Acinetobacter baumannii resistente a carbapenémicos causando osteomielitis e infecciones en piel y tejidos blandos en hospitales de Medellín, Colombia

Vanegas, Johanna M.; Higuita, L.F.; Vargas, Carlos A.; Cienfuegos-Gallet, Astrid V.; Rodríguez, Erika A.; Roncancio, Gustavo; Jiménez, J. Natalia

doi:10.7705/biomedica.v35i4.2572

Cited by 19 publications

(12 citation statements)

References 27 publications

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“…This MLST has been identified previously in Mexican hospitals and in other countries of Latin America [17][18][19]. The MLST758 is an understudied lineage that does not belong to the international clones I and II; it has spread to Canada, Mexico, Honduras, and Colombia.…”

Section: Plos Onementioning

confidence: 71%

High mortality in an outbreak of multidrug resistant Acinetobacter baumannii infection introduced to an oncological hospital by a patient transferred from a general hospital

et al. 2020

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Objective To describe the clinical features, outcomes, and molecular epidemiology of an outbreak of multidrug resistant (MDR) A. baumannii. Methods We performed a retrospective analysis of all MDR A. baumannii isolates recovered during an outbreak from 2011 to 2015 in a tertiary care cancer hospital. Cases were classified as colonized or infected. We determined sequence types following the Bartual scheme and plasmid profiles. Results There were 106 strains of A. baumannii isolated during the study period. Sixty-six (62.3%) were considered as infection and 40 (37.7%) as colonization. The index case, identified by molecular epidemiology, was a patient with a drain transferred from a hospital outside Mexico City. Ninety-eight additional cases had the same MultiLocus Sequence Typing (MLST) 758, of which 94 also had the same plasmid profile, two had an extra plasmid, and two had a different plasmid. The remaining seven isolates belonged to different MLSTs. Fifty-three patients (50%) died within 30 days of A. baumanniii isolation: 28 (20%) in colonized and 45 (68.2%) in those classified as infection (p<0.001). In multivariate regression analysis, clinical infection and patients with hematologic neoplasm, predicted 30-day mortality. The molecular epidemiology of this outbreak showed the threat posed by the introduction of MDR strains from other institutions in a hospital of immunosuppressed patients and

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Section: Plos Onementioning

confidence: 71%

High mortality in an outbreak of multidrug resistant Acinetobacter baumannii infection introduced to an oncological hospital by a patient transferred from a general hospital

et al. 2020

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“…2). According to the PubMLST database, several studies have reported isolates from this ST in Canada (24), Mexico and Honduras (19,23), and even Colombia (25). Of note, ST758 and ST1091 correspond to ST156 under the MLST Pasteur scheme.…”

Section: Resultsmentioning

confidence: 99%

“…Of note, ST758 and ST1091 correspond to ST156 under the MLST Pasteur scheme. Then, given that previous publications considering Latin American isolates (20,25,26) have used the MLST Pasteur scheme, we constructed an eBURST diagram using the Pasteur scheme, and a partial view highlighting ST156 is shown in Fig. 2.…”

Section: Resultsmentioning

confidence: 99%

Origin of OXA-23 Variant OXA-239 from a Recently Emerged Lineage of Acinetobacter baumannii International Clone V

Graña-Miraglia

Evans

López‐Jácome

et al. 2020

mSphere

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Over the last few decades, carbapenemase-producing Acinetobacter baumannii has become a major cause of nosocomial infections all over the world. However, the genome identity of lineages of this species in Latin America has not been studied as much as in developed countries. Here, through a population genomics approach considering the whole genomes of 148 isolates (almost 40 from Mexico and Honduras), we describe the recent emergence of the lineage sequence type 758 (ST758), which belongs to the international clone V and has spread out to Canada, Mexico, Honduras, and Colombia. Notably, this lineage was found to coexist with other A. baumannii lineages in hospitals in Mexico and Honduras. Isolates from this lineage show considerable variation in antibiotic resistance profiles, but most of them are resistant to carbapenems. Moreover, we found a variety of acquired oxacillinase (OXA) families within this lineage and tracked the very recent inception, and subsequent horizontal transmission, of the OXA-239 carbapenemase. This work highlights the urgent need to investigate recently emerged lineages of this species in Latin America and elsewhere, as these might harbor novel antibiotic resistance genes. IMPORTANCE A. baumannii is a major cause of nosocomial infections all over the world. Although many isolates from developed countries have been studied in terms of their genome sequence, isolates from Latin America have been much less studied. In this study, using a population genomics approach considering the whole genomes of 148 isolates, we describe the recent emergence of the lineage ST758 endemic to Latin America and the inception of the OXA-239 carbapenemase. Our study highlights the urgent need to investigate recently emerged lineages of this species in Latin America and elsewhere, as these might harbor novel antibiotic resistance genes.

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“…Recent studies have shown a decrease in the frequency of resistant A. baumannii isolates in comparison with other multidrug-resistant Gram-negative bacilli causing infection in Colombia and particularly in Medellín [21, 49]. Likewise, a surveillance study conducted by our research group in five hospitals of Medellin, included only 32 carbapenem-resistant isolates during two years of study, showing the low frequency of this bacteria in our city [50]. …”

Section: Discussionmentioning

confidence: 85%

Molecular epidemiology of carbapenem resistant gram-negative bacilli from infected pediatric population in tertiary - care hospitals in Medellín, Colombia: an increasing problem

2016

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BackgroundGram-negative bacilli are a cause of serious infections in the pediatric population. Carbapenem are the treatment of choice for infections caused by multidrug-resistant Gram-negative bacilli, but the emergence of carbapenem resistance has substantially reduced access to effective antimicrobial regimens. Children are a population vulnerable to bacterial infections and the emergence of resistance can worsen prognosis. The aim of this study is to describe the clinical and molecular characteristics of infections caused by carbapenem-resistant Gram-negative bacilli in pediatric patients from five tertiary-care hospitals in Medellín, Colombia.MethodsA cross-sectional study was conducted in five tertiary-care hospitals from June 2012 to June 2014. All pediatric patients infected by carbapenem-resistant Gram-negative bacilli were included. Clinical information for each patient was obtained from medical records. Molecular analyses included PCR for detection of blaVIM, blaIMPblaNDM,blaOXA-48 and blaKPC genes and PFGE and MLST for molecular typing.ResultsA total of 59 patients were enrolled, most of them less than 1 year old (40.7 % n = 24), with a previous history of antibiotic use (94.9 %; n = 56) and healthcare-associated infections - predominately urinary tract infections (31.0 %; n = 18). Klebsiella pneumoniae was the most frequent bacteria (47.4 %), followed by Enterobacter cloacae (40.7 %) and Pseudomonas aeruginosa (11.9 %). For K. pneumoniae, KPC was the predominant resistance mechanism (85.7 %; n = 24) and ST14 was the most common clone (39.3 % n = 11), which included strains closely related by PFGE. In contrast, E. cloacae and P. aeruginosa were prevailing non-carbapenemase-producing isolates (only KPC and VIM were detected in 1 and 3 isolates, respectively) and high genetic diversity according to PFGE and MLST was found in the majority of the cases.ConclusionsIn recent years, increasing carbapenem-resistant bacilli in children has become in a matter of great concern. It is important to conduct systemic surveillance and take measures to prevent dissemination of multidrug-resistant bacteria.

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Acinetobacter baumannii resistente a carbapenémicos causando osteomielitis e infecciones en piel y tejidos blandos en hospitales de Medellín, Colombia

Cited by 19 publications

References 27 publications

High mortality in an outbreak of multidrug resistant Acinetobacter baumannii infection introduced to an oncological hospital by a patient transferred from a general hospital

High mortality in an outbreak of multidrug resistant Acinetobacter baumannii infection introduced to an oncological hospital by a patient transferred from a general hospital

Origin of OXA-23 Variant OXA-239 from a Recently Emerged Lineage of Acinetobacter baumannii International Clone V

Molecular epidemiology of carbapenem resistant gram-negative bacilli from infected pediatric population in tertiary - care hospitals in Medellín, Colombia: an increasing problem

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