Six-Year Prospective Study of Risk and Prognostic Factors in Patients with Nosocomial Sepsis Caused by Acinetobacter baumannii

Gómez, Joaquín; Simarro, E.; Baños, V.; Requena, Luis; Ruiz, J.; García, F.; Canteras, Manuel; Valdés, Mariano

doi:10.1007/pl00015019

Cited by 50 publications

(63 citation statements)

References 13 publications

(16 reference statements)

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“…There are many studies in the literature showing that genomic DNA group 2 (A. baumannii), together with genomic DNA groups 1, 3, and 13TU (known as the Acinetobacter calcoaceticus-A. baumannii complex [Acb complex]), is predominantly involved in infection (2,5,8,9,13,17,20,24,28,36,39). Many of these studies were, however, based on outbreak strains or did not use reliable methods for genomic identification (18,40).…”

Section: Discussionmentioning

confidence: 99%

“…The environmental load in the ICU was significantly higher than in the four surgical wards, although there was no significant difference in the distribution of genomic DNA groups. Risk factors, such as antibiotic therapy, mechanical ventilation, and others, are well described for Acinetobacter carriage and infections among ICU patients (2,8,10,14,17,18,20,24,36,42). The presence of a large number of patients with risk factors and a high volume of clinical activities, together with other factors in the ICU, could have contributed to the heavy load of acinetobacters in the environment.…”

Section: Discussionmentioning

confidence: 99%

“…Outbreaks of Acinetobacter infections, often caused by multiresistant strains, have been widely reported, commonly in intensive care units (ICUs) in North America and Europe. Epidemiological features and risk factors of these outbreaks have also been well described (2,5,8,10,14,16,17,18,20,24,36,43). In contrast, there is a paucity of information in regions of Acinetobacter endemicity, such as Hong Kong (28,34,35).…”

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confidence: 99%

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Epidemiology and Infection Control Implications of Acinetobacter spp. in Hong Kong

et al. 2001

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In a previous study, we showed that Acinetobacter genomic DNA group 3 was the most common species among blood culture isolates and was commonly found on superficial carriage sites of the healthy and the sick, which are different findings from those reported in Europe and North America. We used amplified ribosomal DNA restriction analysis and pulsed-field gel electrophoresis to study further the molecular epidemiology of acinetobacters in our region. Over a study period of 6 weeks with 136 consecutive routine clinical isolates (1.33% of all specimens), genomic DNA groups 2 (Acinetobacter baumannii), 3, and 13TU were obtained from 59 of 69 positive patients. There is a significant difference in the specimen sources of the three genomic DNA groups, with group 13TU being significantly associated with the respiratory tract (chi-square exact test, P ‫؍‬ 0.0064). Settle plates showed a significantly heavier environmental load from the intensive care unit (ICU) than from the four surgical wards examined (22 of 70 versus 76 of 120 plates with <5 colonies; chi-square test, P < 0.0001). Genomic group 3 accounted for 6 of 12 clusters of possibly related strains among patients, between patients and the ICU environment, and in the ICU environment. Genomic groups 2 and 3 accounted for 21% of the 132 genomically identified isolates recovered from 21 of 41 local vegetables, 53 of 74 fish and meat samples, and 22 of 60 soil samples. Group 13TU was present only in patients' immediate surroundings. The role played by the environment and by human carriage should be evaluated in order to devise a cost-effective infection control program pertinent to our situation of acinetobacter endemicity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Epidemiology and Infection Control Implications of Acinetobacter spp. in Hong Kong

et al. 2001

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“…In addition, A. baumannii infections have been identified in troops returning from military engagements in the Middle East [4]. A. baumannii has been identified as the causative agent in many serious medical conditions such as sepsis and nosocomial pneumonia [5,6]. Although in general the virulence of this species is low; its colonization poses a threat in a health care setting.…”

Section: Introductionmentioning

confidence: 99%

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States

Vaze¹,

Emery²,

Hamilton³

et al. 2013

AID

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A characterization of the clinical demographic features of patients with infection caused Acinetobacter baumannii, and the antibiotyping of the isolates recovered from these patients was undertaken, with a special reference to carbapenemresistant variants, and their risk factors. This study was conducted retrospectively from January 2010 to March 2011 at a 616-bed tertiary care university hospital. Sixty-four patients were identified. Clinical and microbiological data were analyzed for risk factors and demographic features to derive relative risk and odds ratio. We identified 100 A. baumannii from 64 patients during 15 months period. Significant risk factors were working age (18 -60 years), male gender, hospital stay (>1 week but <1 month), prior hospitalization, in a progressive care nursing units, respiratory/mechanical ventilation, polymicrobial infections and prior antibiotic therapy. Methicillin-resistant staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Klebsiella pneumoniae were the significant co-infecting agents. The antibiogram demonstrated multidrug resistance in a majority of the isolates. Relative risk associated with ventilator, diabetes, and surgery was higher in repeat isolates than in first isolates and were multidrug resistant. Repeat isolates were more resistant that the first isolates to most anti-acinetobacter agents, but the overall crude mortality was not significant during this study period, and couldn't correlated to the choice of treatment. In conclusion, a resistance against all clinically used carbapenems, and colistin is rapidly increasing in repeat isolates of A. baumannii; leaves narrow therapeutic options to treat multidrug-resistant and pandrug-resistant A. baumannii infection. For the first time we report rising incidence of colistin resistance by 20 percent in repeat isolates, and is worrisome for healthcare centers. A combination therapy should be adopted to treat such infection to avoid the emergence of colistin-resistant phenotypes in the United States.

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“…are commonly associated with serious nosocomial infections (10,14,23,37,40,41). Most recently, American troops wounded in Iraq (Operation Iraqi Freedom) and Afghanistan (Operation Enduring Freedom) have suffered severe infections from antibiotic-resistant Acinetobacter baumannii, making this organism an important pathogen in military health (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5345a1.htm).…”

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confidence: 99%

Identification of a New Allelic Variant of the Acinetobacter baumannii Cephalosporinase, ADC-7 β-Lactamase: Defining a Unique Family of Class C Enzymes

Hujer¹,

Hamza

Hujer³

et al. 2005

Antimicrob Agents Chemother

142

138

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Acinetobacter spp. are emerging as opportunistic hospital pathogens that demonstrate resistance to many classes of antibiotics. In a metropolitan hospital in Cleveland, a clinical isolate of Acinetobacter baumannii that tested resistant to cefepime and ceftazidime (MIC ‫؍‬ 32 g/ml) was identified. Herein, we sought to determine the molecular basis for the extended-spectrum-cephalosporin resistance. Using analytical isoelectric focusing, a ␤-lactamase with a pI of >9.2 was detected. PCR amplification with specific A. baumannii cephalosporinase primers yielded a 1,152-bp product which, when sequenced, identified a novel 383-amino-acid class C enzyme. Expressed in Escherichia coli DH10B, this ␤-lactamase demonstrated greater resistance against ceftazidime and cefotaxime than cefepime (4.0 g/ml versus 0.06 g/ml). The kinetic characteristics of this ␤-lactamase were similar to other cephalosporinases found in Acinetobacter spp. In addition, this cephalosporinase was inhibited by meropenem, imipenem, ertapenem, and sulopenem (K i < 40 M). The amino acid compositions of this novel enzyme and other class C ␤-lactamases thus far described for A. baumannii, Acinetobacter genomic species 3, and Oligella urethralis in Europe and South Africa suggest that this cephalosporinase defines a unique family of class C enzymes. We propose a uniform designation for this family of cephalosporinases (Acinetobacter-derived cephalosporinases [ADC]) found in Acinetobacter spp. and identify this enzyme as ADC-7 ␤-lactamase. The coalescence of Acinetobacter ampC ␤-lactamases into a single common ancestor and the substantial phylogenetic distance separating them from other ampC genes support the logical value of developing a system of nomenclature for these Acinetobacter cephalosporinase genes.Acinetobacter spp. are commonly associated with serious nosocomial infections (10,14,23,37,40,41). Most recently, American troops wounded in Iraq (Operation Iraqi Freedom) and Afghanistan (Operation Enduring Freedom) have suffered severe infections from antibiotic-resistant Acinetobacter baumannii, making this organism an important pathogen in military health

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Six-Year Prospective Study of Risk and Prognostic Factors in Patients with Nosocomial Sepsis Caused by Acinetobacter baumannii

Cited by 50 publications

References 13 publications

Epidemiology and Infection Control Implications of Acinetobacter spp. in Hong Kong

Epidemiology and Infection Control Implications of Acinetobacter spp. in Hong Kong

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States

Identification of a New Allelic Variant of the Acinetobacter baumannii Cephalosporinase, ADC-7 β-Lactamase: Defining a Unique Family of Class C Enzymes

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Six-Year Prospective Study of Risk and Prognostic Factors in Patients with Nosocomial Sepsis Caused by Acinetobacter baumannii

Cited by 50 publications

References 13 publications

Epidemiology and Infection Control Implications of Acinetobacter spp. in Hong Kong

Epidemiology and Infection Control Implications of Acinetobacter spp. in Hong Kong

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; in a Teaching Hospital from the United States

Identification of a New Allelic Variant of the Acinetobacter baumannii Cephalosporinase, ADC-7 β-Lactamase: Defining a Unique Family of Class C Enzymes

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Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States