Epidemiology and clonality of carbapenem-resistant Acinetobacter baumannii from an intensive care unit in Palermo, Italy

被引：24

作者：

Caterina Mammina

Daniela Maria Palma

Celestino Bonura

Aurora Aleo

Teresa Fasciana

Concetta Sodano

Maria Antonietta Saporito

Maria Stella Verde

Cinzia Calà

Andrea Neville Cracchiolo

Romano Tetamo

机构：

[1] Department of Sciences for Health Promotion G. DAlessandro, Section of Hygiene, University of Palermo, Palermo

[2] II Intensive Care Unit, ARNAS General Hospital Civico and Benfratelli, Palermo

[3] Department of Sciences for Health Promotion G. DAlessandro, Section of Microbiology, University of Palermo, Palermo

[4] Laboratory of Microbiology, ARNAS General Hospital Civico and Benfratelli, Palermo

来源：

BMC Research Notes | / 5卷 / 1期

关键词：

Imipenem; Meropenem; Tigecycline; Carbapenem Resistance; Carbapenemase Gene;

D O I：

10.1186/1756-0500-5-365

中图分类号：

学科分类号：

摘要：

Background: Multidrug-resistant Acinetobacter baumannii, initially considered as having a poor clinical relevance, is frequently isolated from infection cases in intensive care units. We describe the epidemiology of carbapenem resistant A. baumannii (CRAB) in a general ICU in Palermo, Italy, from October 2010 to March 2011. Findings: 58 of 61 isolates exhibited MICs for meropenem or imipenem ≥16 mg/L. Forty-nine carried blaOXA-23 and two blaOXA-58genes. Five subtype clusters were detected by rep-PCR. Clusters D and E included 10 isolates that tested negative for the carbapenem resistance genes. MLST attributed all isolates, but two, with sequence type (ST)2, whereas the two remaining isolates with ST78. The respiratory tract was the most common site of infection (26 out of 36 cases. 72.2%). A high infection related mortality rate was observed (18 out of 35 patients, 51.4%). Nineteen patients tested positive for other multidrug resistant organisms in addition to CRAB. In eight cases isolates belonging to distinct subtype clusters and/or with distinct carbapenemase profiles were identified. Conclusions: Carbapenem resistance was prominently driven by the dissemination of CRAB isolates belonging to ST2, carrying the carbapenemase gene blaOXA-23. The colonization/infection of some patients by multiple strains is suggestive of an endemic circulation of CRAB. © 2012 Mammina et al.; licensee BioMed Central Ltd.

引用

共 27 条

[1]

Tsakris A., Ikonomidis A., Poulou A., Spanakis N., Vrizas D., Diomidous M., Pournaras S., Markou F., Clusters of imipenem-resistant acinetobacter baumannii clones producing different carbapenemases in an intensive care unit, Clinical Microbiology and Infection, 14, 6, pp. 588-594, (2008)

[2]

Bratu S., Landman D., Martin D.A., Georgescu C., Quale J., Correlation of antimicrobial resistance with -lactamases, the OmpA-like porin, and efflux pumps in clinical isolates of Acinetobacter baumannii endemic to New York City, Antimicrob Agents Chemother, 52, pp. 2999-3005, (2008)

[3]

Higgins P.G., Dammhayn C., Hackel M., Seifert H., Global spread of carbapenem-resistant Acinetobacter baumannii, J Antimicrob Chemother, 65, pp. 233-238, (2010)

[4]

Orsi G.B., Falcone M., Venditti M., Surveillance and management of multidrug-resistant microorganisms, Expert Rev Anti Infect Ther, 9, pp. 653-679, (2011)

[5]

Dijkshoorn L., Nemec A., Seifert H., An increasing threat in hospitals: Multidrug-resistant Acinetobacter baumannii, Nature Reviews Microbiology, 5, 12, pp. 939-951, (2007)

[6]

Vila J., Pachan J., Acinetobacter baumannii resistant to everything: What should we do?, Clin Microbiol Infect, 17, pp. 955-956, (2011)

[7]

Mammina C., Bonura C., Aleo A., Cal C., Caputo G., Cataldo M.C., Di Benedetto A., Distefano S., Fasciana T., Labisi M., Sodano C., Palma D.M., Giammanco A., Characterization of Acinetobacter baumannii from intensive care units and home care patients in Palermo, Italy, Clin Microbiol Infect, 17, pp. 512-515, (2011)

[8]

Sengstock D.M., Thyagarajan R., Apalara J., Mira A., Chopra T., Kaye K.S., Multidrug-resistant Acinetobacter baumannii: An emerging pathogen among older adults in community hospitals and nursing homes, Clin Infect Dis, 50, pp. 1611-1616, (2010)

[9]

Pfeifer Y., Cullik A., Witte W., Resistance to cephalosporins and carbapenems in Gram-negative bacterial pathogens, Int J Med Microbiol, 300, pp. 371-379, (2010)

[10]

D'Arezzo S., Principe L., Capone A., Petrosillo N., Petrucca A., Visca P., Changing carbapenemase gene pattern in an epidemic multidrug-resistant Acinetobacter baumannii lineage causing multiple outbreaks in central Italy, J Antimicrob Chemother, 66, pp. 54-61, (2011)

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