Identification of an epidemic carbapenem-resistant Acinetobacter baumannii strain at hospitals in Buenos Aires City

Barbolla, Raquel Eve; Centrón, Daniela; Martino, Ana Di; Maimone, Stella; Salgueira, Claudia; Famiglietti, Ángela; Vay, Carlos; Catalano, Mariana

doi:10.1016/s0732-8893(02)00538-2

Cited by 28 publications

(24 citation statements)

References 16 publications

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“…In conclusion, these studied strains belong to the three major endemic PFGE types in Buenos Aires city [4]. Thus, our results could be applied in our hospital and other medical centers for the treatment of multiresistant A. baumannii infections.…”

Section: Discussionmentioning

confidence: 63%

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In vitro antimicrobials activity against endemic Acinetobacter baumannii multiresistant clones

Rodríguez

Ambrosio

Bajuk

et al. 2010

J Infect Dev Ctries

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Background: Multidrug-resistant strains of Acinetobacter baumannii have been reported increasingly around the world. The administration of an association of antibiotics has been proposed to create an active combination and to prevent the emergence of resistance. Methodology: The activity of colistin, rifampicin, gentamicin, imipenem and their associations was evaluated by means of killing curves in fourteen isolates belonging to three endemic PFGE types, in a university hospital of Buenos Aires city. The 14 isolates were selected on the basis of different mechanisms responsible for resistance to carbapenems and different susceptibility to colistin. Results: The mechanism responsible for the resistance to imipenem was the production of OXA-23 and OXA-58 carbapenemases. Heteroresistance to colistin was observed in six isolates. The associations colistin-rifampicin and colistin-imipenem were synergistic in heteroresistant isolates and prevented the development of colistin-resistant mutants. The association imipenem-gentamicin was bactericidal in gentamicin susceptible isolates, whereas the association imipenem-rifampicin was always indifferent. Conclusion: The antimicrobial activity and the presence of synergy are related to the antimicrobials' susceptibilities irrespective of the PFGE type or the OXA-carbapenemase produced.

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Section: Discussionmentioning

confidence: 63%

“…In Argentinian hospitals, the dissemination of strains which showed epidemic behaviour and were producers of OXA-23 and OXA-58 carbapenemases has been previously documented [4][5]. For the last 15 years, our hospital has suffered a sustained endemia of multiresistant A. baumannii infections.…”

Section: Introductionmentioning

confidence: 98%

In vitro antimicrobials activity against endemic Acinetobacter baumannii multiresistant clones

Rodríguez

Ambrosio

Bajuk

et al. 2010

J Infect Dev Ctries

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“…The interhospital transmission of A. baumannii is known to be possible (1,5,22). The present study reflects the time distribution of the PFGE types in clones B and D6.…”

Section: Discussionmentioning

confidence: 99%

Clonal Diversity of Nosocomial Epidemic Acinetobacter baumannii Strains Isolated in Spain

et al. 2011

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Acinetobacter baumannii is one of the major pathogens involved in nosocomial outbreaks. The clonal diversity of 729 epidemic strains isolated from 19 Spanish hospitals (mainly from intensive care units) was analyzed over an 11-year period. Pulsed-field gel electrophoresis (PFGE) identified 58 PFGE types that were subjected to susceptibility testing, rpoB gene sequencing, and multilocus sequence typing (MLST). All PFGE types were multidrug resistant; colistin was the only agent to which all pathogens were susceptible. The 58 PFGE types were grouped into 16 clones based on their genetic similarity (cutoff of 80%). These clones were distributed into one major cluster (cluster D), three medium clusters (clusters A, B, and C), and three minor clusters (clusters E, F, and G). Multidrug-resistant Acinetobacter baumannii is a bacterium frequently endemic in certain hospital wards and is responsible for numerous nosocomial outbreaks around the world (3,23,33). Its great capacity to survive in low-moisture environments and its ability to develop resistance to antimicrobial agents afford A. baumannii the possibility of spreading in hospitals. The skin, oropharynx, and digestive tract are the main body areas colonized in hospitalized patients. The risk of colonization and subsequent infection are associated with factors such as the presence of underlying severe illnesses, long-term hospitalization, stays in specific hospital wards, selective antimicrobial pressure, and invasive interventions such as the use of mechanical ventilation or catheters (4,12,14,18).Nosocomial outbreaks of A. baumannii can have their origin in a single reservoir or in multiple contaminated sites (37, 39), and infection can have serious repercussions for patient morbidity and mortality. Patients can acquire the bacterium from an environmental source or from other patients (6, 18).The clonal study of hospital strains is very important in terms of an understanding of the epidemiology of these outbreaks. The aim of the present work was therefore to analyze the genetic diversity and clonal distribution of epidemic strains of A. baumannii isolated from around Spain over a long period of time. Isolates collected during outbreaks at different hospitals were analyzed by pulsed-field gel electrophoresis (PFGE), sequencing of the RNA polymerase ␤ subunit (rpoB) gene, and multilocus sequence typing (MLST). The results were then compared. Antimicrobial susceptibility testing was also performed to determine the multidrug resistance phenotypes of these epidemic strains. MATERIALS AND METHODSBacterial strains. Over the 11-year period from 1997 to 2007, an initial 814 A. baumannii strains isolated from clinical settings and suspected of being involved in nosocomial outbreaks were sent to the Spanish National Center for Microbiology (CNM) for typing. Strains were isolated from 19 public hospitals in 17 Spanish provinces. Hospitals were coded H1 to H19, and provinces were coded P1 to P17. The type of clinical sample, the hospital ward of origin, and the isolation per...

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“…Surprisingly, A. baumannii was not reported as an etiologic agent of necrotizing SSTI in clinical series from the United States published as recently as 2002 [33,34]. In contrast, it is frequently reported in case series from Turkey, Argentina, and Singapore, where A. baumannii infection is endemic [26][27][28][35][36][37]. As cited above, A. baumannii became an important cause of SSTI in personnel from Iraq in the setting of an outbreak across the U.S. military healthcare system.…”

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confidence: 99%

Acinetobacter baumannii-Associated Skin and Soft Tissue Infections: Recognizing a Broadening Spectrum of Disease

Guerrero

Pérez

Conger

et al. 2010

Surgical Infections

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Background: Acinetobacter baumannii is gaining importance as a cause of nosocomial infections, but its role in skin and soft tissue infection (SSTI) is not well defined. As a result of the outbreak of A. baumannii occurring in military personnel in Iraq and Afghanistan, reports of severe wound infections and SSTI caused by this pathogen are increasing in frequency. Methods: We describe four cases of monomicrobial and polymicrobial A. baumannii-associated necrotizing SSTI accompanied by A. baumannii bacteremia and offer a review of similar experiences published in the literature. Results: Our comparative analysis reveals four unique features associated with necrotizing SSTI associated with A. baumannii: i) Occurs in hosts with underlying comorbidities (e.g., trauma, cirrhosis); ii) is often accompanied by bacteremia; iii) multiple drug resistance and the presence of co-pathogens frequently complicated treatment (64% of cases); iv) the cases reported here and in our review required surgical debridement (84% of cases) and led to substantial mortality (*30%). Conclusions: As the prevalence of A. baumannii continues to increase in our health care system, SSTIs caused by this organism may become more common. Clinicians must be aware that the spectrum of disease caused by A. baumannii could include severe necrotizing SSTI and that vigilance for potential complications is necessary.

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Identification of an epidemic carbapenem-resistant Acinetobacter baumannii strain at hospitals in Buenos Aires City

Cited by 28 publications

References 16 publications

In vitro antimicrobials activity against endemic Acinetobacter baumannii multiresistant clones

In vitro antimicrobials activity against endemic Acinetobacter baumannii multiresistant clones

Clonal Diversity of Nosocomial Epidemic Acinetobacter baumannii Strains Isolated in Spain

Acinetobacter baumannii-Associated Skin and Soft Tissue Infections: Recognizing a Broadening Spectrum of Disease

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