Carbapenem Resistant Acinetobacter Baumanii Versus MRSA Isolates in ICU in Clinical Center Skopje

Abstract

Abstract:Backgorund: Acinetobacter baumannii is often referred to as the "Gram-negative methicillin-resistant Staphylococcus aureus", because it is frequently resistant to antibiotics. Clonal outbreaks of carbapenem-resistant and OXA-23-producing A. baumannii have been reported worldwide. Aim: The goal of this study was to promote the phenomenon of disbalance in endemic hospital ECO system which included increase of carbapenemase-resistant Acinetobacter baumanii on account of reduction of MRSA rate in surgical ICU and it's clonal relatedness as well as the specific precautions. Material nad Methods: Computer database from 1994 -2012 from surgical ICU patients in the Clinical Center Skopje was used as basic material for this study. Comparative study indicated 2007/8 as a break point period in which almost a twofold decrease of MRSA rates (from over 80% to 45%) versus increased rates of Acinetobacter baumanii (from 29% to 40%) was observed. In 2011 the very first eight strains of carbapenem resistant (resistant to imipenem and meropenem) A. baumannii, were observed. Disc diffusion and VITEK were used for antibiotic susceptibility testing. Resultes: Three distinct strains were detected by PFEGE and were designated as UKIM01AC-1 (5 strains), UKIM01AC-2 (two strains) and 642/2 (one strain). UKIM01AC-1 representatives were PCR positive for bla , in addition to the bla (OXA-51-like) gene which is intrinsic in Acinetobacter baumannii. All isolated strains belonged to European clone II lineage. Conclusion: This clone dispersed very fast in 2012 and achieved the rate of 61.9%. This implicated changes in infection control precautions.