Outbreak caused by two multi-resistant Acinetobacter baumannii clones in a burns unit: emergence of resistance to imipenem

Lyytikäinen, Outi; Kõljalg, Siiri; Härmä, Maiju; Vuopio‐Varkila, Jaana

doi:10.1016/0195-6701(95)90082-9

Cited by 56 publications

(35 citation statements)

References 31 publications

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“…The majority of strains are resistant to cephalosporin class of antimicrobials, whereas the resistance to carbapenems is increasingly reported (6) . The antimicrobial susceptibility testing showed differences between Acinetobacter species, with Acinetobacter baumannii being the most resistant strains (7) (8) .…”

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confidence: 99%

Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management

Sohail

Rashid

Aslam

et al. 2016

Rev. Soc. Bras. Med. Trop.

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Introduction:The drug resistant Acinetobacter strains are important causes of nosocomial infections that are difficult to control and treat. This study aimed to determine the antimicrobial susceptibility patterns of Acinetobacter strains isolated from different clinical specimens obtained from patients belonging to different age groups. Methods: In total, 716 non-duplicate Acinetobacter isolates were collected from the infected patients admitted to tertiary-care hospitals at Lahore, Pakistan, over a period of 28 months. The Acinetobacter isolates were identified using API 20E, and antimicrobial susceptibility testing was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The isolation rate of Acinetobacter was high from the respiratory specimens, followed by wound samples. Antibiotic susceptibility analyses of the isolates revealed that the resistance to cefotaxime and ceftazidime was the most common, in 710 (99.2%) specimens each, followed by the resistance to gentamicin in 670 (93.6%) isolates, and to imipenem in 651 (90.9%) isolates. However, almost all isolates were susceptible to tigecycline, colistin, and polymyxin B. Conclusions: The present study showed the alarming trends of resistance of Acinetobacter strains isolated from clinical specimens to the various classes of antimicrobials. The improvement of microbiological techniques for earlier and more accurate identification of bacteria is necessary for the selection of appropriate treatments.

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Section: Introductionmentioning

confidence: 99%

Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management

Sohail

Rashid

Aslam

et al. 2016

Rev. Soc. Bras. Med. Trop.

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“…The majority of strains are resistant to cephalosporin class of antimicrobials, whereas the resistance to carbapenems is increasingly reported. 7 The objective of the study is to determine the prevalence of the Acinetobacter infections and antibiotic sensitivity pattern of Acinetobacter species isolated from various clinical samples collected from patients attending Regional Institute of Medical Sciences Hospital.…”

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confidence: 99%

A study of Acinetobacter infections in a tertiary care hospital in Northeast India

et al. 2018

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Background: Acinetobacter is an important opportunistic pathogen and is a common cause of hospital acquired infections. Acinetobacter infections are often extremely difficult to treat because of their widespread resistance to the major groups of antibiotics. The study was conducted to determine prevalence and antibiotic susceptibility pattern of Acinetobacter species isolated from various clinical samples.Methods: Clinical specimens over a period of 2yrs from May 2015 to April 2017 were collected from the patients attending the hospital. Acinetobacter species isolates were identified, and antibiotic susceptibility test was done following standard operative procedures.Results: From 9979 clinical specimens, 3715 were positive for significant bacterial growth of which 111 (2.9%) were culture positive for Acinetobacter spp. Among 111 isolates 109 (98.2%) isolates were Acinetobacter baumanni and 2 (1.8%) were Acinetobacter lwoffii. Maximum isolates were isolated from urine samples 36 (32.4%) and majority of the isolates were from wards (56.7%) giving a probability of increased hospital acquired infections. Maximum resistance was shown by cefipime (80.1%). Imipenem and Meropenem shows resistance of 25.3% and 29.7% respectively. ICU isolates showed extensive resistance in comparison to wards and OPD.Conclusions: Increasing trend of resistance pattern to a large range of antibiotics is a matter of concern. To avoid resistance, antibiotics should be used judiciously, and empirical therapy should be determined for each hospital according to the resistance rates of the hospital. Infection with MDR Acinetobacter species is independently associated with high mortality, emphasizing the need for aggressive infection control strategies.

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“…In fact, most A. baumannii strains isolated in hospitals today are highly resistant to modern noncarbapenem ␤-lactams, aminoglycosides, and fluoroquinolones (2,15,17,38,39,43). Imipenem used to be considered the "gold standard" therapy for severe infections (39,44), but many countries have reported growing resistance to carbapenems (1,5,14,23,28,30,31,41,42).…”

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Efficacy of Colistin versus β-Lactams, Aminoglycosides, and Rifampin as Monotherapy in a Mouse Model of Pneumonia Caused by Multiresistant Acinetobacter baumannii

Montero¹,

Ariza²,

Corbella³

et al. 2002

Antimicrob Agents Chemother

140

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The treatment of life-threatening infections due to carbapenem-resistant Acinetobacter baumannii has become a serious challenge for physicians worldwide. Often, only colistin shows in general good in vitro activity against these carbapenem-resistant strains, but its antibacterial efficacy in comparison with the antibiotics most used in clinical practice is not well known. We studied the efficacy of colistin versus those of imipenem, sulbactam, tobramycin, and rifampin in an experimental pneumonia model with immunocompetent mice. We used three strains of A. baumannii corresponding to the main clones (A, D, and E) involved in the outbreaks of our hospital, with different grades of resistance to imipenem (imipenem MICs of 1, 8, and 512 g/ml, respectively) and to the other antibiotics. The MIC of colistin was 0.5 g/ml for the three strains. Reduction of log 10 CFU/g in lung bacterial counts, clearance of bacteremia, and survival versus results with controls were used as parameters of efficacy. Imipenem and sulbactam (⌬lung counts: ؊5.38 and ؊4.64 log 10 CFU/ml) showed the highest level of bactericidal efficacy in infections by susceptible and even intermediate strains. Tobramycin and rifampin (؊4.16 and ؊5.15 log 10 CFU/ml) provided good results against intermediate or moderately resistant strains, in agreement with killing curves and pharmacodynamics. On the contrary, colistin showed the weakest antibacterial effect among the antibiotics tested, both in killing curves and in the in vivo model (؊2.39 log 10 CFU/ml; P < 0.05). We conclude that colistin did not appear as a good option for treatment of patients with pneumonia due to carbapenem-resistant A. baumannii strains. Other alternatives, including combinations with rifampin, may offer better therapeutic profiles and thus should be studied.

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Outbreak caused by two multi-resistant Acinetobacter baumannii clones in a burns unit: emergence of resistance to imipenem

Cited by 56 publications

References 31 publications

Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management

Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management

A study of Acinetobacter infections in a tertiary care hospital in Northeast India

Efficacy of Colistin versus β-Lactams, Aminoglycosides, and Rifampin as Monotherapy in a Mouse Model of Pneumonia Caused by Multiresistant Acinetobacter baumannii

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