Carbapenem resistance in
            <i>Acinetobacter baumannii</i>
            , and their importance in hospital‐acquired infections: a scientific review

Nguyen, Marie; Joshi, Suresh G.

doi:10.1111/jam.15130

Cited by 113 publications

(103 citation statements)

References 107 publications

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“…3 ) harbouring multiple carbapenemase antibiotic resistance genes, noticeably bla NDM-1 , bla OXA-23 , bla OXA-58 and bla OXA-67 . CRAB have often been linked to hospital-acquired infections (HAI) [ 9 , 20 , 65 , 66 ] and have regularly been detected colonising abiotic hospital surfaces [ 67 ]. We also detected A. nosocomialis within the PW on thermometers and computer keyboards suggesting multiple carbapenem-resistant Acinetobacter species (CRAS) are present with potential to transmit within the wards.…”

Section: Discussionmentioning

confidence: 99%

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

Acolatse

Portal

Boostrom

et al. 2022

Antimicrob Resist Infect Control

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Background The burden of antibiotic resistant infection is mainly felt in low-to-middle income countries, where the rate of antimicrobial resistance is largely under-surveyed and under huge pressure from unregulated, disparate and often self-guided access to antimicrobials. Nosocomial infections from hospital environments have been shown to be a particularly prevalent source of multi-drug resistant strains, yet surveillance of hospital environmental contamination is often not investigated. Methods The study was prospective, observational and cross-sectional, sampling 231 high and low touch surfaces from 15th March to 13th April 2021, from five wards in the Cape Coast Teaching Hospital, Ghana. Microbial growth in the presence of vancomycin and either meropenem or cefotaxime was examined and bacterial species were identified by MALDI-TOF. The presence of common extended-spectrum β-lactamases (ESBL) and carbapenemase antimicrobial resistance genes (ARG) were identified through PCR screening, which were confirmed by phenotypic antimicrobial susceptibility determination. Isolates positive for carbapenem resistance genes were sequenced using a multi-platform approach. Results We recovered microbial growth from 99% of swabs (n = 229/231) plated on agar in the absence of antimicrobials. Multiple sites were found to be colonised with resistant bacteria throughout the hospital setting. Bacteria with multi-drug resistance and ARG of concern were isolated from high and low touch points with evidence of strain dissemination throughout the environment. A total of 21 differing species of bacteria carrying ARG were isolated. The high prevalence of Acinetobacter baumannii carrying blaNDM-1 observed was further characterised by whole genome sequencing and phylogenetic analysis to determine the relationship between resistant strains found in different wards. Conclusion Evidence of multiple clonal incursions of MDR bacteria of high sepsis risk were found in two separate wards for a regional hospital in Ghana. The prevalence of multiple blaNDM carrying species in combination with combinations of ESBLs was particularly concerning and unexpected in Africa. We also identify strains carrying tet(X3), blaVIM-5 or blaDIM-1 showing a high diversity of carbapenamases present as a reservoir in a hospital setting. Findings of multi-drug resistant bacteria from multiple environmental sites throughout the hospital will inform future IPC practices and aid research prioritisation for AMR in Ghana.

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Section: Discussionmentioning

confidence: 99%

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

Acolatse

Portal

Boostrom

et al. 2022

Antimicrob Resist Infect Control

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“…Knowing the mechanism by which resistance developed could be crucial in determining optimal infection control practices and new therapeutic options as the pandemic continues. The acquisition of resistance is known to be an important component of overall antimicrobial stewardship for HAIs in ICUs [40][41][42]. Coupled with investigating this, infection control efforts aimed at Acinetobacter spp.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

et al. 2021

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Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R2 = 0.980, p = 0.01) and carbapenems (R2 = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed.

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“…A. baumannii resistances appeared with three classes Multi drug resistance (MDR), Extensive drug resistance (XDR) and Pan Drug resistance (PDR). Of the total A. baumannii (41) isolates identified in this study, the percentage of (MDR) including ATCC and (XRD) isolates, was calculated and showed 40.48% and 52.38% compared with non-MDR 7.14 % and PDR as mentioned in figure (1). The obtained results were compared with the study conducted in Iraq/Erbil in 2020; it was observed that XDR agreed with that result to show the highest percentage of isolates were XDR (51.35%).…”

Section: Discussionmentioning

confidence: 93%

“…Acintobacter baumannii (A. baumannii ) is a non-fermenting coccobacilli; oxidase negative, aerobic bacilli and human opportunistic extracellular pathogen originating from hospital acquired infections to be known also as a nosocomial infection [1][2]. Most of A. baumannii bacteria were isolated from the patients of ICU who used mechanical ventilation and catheterization, which are considered risk factors that lead to biofilm formation in A. baumannii infection [3].…”

Section: Introductionmentioning

confidence: 99%

Isolation and Evaluation of Clinically Important Acinetobacter Baumannii From Intensive Care Unit Samples

MowfikSehree¹,

Abdullah

Jasim

2021

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Acinetobacter baumannii is considered a critical healthcare problem for patients in intensive care units due to its high ability to be multidrug-resistant to most commercially available antibiotics. The current study is at aimed at isolating and identifying the clinical isolates of A. baumannii from different samples and investigating the antibiotic resistance of isolates. Isolation and diagnosis of bacteria were achieved by conventional techniques, including routine and selective culture media (Chrome agar), biochemical test, EPI 20E, and VITEK-2. These methods were basically considered as a gold standard for identification of A. baumannii infections from different clinical sources, and culture positive isolates were tested for antibiotic susceptibility using a modified Kirby–Bauer method. A total of 375 clinical specimens were collected from different infections in some hospitals in Mosul and Erbil cities/Iraq from Sep 2020 to Jan 2021. Overall, 41 isolates were identified as A. baumannii using conventional and biochemical methods, and then confirmed by VITEK-2 system. Our results established that only 41(14.4%) isolates were diagnosed as A. baumannii, and most of these isolates were from burns (36.5%), surgical wounds (34.1%), and sputum (14.6%). However, it was identified in CSF, blood, and urine samples with lower percentages (7.3%, 4.8%, and 2.4%, respectively). The clinical isolates of A. baumannii showed high to moderate resistance to Piperacillin (97.5%), Piperacillin/ Tazobactam., Ceftazidime (87.8%), Meropenem (85.3%), Tri/slphamethoxazole (82.9%), Levofloxacin (80.4%), Imipenem, Ciprofloxacin (78%), Gentamycin (75.6%), Amikacin (73.1%), Netilmicin (68.2%), Tobramycin (60.9%) and Tetracycline (31.7%). However, two antimicrobial agents which were Colistin and Tigecycline produced 0 and 2.4 % resistance to A. baumannii respectively, which were considered the most used choices to treat A. baumannii infections. The current findings suggest that automated Vitek 2 system is the most common method to accurately detect the isolates and evaluate multi-drug resistant A. baumannii among patients.

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Carbapenem resistance in Acinetobacter baumannii , and their importance in hospital‐acquired infections: a scientific review

Cited by 113 publications

References 107 publications

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

Isolation and Evaluation of Clinically Important Acinetobacter Baumannii From Intensive Care Unit Samples

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