Acinetobacter baumannii Infections in a Tertiary Care Hospital in Mexico over the Past 13 Years

Abstract

Background:Acinetobacter baumannii has evolved from an opportunistic pathogen into a common and persistent nosocomial bacterium capable of causing severe infections during endemic and epidemic periods. Methods: The study period extended from January 1999 to December 2011 and involved patients hospitalized at the Hospital Civil de Guadalajara, Fray Antonio Alcalde, Jalisco, Mexico. From each patient, a single isolate was obtained, and a total of 3,680 unique isolates were collected. Susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. Results:A. baumannii has disseminated throughout the Hospital Civil de Guadalajara, Fray Antonio Alcalde, since 1999. A. baumannii isolates obtained from patients treated in the adult intensive care unit represent the majority of the isolates that have been collected. In addition, A. baumannii was isolated from the adult neurosurgical ward and the adult internal medicine ward, and these isolates were frequently obtained from secretions. A persistent decrease in the susceptibility of A. baumannii isolates to meropenem (92% in 1999 to 12% in 2011), imipenem and amikacin has been observed. Conclusions:A. baumannii became an endemic nosocomial pathogen during the study period at the Hospital Civil de Guadalajara, Fray Antonio Alcalde, and has exhibited a persistent decrease in susceptibility to all categories of antimicrobial agents over the past 13 years.

Efficacy of Sulbactam and Its Combination with Imipenem, Colistin and Tigecycline in an Experimental Model of Carbapenem-Resistant <b><i>Acinetobacter baumannii</i></b> Sepsis

“…However, carbapenem-resistant isolates have been increasing worldwide [2,12,13,14,15]. In recent years, carbapenem resistance rates were reported to be over 50% [16,17,18,19,20,21], and in our last study it was found to be 92% in intensive care units [18]. Carbapenem-resistant A. baumannii poses a significant threat in hospitals, as therapeutic options are limited.…”

The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia

“…This study showed that the A. baumanii isolates were mostly multi-drug resistant, and 55.6% of these were carbapenem-resistant. Recent studies from various countries also showed that rates of carbapenem-resistant A. baumanii (CRAB) varied from 55% to 88% and increased particularly in association with neurosurgical infection [5,17,18]. The high incidence of CRAB is a great concern in terms of nosocomial infection and it had been associated with serious therapeutic problem [5,17].…”

La evolución de la resistencia bacteriana en México, 1973-2013

“…Se analizaron 3.680 aislamientos y se encontró que la diseminación se inició en una unidad de cuidados intensivos de pacientes adultos. Se observó que la sensibilidad a meropenem disminuyó entre 1999 y 2012 (de 92 a 12 %), y que diferentes clones de A. baumannii producían VIM-4, IMP-1 y OXA-24; el microorganismo se aisló más frecuentemente en secreciones y afectó a pacientes que por la gravedad de su cuadro de ingreso (neurocirugía, medicina interna) fueron estabilizados primero en la unidad de cuidados intensivos para después ser trasladados a los servicios hospitalarios del caso (50,51).…”

“…Gracias a las contribuciones mencionadas, en nuestro país hemos identificado las tendencias de resistencia, así como la epidemiologia hospitalaria, el tipo de bacterias implicadas y su evolución (51,72).…”