Persistent <i>Acinetobacter baumannii?</i> Look Inside Your Medical Equipment

Bernards, A.T.; Harinck, H. I. J.; Dijkshoorn, Lenie; Reijden, Tanny J. K. van der; Broek, P.J. van den

doi:10.1086/502335

Cited by 82 publications

(61 citation statements)

References 10 publications

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“…The second set (study phase II) included 30 epidemic A. baumannii isolates representing 10 well-described hospital outbreaks from different parts of Europe (3 isolates per outbreak). Most of the epidemiological data have been published previously, and all outbreak strains have been well characterized by one or more molecular typing methods (2,4,5,6,7,8,12,21,22,23,24,33). The isolates were divided so that each of the three laboratories investigated 1 randomly selected isolate per given outbreak, i.e., 10 epidemiologically independent outbreak isolates.…”

Section: Methodsmentioning

confidence: 99%

Standardization and Interlaboratory Reproducibility Assessment of Pulsed-Field Gel Electrophoresis-Generated Fingerprints of Acinetobacter baumannii

et al. 2005

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A standard procedure for pulsed-field gel electrophoresis (PFGE) of macrorestriction fragments of Acinetobacter baumannii was set up and validated for its interlaboratory reproducibility and its potential for use in the construction of an Internet-based database for international monitoring of epidemic strains. The PFGE fingerprints of strains were generated at three different laboratories with ApaI as the restriction enzyme and by a rigorously standardized procedure. The results were analyzed at the respective laboratories and also centrally at a national reference institute. In the first phase of the study, 20 A. baumannii strains, including 3 isolates each from three well-characterized hospital outbreaks and 11 sporadic strains, were distributed blindly to the participating laboratories. The local groupings of the isolates in each participating laboratory were identical and allowed the identification of the epidemiologically related isolates as belonging to three clusters and identified all unrelated strains as distinct. Central pattern analysis by using the band-based Dice coefficient and the unweighted pair group method with mathematical averaging as the clustering algorithm showed 95% matching of the outbreak strains processed at each local laboratory and 87% matching of the corresponding strains if they were processed at different laboratories. In the second phase of the study, 30 A. baumannii isolates representing 10 hospital outbreaks from different parts of Europe (3 isolates per outbreak) were blindly distributed to the three laboratories, so that each laboratory investigated 10 epidemiologically independent outbreak isolates. Central computer-assisted cluster analysis correctly identified the isolates according to their corresponding outbreak at an 87% clustering threshold. In conclusion, the standard procedure enabled us to generate PFGE fingerprints of epidemiologically related A. baumannii strains at different locations with sufficient interlaboratory reproducibility to set up an electronic database to monitor the geographic spread of epidemic strains.Acinetobacter baumannii is a well-recognized opportunistic pathogen that gives rise to nosocomial infections and outbreaks, in particular, in the intensive care unit setting (1). The increasing rates of resistance of A. baumannii to the major antimicrobial drugs make early identification and control of hospital outbreaks mandatory. Recent data indicate that several successful epidemic A. baumannii strains (clones) circulate in Europe, and a better understanding of the diversity within the species and the emergence of epidemic clones is urgently needed (19,25,29). Molecular typing plays an important role in the study of the epidemiology of A. baumannii and in coping with its epidemic spread.Various genotypic methods have been developed for the typing of acinetobacters, including ribotyping (11), macrorestriction analysis by pulsed-field gel electrophoresis (PFGE) (21), randomly amplified polymorphic DNA (RAPD) analysis (13), and total genomic fingerpr...

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Section: Methodsmentioning

confidence: 99%

Standardization and Interlaboratory Reproducibility Assessment of Pulsed-Field Gel Electrophoresis-Generated Fingerprints of Acinetobacter baumannii

et al. 2005

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“…Além disso, no ambiente hospitalar, algumas espécies foram isoladas de objetos inanimados, tais como equipamentos de Raios-X, bancadas, leitos, ventiladores e sistemas de circulação de ar. 1,3,5,6 As espécies mais comumente encontradas como colonizantes da pele humana são A. baumannii, A. johnsonii, A. lwoffii e A. radioresistens. Fato bastante relevante é que a espécie de maior importância clínica, A. baumannii, raramente tem sido identificada em fontes ambientais, e a prevalência da colonização em pacientes da comunidade por esta espécie é extremamente baixa.…”

Section: Características Do Gênerounclassified

“…A contaminação do ambiente hospitalar e a transmissão entre pacientes mediada pelos profissionais de saúde e pelos equipamentos médicos têm um papel importantíssimo. 5,6,10,22 Os surtos de CRAb podem ocorrer em diferentes unidades hospitalares, como unidades de internação clínica, de internação cirúrgica, de politraumatizados, UTI neonatal, UTI pediátrica e UTI de adultos. No entanto, a maior parte dos relatos de surto ocorre em UTI de adultos, em pacientes com mais de 50 anos.…”

Section: Características Dos Surtosunclassified

“…21 Além do ambiente, os equipamentos médicos também necessitam de atenção especial durante os processos de higienização e esterilização. 6 É importante utilizar sistemas de sucção fechados para evitar a contaminação do ambiente com aerossóis contendo o microrganismo. A adesão dos profissionais de saúde a essas medidas, associada à higienização de mãos e ao uso de precauções de contato, têm demonstrado um grande impacto no combate dos surtos.…”

Section: Medidas De Controle De Infecçãounclassified

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<i>Acinetobacter</i> multirresistente – um desafio para a saúde pública

Martins

Barth

2013

Sci Med

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RESUMOObjetivos: Discutir os diferentes aspectos associados à emergência da resistência aos antibióticos carbapenêmicos em Acinetobacter baumannii e a disseminação de clones epidêmicos. Fonte de dados: Foram consultadas as bases de dados SciELO, PubMed e Science Direct. Foram incluídos artigos publicados em inglês, prioritariamente no período de 2000 a 2011. Os descritores utilizados foram Acinetobacter, multidrug resistance (multirresistência), outbreaks (surtos) infection control measures (medidas de controle de infecções), e risk factors (fatores de risco). Síntese dos dados: Acinetobacter baumannii é um patógeno oportunista envolvido em um amplo espectro de infecções hospitalares, incluindo bacteremia, meningite e infecção do trato urinário. Sua maior prevalência é como agente de pneumonia hospitalar, particularmente pneumonia associada à ventilação mecânica em unidades de terapia intensiva. Os antimicrobianos carbapenêmicos já foram utilizados como tratamento das infecções causadas por Acinetobacter, mas atualmente as elevadas taxas de resistência a essa classe de antimicrobianos têm limitado as opções terapêuticas. A resistência aos carbapenêmicos pode estar relacionada à perda de porinas, à produção de b-lactamases da classe B (metalo-b-lactamases) e, de forma mais significativa, à produção de b-lactamases da classe D (OXA-carbapenemases). Surtos associados à produção de OXA-carbapenemases vêm sendo descritos em diferentes países desde o final da década de 1990, e a disseminação de clones epidêmicos tem sido documentada. Conclusões: O elevado número de surtos já relatados na literatura, a facilidade de disseminação de clones epidêmicos e a dificuldade no tratamento tornam as infecções por Acinetobacter um grave problema de saúde pública. ABSTRACT Aims:To discuss the various aspects associated with the emergence of carbapenem resistance in isolates of Acinetobacter baumannii and the spread of epidemic clones. Source of data: We consulted the databases SciELO, PubMed and Science Direct. We included articles published in English, primarily from 2000 to 2011. The key words were Acinetobacter, multidrug resistance, outbreaks, infection control measures, and risk factors. Summary of findings: Acinetobacter baumannii is an opportunistic pathogen involved in a wide spectrum of nosocomial infections, including bacteremia, meningitis and urinary tract infection. It is most prevalent as an agent of nosocomial pneumonia, particularly pneumonia associated with mechanical ventilation in intensive care units. Carbapenem antibiotics have been used as treatment of choice for infections caused by Acinetobacter, but currently the high rates of resistance to this class of antimicrobials have limited the therapeutic options. Resistance to carbapenem may be related to the loss of porins, to class B b-lactamases (metallo-b-lactamases) and more significantly, to the production class D b-lactamases (OXA-type carbapenemases). Outbreaks associated with the production of OXA-carbapenemases have been reported in different countries ...

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“…In einer Reihe von Ausbrü-chen wurden entsprechende Reservoire in der unbelebten Umgebung als Quelle identifiziert [118,[314][315][316][317][318][319][320][321][322][323]. Neben der Umwelt wurden Reservoire in medizinischen Geräten [324][325][326] March et al [160] berichteten über die Nachweishäufigkeit von ESBL-Bildnern (allgemein) bei insgesamt 225 Personen (Heimbewohner, Mitarbeitern und geriatrische Patienten). Die höchste Sensitivität hatte der Rektalabstrich mit 96 % gefolgt vom Inguinalabstrich mit 73 %, wobei der Goldstandard aus der Summe der Personen errechnet wurde, die in einem der entnommenen Abstriche positiv waren, und daher nicht als unabhängiger Maßstab angesehen werden kann.…”

Section: Reservoire Und üBertragungswegeunclassified

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

2012

Bundesgesundheitsbl.

281

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Persistent Acinetobacter baumannii? Look Inside Your Medical Equipment

Cited by 82 publications

References 10 publications

Standardization and Interlaboratory Reproducibility Assessment of Pulsed-Field Gel Electrophoresis-Generated Fingerprints of Acinetobacter baumannii

Standardization and Interlaboratory Reproducibility Assessment of Pulsed-Field Gel Electrophoresis-Generated Fingerprints of Acinetobacter baumannii

<i>Acinetobacter</i> multirresistente – um desafio para a saúde pública

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

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