1. Epidemiology and clonality of carbapenem-resistant Acinetobacter baumannii from an intensive care unit in Palermo, Italy
- Author
-
Teresa Fasciana, Maria Antonietta Saporito, Maria Stella Verde, Caterina Mammina, Cinzia Calà, Aurora Aleo, Romano Tetamo, Celestino Bonura, Concetta Sodano, Daniela Maria Palma, Andrea Neville Cracchiolo, Mammina, C, Palma, DM, Bonura, C, Aleo, A, Fasciana, T, Sodano, C, Saporito, MA, Verde, MS, Calà, C, Cracchiolo, AN, and Tetamo, R
- Subjects
Male ,Acinetobacter baumannii ,Imipenem ,Settore MED/07 - Microbiologia E Microbiologia Clinica ,Time Factors ,lcsh:Medicine ,Tigecycline ,Polymerase Chain Reaction ,intensive care unit ,law.invention ,law ,Drug Resistance, Multiple, Bacterial ,Epidemiology ,polycyclic compounds ,Medicine ,lcsh:QH301-705.5 ,Medicine(all) ,Aged, 80 and over ,biology ,General Medicine ,Middle Aged ,Intensive care unit ,Intensive Care Units ,Italy ,Female ,Acinetobacter Infections ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Short Report ,Microbial Sensitivity Tests ,Meropenem ,General Biochemistry, Genetics and Molecular Biology ,Young Adult ,Intensive care ,Humans ,Intensive care medicine ,lcsh:Science (General) ,Aged ,Demography ,Biochemistry, Genetics and Molecular Biology(all) ,business.industry ,lcsh:R ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,biology.organism_classification ,Clone Cells ,Carbapenems ,lcsh:Biology (General) ,bacteria ,business ,Carbapenem resistant Acinetobacter baumannii ,lcsh:Q1-390 - Abstract
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-58 genes. 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.
- Published
- 2012