1. Clinical epidemiology and resistance mechanisms of carbapenem-resistant Acinetobacter baumannii, French Guiana, 2008-2014
- Author
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Magalie Demar, Pierre Couppié, Hatem Kallel, Mathieu Nacher, Christine Simonnet, Didier Hommel, Félix Djossou, Aba Mahamat, Xavier Bertrand, B. Moreau, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Institut de l’Élevage, Centre Hospitalier Andrée-Rosemond, Epidemiologie des Parasitoses Tropicales ( EPaT Team ), Université des Antilles et de la Guyane ( UAG ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Département de Biologie, Unité de Biochimie des Lipides et des Protéines, Faculté des Sciences de Tunis, Ecosystemes Amazoniens et Pathologie Tropicale ( EPat ), Université de Guyane ( UG ) -Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles ( UA ), Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyanne Française], Centre d'investigation clinique Antilles-Guyane ( CIC - Antilles Guyane ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine ( COREVIH Guyane ), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Faculté des Sciences Mathématiques, Physiques et Naturelles de Tunis (FST), Université de Tunis El Manar (UTM)-Université de Tunis El Manar (UTM), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH Guyane)
- Subjects
0301 basic medicine ,Male ,Acinetobacter baumannii ,Imipenem ,MESH : Retrospective Studies ,Epidemiology ,MESH : Multilocus Sequence Typing ,MESH: beta-Lactamases ,MESH : Carbapenems ,Disease Outbreaks ,MESH: Carbapenems ,Disk Diffusion Antimicrobial Tests ,[ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology ,polycyclic compounds ,MESH : Bacterial Proteins ,Pharmacology (medical) ,MESH : Female ,MESH: Disease Outbreaks ,MESH: Bacterial Proteins ,Cross Infection ,Molecular Epidemiology ,MESH: Middle Aged ,biology ,MESH : beta-Lactamases ,General Medicine ,Middle Aged ,MESH : Adult ,MESH: Hospitals ,Hospitals ,3. Good health ,Electrophoresis, Gel, Pulsed-Field ,French Guiana ,MESH : Hospitals ,Infectious Diseases ,MESH: Multilocus Sequence Typing ,MESH: Electrophoresis, Gel, Pulsed-Field ,[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology ,Amikacin ,MESH: Young Adult ,MESH: Disk Diffusion Antimicrobial Tests ,Female ,MESH: Acinetobacter Infections ,MESH : Cross Infection ,medicine.drug ,Acinetobacter Infections ,Microbiology (medical) ,Adult ,MESH : French Guiana ,MESH : Male ,030106 microbiology ,MESH : Molecular Epidemiology ,MESH : Young Adult ,Tazobactam ,beta-Lactam Resistance ,beta-Lactamases ,Microbiology ,Carbapenem-resistant ,03 medical and health sciences ,Young Adult ,Bacterial Proteins ,MESH : beta-Lactam Resistance ,MESH: French Guiana ,medicine ,Humans ,MESH: Molecular Epidemiology ,MESH : Acinetobacter Infections ,Intensive care unit ,MESH : Middle Aged ,MESH : Disease Outbreaks ,MESH : Disk Diffusion Antimicrobial Tests ,MESH : Acinetobacter baumannii ,Retrospective Studies ,MESH : Electrophoresis, Gel, Pulsed-Field ,MESH: Humans ,Molecular epidemiology ,business.industry ,MESH: Acinetobacter baumannii ,MESH : Humans ,Outbreak ,MESH: Cross Infection ,MESH: Retrospective Studies ,MESH: Adult ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,bacterial infections and mycoses ,MESH: Male ,MESH: beta-Lactam Resistance ,Carbapenems ,Colistin ,Nosocomial ,business ,MESH: Female ,Piperacillin ,Multilocus Sequence Typing - Abstract
International audience; This study investigated the clinical epidemiology and resistance mechanisms of Acinetobacter baumannii and characterised the clonal diversity of carbapenem-resistant A. baumannii (CRAB) during an ICU-associated outbreak at Cayenne Hospital, French Guiana. All non-duplicate A. baumannii isolates from 2008 to 2014 were tested for antibiotic susceptibility by disk diffusion. Multilocus sequence typing, pulsed-field gel electrophoresis (PFGE) and characterisation of carbapenemase-encoding genes were performed on CRAB. Of the 441 A. baumannii isolates, most were from males (54.0%) and were detected mainly from the ICU (30.8%) and medicine wards (21.8%). In the ICU, strains were mainly isolated from the respiratory tract (44.1%) and bloodstream (14.0%), whereas in medicine wards they mainly were from wound/drainage (36.5%) and bloodstream (25.0%). A. baumannii showed the greatest susceptibility to piperacillin/tazobactam (92.7%), imipenem (92.5%), colistin (95.6%) and amikacin (97.2%), being lower in the ICU and medicine wards compared with other wards. An outbreak of OXA-23-producing CRAB occurred in the 13-bed ICU in 2010. CRAB strains were more co-resistant to other antimicrobials compared with non-CRAB. Molecular genetics analysis revealed five sequence types [ST78, ST107 and ST642 and two new STs (ST830 and ST831)]. Analysis of PFGE profiles indicated cross-transmissions of CRAB within the ICU, between the ICU and one medicine ward during transfer of patients, and within that medicine ward. This study provides the first clinical and molecular data of A. baumannii from French Guiana and the Amazon basin. The ICU was the highest risk unit of this nosocomial outbreak of OXA-23-producing CRAB, which could subsequently disseminate within the hospital.
- Published
- 2016