Sequential outbreaks of multidrug-resistant Acinetobacter baumannii in intensive care units of a tertiary referral hospital in Italy: combined molecular approach for epidemiological investigation

被引：19
作者：
Ansaldi, F. [1 ]
Canepa, P. [1 ]
Bassetti, M. [2 ]
Zancolli, M. [1 ]
Molinari, M. P. [3 ]
Talamini, A. [4 ]
Ginocchio, F. [2 ]
Durando, P. [1 ]
Mussap, M. [3 ]
Orengo, G. [4 ]
Viscoli, C. [2 ]
Icardi, G. [1 ]
机构：
[1] Univ Genoa, Dept Hlth Sci, I-16100 Genoa, Italy
[2] San Martino Univ Hosp, Dept Infect Dis, Genoa, Italy
[3] San Martino Univ Hosp, Dept Biomed Lab, Genoa, Italy
[4] San Martino Univ Hosp, Hlth Direct, Genoa, Italy
来源：
JOURNAL OF HOSPITAL INFECTION | 2011年 / 79卷 / 02期
关键词：
Molecular epidemiology; Multidrug-resistant Acinetobacter baumannii; Multilocus sequence typing; Outbreak; Repetitive extragenic palindromic polymerase chain reaction (REP-PCR); TYPING SCHEME; MULTIPLEX PCR; STRAINS; IDENTIFICATION; INFECTIONS; EXPRESSION; OXA-58; GENES;
D O I：
10.1016/j.jhin.2011.05.027
中图分类号：
R1 [预防医学、卫生学];
学科分类号：
1004 ; 120402 ;
摘要：
A laboratory-based surveillance study was conducted from January 2007 to May 2010 in San Martino Tertiary Referral Hospital in Genoa, Italy in which the molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the five intensive care units (ICUs). A total of 53 A. baumannii strains were isolated from patients admitted to ICUs (69.8%) and to other epidemiologically linked hospital wards (30.2%) and were genotyped by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), multilocus sequence typing (MLST) and adeB sequence typing. REP-PCR fingerprinting analysis, MLST and adeB typing results were well correlated and allowed us to classify strains causing epidemic events into three major epidemic clones: A (REP-I/ST4, adeB-STII genotype) isolated for the first time in May 2007, B (REP-IV/ST95, adeB-STI genotype) from November 2007 to May 2009 and C (REP-VII/ST118, adeB-STII genotype) from July 2008 to May 2010. MLST results demonstrated that epidemic clones A and C were related as they were members of the widespread clonal complex CC92. The genetic determinants of carbapenem resistance were investigated and resistance associated with the presence of the bla(OxA-58-like) gene with ISAba2 and ISAba3 elements flanking it in clone A, and with the bla(OxA-23-like) gene flanked by ISAba1 in clones B and C. A molecular approach allowed the prompt introduction of infection control measures and the evaluation of data in a global epidemiological context. (C) 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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页码：134 / 140
页数：7
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