Citywide Clonal Outbreak of Multiresistant Acinetobacter baumannii and Pseudomonas aeruginosa in Brooklyn, NY

Abstract

Approximately 400 patients were infected or colonized with carbapenem-resistant A baumannii and P aeruginosa during a 3-month period in 1999. A few strains have spread widely throughout hospitals in this region. The prevalence of resistant A baumannii seems to be correlated with cephalosporin use. Multiresistant hospital-acquired bacteria should be viewed as a serious public health issue rather than an individual hospital's problem. An intensive coordinated effort will be needed to effectively address this problem.

Multidrug resistant Acinetobacter baumannii--the role of AdeABC (RND family) efflux pump in resistance to antibiotics.

“…One of the main reasons is that clinical isolates are frequently resistant to many commonly used antimicrobial agents (multidrug resistant -MDR) [10,33]. Often are susceptible only to carbapenems (imipenem, meropenem), though resistant strains are increasingly reported, and amikacin, polymyxins, but some may be susceptible only to polymyxins [29,35,40,43,56,57,74,106,129,136]. Colonization of the digestive tract intensive care unit patients is an important epidemiologic reservoir for multi-drug resistant Acinetobacter baumannii infections in hospital outbreaks [22].…”

A prospective study to analyse antibiotic susceptibility pattern of Pseudomonas aeruginosa in a tertiary care hospital

“…9,10,12 The reasons for increasing nosocomial spread of MDR isolates may include lack of adherence to approved infection control policies in hospitals, increasing or cumulative antimicrobial use, and changes in the public health infrastructure. [12][13][14][15][16] In conclusion, susceptibility of antipseudomonal agents against different isolates has decreased. Significant reduction in susceptibilities of P. aeruginosa isolates may compromise the ability to choose efficacious empirical regimens for treatment of this formidable pathogen especially in critically ill patients.…”

Comparison of Acinetobacter baumannii multidrugs resistant Isolates obtained from French and Tunisian hospitals

“…They showed multiple epidemic strains that persisted two years in some cases in the two hospitals study. The analysis of the molecular epidemiology and multidrug resistance of A. baumanni strains in the various parts of the world indicates a considerable degree of geographic diversity in the spread of various strains [23,24,25,26]. It's also demonstrated by multiple studies in Tunisia [20,21,27] and in France [28,29,30] that the multiresistance is common among A.baumannii giving nosocomial epidemics which were difficult to treat.…”