Endemic Carbapenem-Resistant Acinetobacter Species in Brooklyn, New York: Citywide Prevalence, Interinstitutional Spread, and Relation to Antibiotic Usage

Abstract

Acinetobacter species are problematic nosocomial pathogens. In November 1997, pathogens isolated by microbiology laboratories were collected from 15 hospitals in Brooklyn, New York. Acinetobacter species accounted for 10% of gram-negative isolates. Only half of Acinetobacter species were susceptible to carbapenems; 11 hospitals had at least 1 isolate resistant to carbapenems. Other Acinetobacter susceptibility rates were as follows: polymyxin, 99%; amikacin, 87%; ampicillin/sulbactam, 47%; ceftazidime, 25%; and ciprofloxacin 23%. Overall, 10% were resistant to all commonly used antibiotics. Genetic analysis by use of pulsed-field gel electrophoresis of 12 carbapenem-resistant isolates revealed 4 strains that were recovered from >1 hospital, which suggests interinstitutional spread. Antibiotic usage data from 11 hospitals revealed that the use of third-generation cephalosporins was associated significantly with the percentage of carbapenem-resistant strains (P=.03). Resistant Acinetobacter species have become endemic in Brooklyn, New York. Citywide strategies that involve surveillance, infection-control practices, and the reduction of antibiotic usage may be necessary to control the spread of these pathogens.

Molecular Epidemiology and Mechanisms of Carbapenem Resistance in Acinetobacter baumannii Endemic in New York City

“…We did not identify an efficient carbapenem-hydrolyzing enzyme (e.g., OXA enzyme or metallo-b-lactamase) in any of the isolates we studied. The finding of increased production of a cephalosporinase in the carbapenem-resistant isolates may explain the persistent relationship we have observed between the rates of carbapenem-resistance and cephalosporin use in individual hospitals in our area [5,17].…”

“…However, A. baumannii is problematic in hospitals in selected geographic regions [3][4][5]. Approximately 10% of all gram-negative isolates identified in Brooklyn, New York, hospital microbiology laboratories are A. baumannii [5].…”

Acinetobacter baumannii Infections in a Tertiary Care Hospital in Mexico over the Past 13 Years

“…That is, once A. baumannii is introduced into a hospital, it may persist and become endemic [15,16]. After disseminating throughout our hospital system from the adult ICU, A. baumannii became 1 of the 5 most frequent bacterial pathogens isolated in 2007.…”

Study to detect incidence of carbapenemase among Gram negative clinical isolates from tertiary care hospital

“…In the year 2010, in India, a study done by Manoharan et al (10) quoted the prevalence of MBLs in P.aeruginosa to be as high as 65 %. In acinetobacter spp, in a study by Manikal et al, (11) in the year 2000 in New York hospitals, the MBLs prevalence was found to be 50%. Later in one Indian study by Taneja et al, in 2003 the prevalence of MBL in acinetobacter was found to be 20%.…”