Genotypic analysis of Acinetobacter bloodstream infection isolates in a Turkish university hospital

Abstract

Acinetobacter baumannii is a significant pathogen of bloodstream infections in hospital patients that frequently causes single clone outbreaks. We aimed to evaluate the genetic relatedness and antimicrobial susceptibility of Acinetobacter spp. bloodstream isolates, in order to obtain insight into their cross-transmission. This prospective study was conducted at the Erciyes University Hospital. During a 1-y period, all patients with nosocomial BSI caused by Acinetobacter spp. were included in the study. All data with regard to the patients, underlying diseases and risk factors for BSI and the severity of disease were collected. Blood culture isolates of Acinetobacter spp. were identified according to their morphology and biochemical reactions. The antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion test according to the NCCLS; the genetic relatedness of isolates was determined by RAPD-PCR analysis and pulsed-field gel electrophoresis (PFGE). 41 patients acquired a nosocomial bloodstream infection caused by A. baumanii during this period. 88% of these infections (36 of 41) occurred while the patients were treated in the intensive care unit. Nearly 80% of the isolates belonged to 3 genotypes, suggesting cross-transmission in ICU settings where infection control practices are poor. All Acinetobacter isolates were multidrug-resistant and the crude mortality of patients infected with A. baumanii was 80.5%. We concluded that the genetic relatedness of Acinetobacter spp. causing BSI was very high, indicating cross-transmission within the ICU setting. Essential components of an infection control programme to prevent nosocomial transmission of A. baumannii are early detection of colonized patients, followed by strict attention to standard precautions and contact isolation.

Acinetobacter septicus sp. nov. Association with a Nosocomial Outbreak of Bacteremia in a Neonatal Intensive Care Unit

“…A. baumannii remains the main species associated with outbreaks of nosocomial infection. A genotypic analysis of Acinetobacter bloodstream infection isolates in a Turkish university hospital indicated that 80.5% were A. baumannii (1). Nosocomial infections caused by other Acinetobacter species have rarely been reported, although an outbreak of infections with A. calcoaceticus in burn patients has been reported (39).…”

“…Risk factors associated with these infections include antibiotic exposure, length of stay in intensive care units, mechanical ventilations, and severity of underlying illness (1,7,9,11,21,23,39). Hospitalized patients can become "colonized" with Acinetobacter species, which may cause endemic problems in the hospital setting due to cross-transmission between patients (7,11,23).…”

Predictors Of Multidrug Resistant Acinetobacter Baumannii Infections in Intensive Care Unit

“…Yapılan bir çalışmada, Acinetobacter baumannii bakteriyemisi olan hastalarda yoğun bakımda yatış süre-sinin kontrol grubuna göre beş gün uzadığını bildirilmiştir (12) . Çalışmamızda da literatürle uyumlu olarak çoklu ilaç direnci olan Acinetobacter baumannii enfeksiyonu gelişen hastaların yoğun bakım ünitesin-de kalış süresi çoklu ilaç direnci olmayan gruba göre daha uzundur.…”

Combined therapy for multi-drug-resistant Acinetobacter baumannii infection – is there evidence outside the laboratory?

“…Martinez-Martinez et al, 1996;Kiffer et al, 2005;Sader & Jones, 2005;Timurkaynak et al, 2006;Wareham & Bean, 2006). Most of these controversial findings may be associated with method adequacy, resistance pattern of the strains and heterogeneity of the Acinetobacter genomic species (Christie et al, 1995;Drago et al, 2005;Alp et al, 2006). Therefore, results may not be extrapolated for Acinetobacter from different hospitals.…”