Dissemination of <i>Acinetobacter baumannii</i> OXA-23 in old and new intensive care units without transfer of colonized patients

Moreira, Rafael Renato Brondani; Viana, Giselle Fukita; Moraes, Amanda Carina Coelho de; Bastos, Marina de Souza; Nishiyama, Sheila Alexandra Belini; Anjos, Márcia Maria dos; Cardoso, Celso Luíz; Tognim, Maria Cristina Bronharo

doi:10.1017/ice.2018.168

Cited by 6 publications

(5 citation statements)

References 9 publications

(28 reference statements)

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“…Two studies involved different Brazilian regions (9.5 %) [38,39]. The prospective design (9/21; 42.8 %) [13,23,25,27,29,36,37,40,41] was more common than retrospective (5/21; 23.8 %) [31,32,34,38,39]. Five case reports were also included (5/21; 23.8 %) [11,24,26,30,33].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the states where the studies were conducted, the most frequent were Parana [13,33,34] and Minas Gerais [27,29,35], each with 3 studies (3/21; 14.3 %). The state of Paraná was where the first CRAB outbreak occurred in two different hospitals, making this a "model state" to study the resistance dynamics of this XDR bacterium in Brazil (Anvisa, 2013).…”

Section: Resultsmentioning

confidence: 99%

“…Among the different carbapenemase types, the OXAs play an important role in the resistance of A. baumannii isolates to carbapenems, and has been reported in several countries as the main determinant of resistance [11]. It has been described in different families in this species: intrinsic, chromosomally located and also found in plasmid OXA-51-likes (Neves et al, 2016); and the acquired OXA-23-like, OXA-40-like (formally OXA-24-like), OXA-58-like, OXA-143-like, and OXA-235like [12,13]. The presence of insertion sequences (IS) immediately upstream of bla OXA genes is known to induce the overexpression of OXA-51, OXA-23, or OXA-58, and to generate carbapenem resistance at a high level in A. baumannii.…”

Section: Introductionmentioning

confidence: 99%

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Mechanisms involved in resistance to carbapenems among Acinetobacter baumannii isolates recovered in Brazil: A systematic review and meta-analysis

Pieve de Castro,

Gustavo de Lima,

Sanches

et al. 2022

Rev. Colomb. Cienc. Quím. Farm.

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Introduction: Infections caused by carbapenem-resistant Acinetobacter baumannii(CRAB) is a health problem due to the limited therapeutic options available. This study was carried out to evaluate the main mechanisms of resistance of carbapenems in CRAB in the last 10 years in Brazil and to describe the susceptibility profile to tigecycline and polymyxins in these isolates. Material and methods: A systematic review was carried out according to Prisma in PUBMED/MEDLINE, Scopus, SciELO, Biblioteca Virtual de Saúde (BVS) and Cochrane Library. Data regarding enzyme resistance to carbapenems were evaluated by meta-analysis according to the random effect. Results: 21 articles were selected according to inclusion and exclu-sion criteria that evaluated 1096 CRAB. Most of the studies were carried out in the southern (33.3 %) and southeast (23.8 %) regions of Brazil (33.3 %) and in 2016 and 2018. According to the meta-analyzes, OXA-type carbapenemase was the main mechanism involved in the low susceptibility to carbapenems in CRAB (98%; 95% CI: 0.91, 0.99; I² = 95%), with blaOXA-23-like(91 %; 95 % CI: 0.76; 0.97; I² = 97 %) or blaOXA-51-like/ ISAba1 (84 %; 95 % CI: 0.15, 0.99; I² = 98 %) genes, followed by metallo-β-lactamases (MBL) (12 %, 95 % CI: 0.09, 0.15, I² = 99 %) and Klebsiella pneumoniae carbapenemase (KPC) (6 %, 95 % CI: 0.04; 0.08; I² = 87 %). Conclu-sion: The included studies showed that susceptibility to colistin (99 %) and tigecy-cline (93 %) remains high and was not affected by carbapenem resistance.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mechanisms involved in resistance to carbapenems among Acinetobacter baumannii isolates recovered in Brazil: A systematic review and meta-analysis

Pieve de Castro,

Gustavo de Lima,

Sanches

et al. 2022

Rev. Colomb. Cienc. Quím. Farm.

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“…Our study suggests that the risk factors associated with A. baumannii infection that may influence both the rates of resistance and spread in the ICU includes: having comorbidities, undergoing invasive procedures, prolonged hospitalization, previous exposure to many classes of antimicrobials and old age [ 12 , 21 ]. A study carried out in several countries also linked these risk factors to a higher prevalence of infections and colonization of A. baumannii in the ICUs; moreover, seasonality was cited as a considerable risk factor in warmer seasons [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Genetic, antimicrobial resistance profile and mortality rates of Acinetobacter baumannii infection in Brazil: A systematic review

Silva

Werlang

Vandresen

et al. 2022

Narra J

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The increase of multidrug-resistant bacteria - including Acinetobacter baumannii (A. baumannii) - has been reported globally. The aim of this systematic review was to determine the risk factors of A. baumannii infection, its resistance profile, reservoirs and mortality rates in Brazil. Data from over 3,000 patients were included. Results suggested that A. baumannii is widely transmitted in Brazil and the endemic clones ST1, ST15, ST 25, ST79, ST162 and ST730 were the most reported; also, blaOXA23, blaOXA51 and blaOXA143 were common resistant genes. The risk factors for A. baumannii infectionincluded the procedure of using invasive devices, previous antibiotic therapy, hemodialysis, comorbidities and higher scores on the Sequential Organ Failure Assessment (SOFA). Two out of five studies identified multidrug resistant A. baumannii to polymyxin. Mortality rates varied between 43.7% to 81%, except for the ST25 strain in which there was a 100% mortality rate. Mortality was associated with sepsis, respiratory infection, septic shock, old age (>60 years) and administration of norepinephrine. Nonetheless, this review highlights the need for more data on A. baumannii infectionacross Brazil to support public policies aiming to control and prevent the dissemination of this bacteria.

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“…Persistent environmental contamination and HCW infection may be possible sources of carbapenem-resistance in both Klebsiella pneumoniae and Acinetobacter baumannii . 10 , 11 Several studies have shown the genetically similarity between strains isolated from the patients, HCWs, and the environment. 5 , 11 However, the origin of transmission between patient, HCW, and environment remains unknown, and thus should be elucidated in the future.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Surveillance and Sampling Reveal Carbapenem-Resistant Organism Spreading in Tertiary Hospitals in China

Zhang¹,

Yu²,

Chen³

et al. 2022

IDR

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Purpose Carbapenem-resistant organisms (CROs) have posed a great threat to antibiotic use and induce multi-drug resistance. Contamination of the hospital environment and infection of healthcare workers (HCWs) are reported as sources of nosocomial infections. Here, we performed a comprehensive environment sampling and timely epidemiological investigation during outbreaks to investigate the role of the environment and HCWs in CRO transmission. Patients and Methods We enrolled carbapenem-resistant organism outbreaks in ICU-1 of Huashan Hospital from January 2019 to March 2019, and ICU-2 located at west branch of Huashan Hospital from October 2019 to November 2019. Carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Acinetobacter baumannii (CRAB) isolates were collected from the patients. We performed a real-time comprehensive environmental and HCW sampling in the two ICUs. Isolated strains from patients and the positive colonies from the screening were sent for whole-genome sequencing. Finally, phylogenetic trees were constructed. Results CRAB and CRKP outbreaks simultaneously occurred in ICU-1; the outbreak involved 13 patients. Meanwhile, the CRKP outbreak in ICU-2 included 11 patients. Twelve out of 146 environment and HCWs samples in ICU-1 were carbapenem-resistant bacteria, including six CRKP and six CRAB strains. For ICU-2, hospital surfaces and HCWs were negative for CRKP. Phylogenetic analyses showed that CRKP strains in ICU-1 were classified into two clades: Clade 1 and Clade 2, sharing a high similarity of isolates from the environment and HCWs. The same phenomenon was observed in CRAB. Conclusion A timely comprehensive sampling combined with genome-based investigation may aid in tracking the transmission route of and controlling the infections. The environment and HCWs could be contaminated during CRO transmission, which calls for strengthened prevention and control measures.

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Dissemination of Acinetobacter baumannii OXA-23 in old and new intensive care units without transfer of colonized patients

Abstract: Molecular heterogeneity of Acinetobacter baumannii isolates during seasonal increase in prevalence.

Cited by 6 publications

References 9 publications

Mechanisms involved in resistance to carbapenems among Acinetobacter baumannii isolates recovered in Brazil: A systematic review and meta-analysis

Mechanisms involved in resistance to carbapenems among Acinetobacter baumannii isolates recovered in Brazil: A systematic review and meta-analysis

Genetic, antimicrobial resistance profile and mortality rates of Acinetobacter baumannii infection in Brazil: A systematic review

Comprehensive Surveillance and Sampling Reveal Carbapenem-Resistant Organism Spreading in Tertiary Hospitals in China

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