Carbapenem-resistant<i>Acinetobacter baumannii</i>: diversity of resistant mechanisms and risk factors for infection

Kim, Y. J.; Kim, S. I.; Kim, Y. R.; Hong, Kyung-Soon; Wie, Seong Heon; Park, Y. J.; Jeong, Heekyoung; Kang, Moon Won

doi:10.1017/s0950268811000744

Cited by 54 publications

(29 citation statements)

References 32 publications

(52 reference statements)

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“…(17,(20)(21)(22) In this study, through discriminant canonical function coefficients of resistant micro- did not lead to the occurrence of a particular microorganism, suggesting that the selection promoted by the use of broad-spectrum antimicrobials is homogeneous, regardless of resistance mechanism. Multiple predisposing factors have been linked to emergence and spread of resistant microorganisms, such as declining age, length of hospital stay, severity of underlying disease, enteral feeding, transfers between units and hospitals, surgeries, exposure to invasive procedures and use of antibiotics.…”

Section: Discussionmentioning

confidence: 53%

Infecção ou colonização por micro-organismos resistentes: identificação de preditores

et al. 2013

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Objective: Identifying predictors of infection or colonization with resistant microorganisms. Methods: A quantitative study of prospective cohort was carried out. A descriptive analysis was performed in order to know the population of the study and a discriminant analysis was performed to identify the predictors. Results: In this study were included 85 patients with infections caused by resistant microorganisms: carbapenem-resistant Pseudomonas aeruginosas (24.7%); carbapenem-resistant Acinetobacter (21.2%); methicillin-resistant Staphylococcus aureus (25.9%), vancomycin-resistant Enterococcus spp (17.6%) and carbapenem-resistant Klebsiella pneumonia (10.6%). The discriminant analysis identified transfers from other hospitals and hospitalization in intensive care unit as predictors for the occurrence of infections by the following groups: S. aureus resistant to methicillin, Acinetobacter resistant to carbapenems and K. pneumoniae resistant to carbapenems. None of the studied variables was discriminant for vancomycin-resistant Enterococcus spp. and carbapenem-resistant P. aeruginosas. Conclusion: The predictors found were: ICU hospitalization and transfers from other hospitals. ResumoObjetivo: Identificar os fatores preditores de infecção ou colonização por micro-organismos resistentes. Métodos: Foi realizado estudo quantitativo de coorte prospectivo. Foram realizadas a análise descritiva, para conhecimento da população do estudo, e a análise discriminante, para identificação dos fatores preditores. Resultados: Foram incluídos 85 pacientes com infecções por micro-organismos resistentes: Pseudomonas aeruginosas resistente aos carbapenêmicos (24,7%), Acinetobacter resistente aos carbapenêmicos (21,2%), Staphylococcus aureus resistente à meticilina (25,9%), Enterococcus spp. resistente à vancomicina (17,6%) e Klebsiella pneumoniae resistente aos carbapenêmicos (10,6%). A análise discriminante identificou transferências de outros hospitais e internação na Unidade de Terapia Intensiva como fatores preditores para ocorrência de infecção pelos grupos S. aureus resistente à meticilina, Acinetobacter resistente aos carbapenêmicos e K. pneumoniae resistente aos carbapenêmicos. Nenhuma das variáveis estudadas foi discriminante para Enterococcus spp. resistente à vancomicina e P. aeruginosas resistente aos carbapenêmico. Conclusão: Os fatores preditores encontrados foram: internação na UTI e a transferências de outros hospitais.

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Section: Discussionmentioning

confidence: 53%

Infecção ou colonização por micro-organismos resistentes: identificação de preditores

et al. 2013

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“…For 108 CRAB isolates, genes encoding oxacillinase (OXA) carbapenemases, such as bla OXA-23-like , bla OXA-24-like , bla OXA-51-like , and bla OXA-58-like , were identified as previously described (20). The presence of ISAba1 upstream of the bla genes was investigated by PCR, as described previously (21,22). In addition, bla IMP and bla VIM were also tested by PCR as previously described (22).…”

Section: Methodsmentioning

confidence: 99%

Spread of Carbapenem-Resistant Acinetobacter baumannii Global Clone 2 in Asia and AbaR-Type Resistance Islands

Kim

Choi

Kim

et al. 2013

Antimicrob Agents Chemother

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In this surveillance study, we identified the genotypes, carbapenem resistance determinants, and structural variations of AbaRtype resistance islands among carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from nine Asian locales. Clonal complex 92 (CC92), corresponding to global clone 2 (GC2), was the most prevalent in most Asian locales (83/108 isolates; 76.9%). CC108, or GC1, was a predominant clone in India. OXA-23 oxacillinase was detected in CRAB isolates from most Asian locales except Taiwan. bla OXA-24 was found in CRAB isolates from Taiwan. AbaR4-type resistance islands, which were divided into six subtypes, were identified in most CRAB isolates investigated. Five isolates from India, Malaysia, Singapore, and Hong Kong contained AbaR3-type resistance islands. Of these, three isolates harbored both AbaR3-and AbaR4-type resistance islands simultaneously. In this study, GC2 was revealed as a prevalent clone in most Asian locales, with the AbaR4-type resistance island predominant, with diverse variants. The significance of this study lies in identifying the spread of global clones of carbapenemresistant A. baumannii in Asia.

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“…Resistance to carbapenems in A. baumannii may be due to various mechanisms, including the loss of outer membrane protein (OMP), overexpression of efflux pumps, or through alterations in the penicillin-binding protein (3). An increase in reported carbapenem resistance by A. baumannii isolates, however, has been mostly attributed to yet another mechanism, the production of carbapenemases, such as those belonging to the class D OXA type (4).…”

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confidence: 99%

High Frequency of OXA-253-Producing Acinetobacter baumannii in Different Hospitals in Recife, Brazil

Cavalcanti

Mendes-Marques

Vasconcelos

et al. 2017

Antimicrob Agents Chemother

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Here, we report the isolation of 31 Acinetobacter baumannii strains producing OXA-253 in a single large Brazilian city. These strains belonged to five different sequence types (STs), including 4 STs not previously associated with bla . In all strains, the bla OXA-253 gene was located in a plasmid within a genetic environment similar to what was found previously in Brazil and Italy. The reported data emphasize the successful transmission of the bla OXA-253 gene through a large area and the tendency for this resistance determinant to remain in the A. baumannii population.KEYWORDS Acinetobacter, MLST, antibiotic resistance, genome analysis, oxacillinase A cinetobacter baumannii is an opportunistic Gram-negative pathogen responsible for a large number of outbreaks of hospital-acquired infections. This bacterium has been linked with serious infections affecting mainly debilitated patients in intensive care units (1), and it can become resistant to a wide range of antibiotics, leading to serious impediments to treatment. Carbapenems, such as imipenem and meropenem, have been often used as drugs of last resort, but outbreaks of carbapenem-resistant A. baumannii have been reported in several countries, including Brazil (2).Resistance to carbapenems in A. baumannii may be due to various mechanisms, including the loss of outer membrane protein (OMP), overexpression of efflux pumps, or through alterations in the penicillin-binding protein (3). An increase in reported carbapenem resistance by A. baumannii isolates, however, has been mostly attributed to yet another mechanism, the production of carbapenemases, such as those belonging to the class D OXA type (4).Here, we report OXA-253-producing A. baumannii strains isolated from different hospitals localized within the city of Recife, state of Pernambuco, in northeastern Brazil. This variant of the OXA-143-like carbapenemase belongs to the Ambler class D of ␤-lactamases (5), which has previously been the subject of studies discussing its incidence in Brazil. So far, however, the bla OXA-143 gene has only been reported for samples from the states of São Paulo and Rio de Janeiro, over 1,800 km to the south of Recife (2, 6-8).Identification of the OXA-253-producing strains occurred after sequencing of the genomes of 45 A. baumannii strains displaying an extensively drug-resistant (XDR) phenotype and isolated from different individuals hospitalized in five public hospitals in Recife between 2010 and 2014. These strains were considered resistant to the two carbapenems tested (imipenem and meropenem) according to the Brazilian Committee on Antimicrobial Susceptibility Testing (BrCAST) guidelines, using the broth microdilution method. A detailed report of the whole-genomic data analysis, in the context of resistance and virulence characteristics, will be provided in future publications. Analysis of the sequencing data led to identification in 31 strains of the recently described class D ␤-lactamase bla OXA-253 (9). According to a multilocus sequence typing (MLST) analysis...

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Carbapenem-resistantAcinetobacter baumannii: diversity of resistant mechanisms and risk factors for infection

Cited by 54 publications

References 32 publications

Infecção ou colonização por micro-organismos resistentes: identificação de preditores

Infecção ou colonização por micro-organismos resistentes: identificação de preditores

Spread of Carbapenem-Resistant Acinetobacter baumannii Global Clone 2 in Asia and AbaR-Type Resistance Islands

High Frequency of OXA-253-Producing Acinetobacter baumannii in Different Hospitals in Recife, Brazil

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