Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Kurihara, Mariana Neri Lucas; Sales, Romário Oliveira de; Silva, Késia Esther da; Maciel, Wirlaine Glauce; Simionatto, Simone

doi:10.1590/0037-8682-0248-2020

Cited by 36 publications

(15 citation statements)

References 151 publications

(127 reference statements)

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“…Carbapenem-resistant A. baumannii has emerged as a major culprit involved in nosocomial infections, especially in intensive care units [ 1 , 2 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous nosocomial outbreaks involving A. baumannii have been reported and especially carbapenem-resistant A. baumannii is now endemic in many hospitals worldwide [ 28 , 34 ]. Several resistance mechanisms against carbapenems in A. baumannii have been reported, and for many countries, the molecular epidemiology of carbapenem and/or MDR A. baumannii is known [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Almost one-third of the isolates harbored multiple CHDLs which was rare in previous studies pointing out to the increasing capacity of A. baumannii to accumulate carbapenem resistance determinants [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Diversity of Oxacillinases and Sequence Types in Carbapenem-Resistant Acinetobacter baumannii from Austria

Grisold¹,

Luxner²,

Bedenić

et al. 2021

IJERPH

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Carbapenem-resistant Acinetobacter baumannii is a significant health problem worldwide. A multicenter study on A. baumannii was performed to investigate the molecular epidemiology and genetic background of carbapenem resistance of A. baumannii isolates collected from 2014–2017 in Austria. In total, 117 non-repetitive Acinetobacter spp. assigned to A. baumannii (n = 114) and A. pittii (n = 3) were collected from four centers in Austria. The isolates were uniformly resistant to piperacillin/tazobactam, ceftazidime, and carbapenems, and resistance to imipenem and meropenem was 97.4% and 98.2%, respectively. The most prominent OXA-types were OXA-58-like (46.5%) and OXA-23-like (41.2%), followed by OXA-24-like (10.5%), with notable regional differences. Carbapenem-hydrolyzing class D carbapenemases (CHDLs) were the only carbapenemases found in A.baumannii isolates in Austria since no metallo-β-lactamases (MBLs) nor KPC or GES carbapenemases were detected in any of the isolates. One-third of the isolates harbored multiple CHDLs. The population structure of A. baumannii isolates from Austria was found to be very diverse, while a total of twenty-three different sequence types (STs) were identified. The most frequent was ST195 found in 15.8%, followed by ST218 and ST231 equally found in 11.4% of isolates. Two new ST types, ST2025 and ST2026, were detected. In one A. pittii isolate, blaOXA-143-like was detected for the first time in Austria.

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“…Carbapenem-resistant A. baumannii has emerged as a major culprit involved in nosocomial infections, especially in intensive care units [ 1 , 2 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diversity of Oxacillinases and Sequence Types in Carbapenem-Resistant Acinetobacter baumannii from Austria

Grisold¹,

Luxner²,

Bedenić

et al. 2021

IJERPH

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“… 3 , 4 Advanced age and chronic diseases are risk factors related to multidrug-resistant bacteria infections. 5 Because of the efficacy and safety, tigecycline is often used in elderly people infected with multidrug–resistant bacteria in clinical practice. 6 …”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Tigecycline-Associated Hypofibrinogenemia

Liu

Yan

Zhang

2021

TCRM

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Background With the widespread use of tigecycline, especially in elderly people infected with multidrug-resistant bacteria, the associated coagulation disorders are attracting the attention of clinicians. The risk factors of tigecycline-associated hypofibrinogenemia are still controversial. Purpose The aims of our study were to explore the related factors of hypofibrinogenemia caused by tigecycline, and to establish the risk assessment criteria for tigecycline-associated hypofibrinogenemia. Patients and Methods This was an observational retrospective cohort study of patients treated for at least 3 days with tigecycline. Hypofibrinogenemia was defined as plasma fibrinogen <2.0 g/L. Risk factors were determined using logistic regression analysis, and the risk assessment criteria were identified by using receiver operating characteristic curves. Results In total, 148 patients were included in the analysis, mean age was 77.09±15.11 years old. Ninety patients who developed hypofibrinogenemia during tigecycline treatment with mean plasma fibrinogen of 1.42 g/L were included in the hypofibrinogenemia group, the other 58 patients with mean plasma fibrinogen of 2.68 g/L were included in the normal group. In the multivariate analysis, age ( p = 0.035), tigecycline treatment duration ( p = 0.044), and baseline fibrinogen level ( p = 0.002) were independently associated with hypofibrinogenemia. An age of ≥82 years, ≥9 days of medication, and a baseline fibrinogen level of ≤3.5 g/L were selected for predicting hypofibrinogenemia. Hypofibrinogenemia was independently associated with bleeding (OR 8.96, 95% CI [1.132–70.946], p = 0.038). Conclusion Hypofibrinogenemia is a common adverse effect of tigecycline in our study. Elderly patients are more prone to developing hypofibrinogenemia after the administration of tigecycline. It is independently associated with bleeding but not death. The risk assessment criteria can help in the identification of patients with high risk of hypofibrinogenemia.

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“…Acinetobacter ( A .) baumannii is a notorious Gram-negative pathogen associated with a multitude of severe nosocomial infections and high mortalities in intensive care units (ICUs) [ 1 ]. The pathogen is known to cause ventilator-associated pneumonia, bloodstream, skin and urinary tract infections and secondary meningitis [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

WGS-Based Analysis of Carbapenem-Resistant Acinetobacter baumannii in Vietnam and Molecular Characterization of Antimicrobial Determinants and MLST in Southeast Asia

et al. 2021

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Carbapenem-resistant Acinetobacter baumannii (A. baumannii, CRAb) is an emerging global threat for healthcare systems, particularly in Southeast Asia. Next-generation sequencing (NGS) technology was employed to map genes associated with antimicrobial resistance (AMR) and to identify multilocus sequence types (MLST). Eleven strains isolated from humans in Vietnam were sequenced, and their AMR genes and MLST were compared to published genomes of strains originating from Southeast Asia, i.e., Thailand (n = 49), Myanmar (n = 38), Malaysia (n = 11), Singapore (n = 4) and Taiwan (n = 1). Ten out of eleven Vietnamese strains were CRAb and were susceptible only to colistin. All strains harbored ant(3”)-IIa, armA, aph(6)-Id and aph(3”) genes conferring resistance to aminoglycosides, and blaOXA-51 variants and blaADC-25 conferring resistance to ß-lactams. More than half of the strains harbored genes that confer resistance to tetracyclines, sulfonamides and macrolides. The strains showed high diversity, where six were assigned to sequence type (ST)/2, and two were allocated to two new STs (ST/1411-1412). MLST analyses of 108 strains from Southeast Asia identified 19 sequence types (ST), and ST/2 was the most prevalent found in 62 strains. A broad range of AMR genes was identified mediating resistance to ß-lactams, including cephalosporins and carbapenems (e.g., blaOXA-51-like, blaOXA-23, blaADC-25, blaADC-73, blaTEM-1, blaNDM-1), aminoglycosides (e.g., ant(3”)-IIa, aph(3”)-Ib, aph(6)-Id, armA and aph(3’)-Ia), phenicoles (e.g., catB8), tetracyclines (e.g., tet.B and tet.39), sulfonamides (e.g., sul.1 and sul.2), macrolides and lincosamide (e.g., mph.E, msr.E and abaF). MLST and core genome MLST (cgMLST) showed an extreme diversity among the strains. Several strains isolated from different countries clustered together by cgMLST; however, different clusters shared the same ST. Developing an action plan on AMR, increasing awareness and prohibiting the selling of antibiotics without prescription must be mandatory for this region. Such efforts are critical for enforcing targeted policies on the rational use of carbapenem compounds and controlling AMR dissemination and emergence in general.

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Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Cited by 36 publications

References 151 publications

Diversity of Oxacillinases and Sequence Types in Carbapenem-Resistant Acinetobacter baumannii from Austria

Diversity of Oxacillinases and Sequence Types in Carbapenem-Resistant Acinetobacter baumannii from Austria

Risk Factors for Tigecycline-Associated Hypofibrinogenemia

WGS-Based Analysis of Carbapenem-Resistant Acinetobacter baumannii in Vietnam and Molecular Characterization of Antimicrobial Determinants and MLST in Southeast Asia

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