Genetic relatedness of clinical and environmental Acinetobacter baumanii isolates from an intensive care unit outbreak

Senok, Abiola; Garaween, Ghada; Raji, Adeola; Khubnani, Harish; Sing, Garwin K.; Shibl, Atef M.

doi:10.3855/jidc.6726

Cited by 22 publications

(22 citation statements)

References 22 publications

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“…Second, we did not apply sequencing techniques. Instead, we used the DiversiLab system, that has demonstrated to be an accurate and reliable typing method particularly vocated to outbreak investigations [23–26]. Third, this study was carried out in a descriptive manner, since we could not perform a case–control study due to the small number of colonized/infected patients, so associations between exposure to certain risk factors and XDRAB acquisition could not be detected.…”

Section: Discussionmentioning

confidence: 99%

Control of carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit of a teaching hospital in Southern Italy

et al. 2016

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Background Acinetobacter baumannii is an opportunistic pathogen that has become a major cause of concern, since it is a frequent cause of healthcare-associated infections (HAIs). The aim of the study was to describe the occurrence, the management and the control of an outbreak that occurred in an intensive care unit (ICU) of a teaching hospital in Southern Italy caused by multiple strains of extensively drug-resistant A. baumannii (XDRAB).MethodsCase-patient was defined as a patient with an healthcare-associated infection caused by an XDRAB isolate identified in a clinically significant culture. Environmental samples were collected from different surfaces. The isolates were identified by typical Gram stain morphology, using the Vitek 2 system (bioMérieux, France) and by MALDI-TOF MS mass spectrometry (bioMèrieux, France). Genotyping was performed through rep-PCR analysis.ResultsA patient presented an XDRAB ventilator-associated pneumonia at admission and was managed with strict isolation precautions until discharge. Five patients had a ventilator-associated pneumonia and two had a central line-associated bloodstream infection. Of the environmental samples, 1 sample obtained from the side of the bed of an infected patient yielded growth of XDRAB. Infection control measures were adopted. Rep-PCR analysis identified four patterns.ConclusionsThe integration of epidemiological and microbiological data and the application of infection control measures were crucial to bring such an outbreak to a rapid halt. The distinctive characteristic of this study was the complex molecular pattern of the outbreak, which subsided in a short period of time due to adherence to infection-control measures, confirming the fundamental role of molecular typing in the comprehension of outbreaks dynamics and of integrated control interventions for the interruption of epidemic events.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2036-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Control of carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit of a teaching hospital in Southern Italy

et al. 2016

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“…These are not the only molecular tools to type isolates, repPCR 30,31 and whole genome sequencing 10 are also gaining ground as potential methods for typing. However, we did not choose these methods for several reasons.…”

Section: Discussionmentioning

confidence: 99%

Comparison of molecular typing methods for the analyses of Acinetobacter baumannii from ICU patients

Johnson

Robinson

Zhao

et al. 2016

Diagnostic Microbiology and Infectious Disease

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Acinetobacter baumannii has emerged as an important cause of healthcare-associated infections causing great morbidity and mortality. Despite its clinical importance, it is still unknown which molecular typing method is the best to determine or confirm institutional outbreaks as well as to identify epidemiologically related isolates from different geographical areas. To determine the most discriminatory molecular typing method, we isolated A. baumannii from perianal swabs collected from intensive care unit (ICU) patients in a cohort study during 2002 and 2008. Strains from each year were analyzed by pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST), and multi-locus variable-number tandem repeat analysis (MLVA). Genetic relatedness of the isolates was consistent between PFGE and MLST as well as between analyses of loci containing MLVA and MLST. Our data show that PFGE and MLVA are similar when discriminating between isolates and are both good methods to use when questioning whether two isolates are indistinguishable.

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“…Outbreaks caused by ABA-MDR have been described worldwide [1][2][3][4][5][6][7]13] yet few studies in the literature refer to Latin America [8]. The few manuscripts investigating adult ICU Gram-negative outbreaks in Latin America and the Caribbean mostly originate from the more affluent nations.…”

Section: Discussionmentioning

confidence: 99%

“…The reported outbreak affected a low number of patients; just seven people presented a positive culture, all with extensive previous antibiotic therapy treatments and more than 72 hours spent in the hospital. These factors have been previously associated with an increased risk of acquiring nosocomial infections [1,3,4,6,7]. The outbreak strain was found on the stethoscope of the isolation room in the ICU; this room is considered to be the common factor to all patients infected or colonized by ABA.…”

Section: Discussionmentioning

confidence: 99%

“…Because ABA is a major opportunistic pathogen pervasive in the environment, it constitutes a leading cause of cross-contamination and infections, particularly multidrug-resistant (MDR) infections associated with high mortality rates in intensive care units (ICUs) [3,6,7]. In Latin America, few outbreak studies of ABA have been published, the first being in Brazil in 2003 [4].…”

Section: Introductionmentioning

confidence: 99%

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Early detection and control of an Acinetobacter baumannii multi-resistant outbreak in a hospital in Quito, Ecuador

Gestal¹,

Zurita²,

Gualpa

et al. 2016

J Infect Dev Ctries

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Introduction: Acinetobacter baumannii (ABA) is an important opportunistic pathogen associated with high mortality rates in intensive care units (ICUs). An outbreak in the ICU of a secondary-level hospital in Quito, Ecuador, occurred during April and May 2015 and was successfully controlled. Methodology: Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) and repetitive element palindromic (REP)-PCR was conducted on all isolates recovered from patients, as well as environmental samples, to confirm the presence of an outbreak. A case-control study was conducted by comparing the clinical histories of the affected patients and of control patients present in the ICU during the outbreak period who did not present a positive culture for ABA. Results: Five patients were infected and two were colonized with the same clonal strain of ABA, which was also identified on the stethoscope and a monitor associated with an isolation room. Statistical analysis of case histories did not identify any additional risk factors, but the outbreak was initiated by one patient in the isolation room of the ICU who was infected with the outbreak strain. All patients who ocupied that room after the index case tested positive for at least one culture of ABA. The outbreak strain was found on the stethoscope, and a subclone was found on the monitor of that room. Conclusion: Having access to basic equipment will enable well-trained professionals to rapidly detect and initiate the control process of an outbreak, saving lives and money spent on nosocomial infection treatments.

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Genetic relatedness of clinical and environmental Acinetobacter baumanii isolates from an intensive care unit outbreak

Cited by 22 publications

References 22 publications

Control of carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit of a teaching hospital in Southern Italy

Control of carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit of a teaching hospital in Southern Italy

Comparison of molecular typing methods for the analyses of Acinetobacter baumannii from ICU patients

Early detection and control of an Acinetobacter baumannii multi-resistant outbreak in a hospital in Quito, Ecuador

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