolates of Acinetobacter species to the Health Protection Agency.

The numbers of A. baumannii bloodstream infections in England, Wales and Northern Ireland reported in the past five years are shown.

Part of the increase in cases of A. baumannii reflects the increase in the proportion of cases of acinetobacter bloodstream infections in which the organism has been fully identified to species level (51 per cent. in 2001, 62 per cent. in 2005). A. baumannii is one of the less difficult species to identify and both this and clinical concern have probably contributed to increased reporting.

Two multi-resistant clones of A. baumannii (Southeast clone, OXA-23 Clone 1) have affected hospitals in the United Kingdom in the past few years. Both clones have been identified in about 40 hospitals, predominantly in the London area and in south-east England^2,3.

The HPA has advised hospitals to implement urgently robust infection control measures to prevent spread of these clones, and is currently undertaking an analysis of outcomes, in order to identify optimum treatment for those patients who become infected⁴.

A multi-resistant strain of A. baumannii, known as the T strain, has been isolated from casualties returning to the United Kingdom from Iraq⁵ but the exact source has not been identified. The T strain has also been isolated from US casualties from Iraq and it is very similar to the Southeast clone.

¹ Acinetobacter spp bacteraemia in England, Wales, and Northern Ireland: 2001 to 2005 Communicable Disease Report (CDR) Weekly 2006; 16 (42) 19 October 2006.

² JF Turton, ME Kaufmann, M Warner et al. A prevalent, multiresistant clone of Acinetobacter baumanii in Southeast England. Journal of Hospital Infection 2004; 58: 170-179.

³ JM Coelho, JF Turton, ME Kaufman et al. Occurrence of carbapenem-resistant Acinetobacter baumanii clones at multiple hospitals in London and Southeast England. Journal of Clinical Microbiology 2006; 44: 3623-3627.

⁴ Working Party Guidance on the Control of multi-resistant Acinetobacter Outbreaks. www.hpa.org.uk/infections/topics_az/acinetobacter_b/guidance.htm.

⁵ JF Turton, ME Kaufmann, MJ Gill et al. Comparison of Acinetobacter baumanii isolates from the United Kingdom and the United States that were associated with repatriated casualties of the Iraq conflict. Journal of Clinical Microbiology 2006; 44: 2630-2634.