Epidemiological characterization of Acinetobacter baumannii bloodstream isolates from a Chinese Burn Institute: A three-year study

Huang, Guangtao; Yin, Supeng; Xiang, Lijuan; Gong, Yanhong; Sun, Kedai; Luo, X. G.; Zhang, Cheng; Yang, Zichen; Deng, Liuyang; Jiang, Bei; Jin, Song; Chen, Jing; Peng, Yizhi

doi:10.1016/j.burns.2016.02.021

Cited by 15 publications

(11 citation statements)

References 25 publications

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“…However, CRAB has rapidly increased worldwide in recent years. Huang et al reported a resistance rate of A. baumannii towards imipenem and meropenem of about 85% in Southwest Hospital, while the resistance rate of bloodstream isolates towards imipenem and meropenem is >90% [ 31 , 32 ]. In this study, 30 clinical isolates of A. baumannii were collected from the burn ward, most of which were MDR-AB.…”

Section: Discussionmentioning

confidence: 99%

Rapid and accurate detection of carbapenem-resistance gene by isothermal amplification in Acinetobacter baumannii

et al. 2020

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Background Acinetobacter baumannii (A. baumannii) is one of the pivotal pathogens responsible for nosocomial infections, especially in patients with low immune response, and infection with carbapenem-resistant A. baumannii has been increasing in recent years. Rapid and accurate detection of carbapenem-resistance genes in A. baumannii could be of immense help to clinical staff. Methods In this study, a 15-μL reaction system for recombinase polymerase amplification (RPA) was developed and tested. We collected 30 clinical isolates of A. baumannii from the Burn Institute of Southwest Hospital of Third Military Medical University (Army Medical University) for 6 months and tested antibiotic susceptibility using the VITEK 2 system. A. baumannii was detected based on the blaOXA-51 gene by PCR, qPCR and 15 μL-RPA, respectively. Sensitivity and specificity were evaluated. In addition, PCR and 15 μL-RPA data for detecting the carbapenem-resistance gene blaOXA-23 were comparatively assessed. Results The detection limit of the blaOXA-51 gene by 15 μL RPA was 2.86 CFU/ml, with sensitivity comparable to PCR and qPCR. No positive amplification signals were detected in non-Acinetobacter isolates, indicating high specificity. However, only 18 minutes were needed for the 15 μL RPA assay. Furthermore, an antibiotic susceptibility test showed that up to 90% of A. baumannii strains were resistant to meropenem and imipenem; 15 μL RPA data for detecting blaOXA-23 showed that only 10% (n = 3) of A. baumannii isolates did not show positive amplification signals, and the other 90% of (n = 27) isolates were positive, corroborating PCR results. Conclusion We demonstrated that the new 15 μL RPA assay for detecting blaOXA-23 in A. baumannii is faster and simpler than qPCR and PCR. It is a promising alternative molecular diagnostic tool for rapid and effective detection of A. baumannii and drug-resistance genes in the field and point-of-care testing.

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Section: Discussionmentioning

confidence: 99%

Rapid and accurate detection of carbapenem-resistance gene by isothermal amplification in Acinetobacter baumannii

et al. 2020

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“…The MLST showed that four of seven CR-hvAB isolates belongs to the ST457, which was initially isolated from Israel in 2013–2014 [ 19 ]. In China, ST457 has been identified in the south [ 11 , 20 ] and southwest region [ 21 ], and increasing endemicity was first observed in Hong Kong in 2012–2014 [ 22 ]. Zhou et al [ 11 ] reported that ST457 A. baumannii isolates were only second to ST195 and had a higher 7-day/28-day mortality rate than other STs of CC92, except for ST195 and ST208, and enhanced virulence with a high mortality rate through use of G. mellonella larvae infection model.…”

Section: Discussionmentioning

confidence: 99%

Characterization of carbapenem-resistant hypervirulent Acinetobacter baumannii strains isolated from hospitalized patients in the mid-south region of China

Luo

et al. 2020

BMC Microbiol

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Background Acinetobacter baumannii has traditionally been considered an opportunistic pathogen with low virulence. In this study, we characterized the carbapenem-resistant hypervirulent A. baumannii (CR-hvAB) stains isolated from our hospital in mid-south region of China. Results Blood samples collected between January 2017 and May 2019 were used for virulence experiments and biofilm assays of individual carbapenem-resistant A. baumannii (CR-AB) strains, performed using a Galleria mellonella infection model and crystal violet staining method, respectively. CR-AB isolates that induced high mortality in the G. mellonella infection model were subjected to genotyping, susceptibility testing, and clinical data analysis, and the genetic characterization of these isolates was performed by whole-genome sequencing (WGS). Among the 109 CR-AB clinical strains, the survival rate of G. mellonella larvae infected with 7 (6.4%) CR-AB isolates (number of strains with mortality of 0, 10 and 20% was 4, 1, and 2, respectively), was significantly lower than that of A. baumannii ATCC 19606 (100.0%) and the remaining CR-AB isolates (> 80.0%). Consistent with these results, patients infected with these seven isolates had an average 7-day mortality rate of 42.9%, suggesting that the isolates were CR-hvAB. These seven isolates belonged to four sequence types (STs): ST457, ST195, ST369, and ST2088 (a new ST), and mainly ST457 (n = 4). The results of the biofilm study showed that eight strains had powerful biofilm ability (strong [n = 1] and moderate [n = 7] biofilm producers) including these seven CR-hvAB isolates. Conclusions CR-hvAB isolates that induced a high mortality rate were cloned in our hospital, most of which belonged to ST457; thus, monitoring of these strains, particularly ST457, should be strengthened in the future. Meanwhile, A. baumannii, which was isolated from blood specimens and found to powerful biofilm-forming ability, is a probable hvAB isolate.

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“…This finding is similar to previous studies that report the high resistance rate of Acinetobacter baumannii among their burn patients, primarily attributed to prolonged hospitalization. 6,28,43 One study by Park et al showed that multi-drug resistant bacteria commonly occur due to the prolonged use of cephalosporin antibiotics among patients, particularly their use as prophylaxis treatment. 44 Similarly, Klebsiella pneumoniae, which has just become one of the major infection-causing bacteria in our burn unit, is found to have high resistance, with approximately 50% of the isolates showing resistance.…”

Section: Discussionmentioning

confidence: 99%

“…However, a monotherapy approach is not recommended for the treatment of burn infections due to its ineffectiveness in targeting all of the bacteria in burn patients, and its low success rates in increasing survival. 6,47 Therefore, a combination of carbapenem antibiotics with another antibiotic is suggested. According to Tumbarello et al, a combination of carbapenem with tigecycline and polymixin B is significantly correlated with a decreased risk of death among burn patients.…”

Section: Discussionmentioning

confidence: 99%

“…pathogens worldwide, the treatment of infections in burn patients is becoming more difficult. 6 Therefore, to effectively reduce the incidence of infection and sepsis, an antimicrobial stewardship program needs to be developed. Every burn unit should routinely identify and track the pattern of microbial colonization at the unit.…”

Section: Mots-clés: Brûlure Infection Antibiogramme Bactéries Multmentioning

confidence: 99%

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Bacterial and Antimicrobial Susceptibility Profile, and Prevalence of Sepsis Among Burn Patients at the Burn Unit of Cipto Mangunkusumo Hospital

Djan¹

2017

Preprint

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Infection is a major cause of mortality and morbidity among burn patients. An effective measure to reduce infection is routine monitoring of bacterial infection and antimicrobial susceptibility patterns at the burn unit. This will help to create a burn centre-specific empirical antibiotic therapy protocol. A retrospective, descriptive study was conducted at the Cipto Mangunkusumo Hospital (RSCM) Burn Unit between September-November 2016. Data regarding bacterial culture isolates, antimicrobial susceptibility spectrum, and the number of burn patients diagnosed with sepsis were collected. There were 36 patients with positive bacterial cultures, with the isolates changing continuously between Klebsiella pneumonia (17%), Pseudomonas Aeruginosa (12%) and Acinetobacter baumannii (11%). High resistance was found for 10 antimicrobials, particularly cephalosporins. The three bacteria were only sensitive to carbapenem, aminoglycosides and tigecycline. Fourteen patients were diagnosed with sepsis (38.9%), 10 died. Two major sepsis-causing bacteria were P. aeruginosa (33.3%) and K. pneumoniae (28.9%). Bacterial isolates in our setting changed every month. Almost all bacterial isolates are multi-drug resistant, highly resistant to the empirical therapy given (ceftriaxone), leading to outbreaks of sepsis and increased mortality rates. Carbapenem (imipenem, meropenem and doripenem) and aminoglycosides (amikacin) combination was the selected empirical therapy.

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Epidemiological characterization of Acinetobacter baumannii bloodstream isolates from a Chinese Burn Institute: A three-year study

Cited by 15 publications

References 25 publications

Rapid and accurate detection of carbapenem-resistance gene by isothermal amplification in Acinetobacter baumannii

Rapid and accurate detection of carbapenem-resistance gene by isothermal amplification in Acinetobacter baumannii

Characterization of carbapenem-resistant hypervirulent Acinetobacter baumannii strains isolated from hospitalized patients in the mid-south region of China

Bacterial and Antimicrobial Susceptibility Profile, and Prevalence of Sepsis Among Burn Patients at the Burn Unit of Cipto Mangunkusumo Hospital

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