Unusual genetic heterogeneity of Acinetobacter baumannii isolates in a university hospital in Italy

Villari, Paolo; Iacuzio, L.; Vozzella, Emilia Anna; Bosco, Umberto

doi:10.1053/ic.1999.v27.a96961

Cited by 34 publications

(53 citation statements)

References 30 publications

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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%

“…Contrary to nosocomial infections caused by other gram-negative rods, airborne sources have been suggested to be important in outbreaks of Acinetobacter infection (1). Samples from environmental sources often did not yield any acinetobacters, although their elimination when detected has been regarded as an important step toward the control of the outbreak (1,5,10,18,20,39). Acinetobacter-carrying particles may be skin scales, droplets from respiratory secretions, or dust (15,27).…”

Section: Discussionmentioning

confidence: 99%

“…We did not study the clinical significance of positive samples. Others have shown infection rates of 30 to 55% among patients with positive specimens (13,39 (2) 1 (3) 2 (2) 8 (10) 12 (17) Total c 7 (11) 11 (13) 13 (13) 15 (22) 37 (68) 68 (127) a Miscellaneous sources were urine, ears, eyes, bile, and continuous ambulatory peritoneal dialysis fluid.…”

Section: Discussionmentioning

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%

Section: Discussionmentioning

confidence: 99%

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

et al. 2001

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“…Acinetobacter baumannii is a glucose-nonfermentative gramnegative coccobacillus that is widely distributed in the hospital environment and is an important opportunistic pathogen responsible for a variety of nosocomial infections, comprising bacteremia, urinary tract infection, secondary meningitis, surgical-site infection, and nosocomial and ventilator-associated pneumonia, especially in intensive-care-unit (ICU) patients (4,6,7,10,15,16,24,29). Extensive use of antimicrobial chemotherapy within hospitals has contributed to the emergence and increase in the number of A. baumannii strains resistant to a wide range of antibiotics, including broad-spectrum beta-lactams, aminoglycosides, and fluoroquinolones (4,7,10,15,24,28).…”

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confidence: 99%

Molecular Epidemiology of Sequential Outbreaks of Acinetobacter baumannii in an Intensive Care Unit Shows the Emergence of Carbapenem Resistance

et al. 2004

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The molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the medicalsurgical intensive care unit (ICU) of a university hospital in Italy during two window periods in which two sequential A. baumannii epidemics occurred. Genotype analysis by pulsed-field gel electrophoresis (PFGE) of A. baumannii isolates from 131 patients identified nine distinct PFGE patterns. Of these, PFGE clones B and I predominated and occurred sequentially during the two epidemics. A. baumannii epidemic clones showed a multidrug-resistant antibiotype, being clone B resistant to all antimicrobials tested except the carbapenems and clone I resistant to all antimicrobials except ampicillin-sulbactam and gentamicin. Type 1 integrons of 2.5 and 2.2 kb were amplified from the chromosomal DNA of epidemic PFGE clones B and I, respectively, but not from the chromosomal DNA of the nonepidemic clones. Nucleotide analysis of clone B integron identified four gene cassettes: aacC1, which confers resistance to gentamicin; two open reading frames (ORFs) coding for unknown products; and aadA1a, which confers resistance to spectinomycin and streptomycin. The integron of clone I contained three gene cassettes: aacA4, which confers resistance to amikacin, netilmicin, and tobramycin; an unknown ORF; and bla OXA-20 , which codes for a class D ␤-lactamase that confers resistance to amoxicillin, ticarcillin, oxacillin, and cloxacillin. Also, the bla IMP allele was amplified from chromosomal DNA of A. baumannii strains of PFGE type I. Class 1 integrons carrying antimicrobial resistance genes and bla IMP allele in A. baumannii epidemic strains correlated with the high use rates of broad-spectrum cephalosporins, carbapenems, and aminoglycosides in the ICU during the study period.

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“…Preparation of bacterial gel plugs and cell lysis were performed as previously described (18). Whole-cell DNA was digested in a 1% agarose gel with ApaI enzyme (New England Biolabs, Beverly, MA) at 25°C for 4 h. Electrophoresis was performed with a CHEF-DRII system (Bio-Rad Laboratories, Hercules, CA) over 18.5 h at 14°C with 5 to 13 s of linear ramping at 200 V. Pulsed-field gel electrophoresis (PFGE) patterns were interpreted visually by using the criteria proposed by Tenover et al (17).…”

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confidence: 99%

Characterization of Genetic Diversity of Carbapenem-Resistant Acinetobacter baumannii Clinical Strains Collected from 2004 to 2007

Malczynski

Parker

et al. 2008

J Clin Microbiol

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Unusual genetic heterogeneity of Acinetobacter baumannii isolates in a university hospital in Italy

Cited by 34 publications

References 30 publications

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

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

Molecular Epidemiology of Sequential Outbreaks of Acinetobacter baumannii in an Intensive Care Unit Shows the Emergence of Carbapenem Resistance

Characterization of Genetic Diversity of Carbapenem-Resistant Acinetobacter baumannii Clinical Strains Collected from 2004 to 2007

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