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WOS: 000474355000001, PubMed ID: 31266519, BackgroundMultidrug-resistant (MDR) Acinetobacter baumannii infections are considered as emerging nosocomial infections particularly in patients hospitalized in intensive care units (ICUs). Therefore, reliable detection of MDR strains is crucial for management of treatment but also for epidemiological data collections. The purpose of this study was to compare antimicrobial resistance and the clonal distribution of MDR clinical and environmental A. baumannii isolates obtained from the ICUs of 10 different hospitals from five geographical regions of Turkey in the context of the demographic and clinical characteristics of the patients.MethodsA multicenter-prospective study was conducted in 10 medical centers of Turkey over a 6month period. A total of 164 clinical and 12 environmental MDR A. baumannii isolates were included in the study. Antimicrobial susceptibility testing was performed for amikacin (AN), ampicillin-sulbactam (SAM), ceftazidime (CAZ), ciprofloxacin (CIP), imipenem (IMP) and colistin (COL) by microdilution method and by antibiotic gradient test for tigecycline (TIG). Pulsed-field gel electrophoresis (PFGE) was performed to determine the clonal relationship between the isolates. The detection of the resistance genes, bla(OXA-23),bla(OXA-24),bla(OXA-51,)bla(OXA-58,)bla(IMP,)bla(NDM), bla(KPC), bla(OXA-48) and bla(PER-1) was carried out using the PCR method.ResultsThe mortality rate of the 164 patients was 58.5%. The risk factors for mortality included diabetes mellitus, liv1er failure, the use of chemotherapy and previous use of quinolones. Antimicrobial resistance rates for AN, SAM, CAZ, CIP, IMP, COL and TIG were 91.8%, 99.4%, 99.4%, 100%, 99.4%, 1.2% and 1.7% respectively. Colistin showed the highest susceptibility rate. Four isolates did not grow on the culture and were excluded from the analyses. Of 172 isolates, 166 (96.5%) carried bla(OXA-23), 5 (2.9%) bla(OXA-58) and one isolate (0.6%) was positive for both genes. The frequency of bla(PER-1) was found to be 2.9%. None of the isolates had bla(IMP), bla(KPC), bla(NDM) and bla(OXA-48) genes. PFGE analysis showed 88 pulsotypes. Fifteen isolates were clonally unrelated. One hundred fifty-seven (91.2%) of the isolates were involved in 14 different clusters.ConclusionsColistin is still the most effective antibiotic for A. baumannii infections. The gene bla(OXA-23) has become the most prevalent carbapenemase in Turkey. The distribution of invasive A. baumannii isolates from different regions of Turkey is not diverse so, infection control measures at medical centers should be revised to decrease the MDR A. baumannii infections across the country. The results of this study are expected to provide an important baseline to assess the future prophylactic and therapeutic options., Hacettepe University Scientific Research UnitHacettepe University [011 D07 101 007-135], This study was supported by a Hacettepe University Scientific Research Unit (Project no: 011 D07 101 007-135) grant.

WOS: 000472129100006, Myroides sp is a rare cause of infection, which can be fatal. Myroides spp isolates were obtained from urinal specimens of in- and out-patients attending a hospital in Turkey during July 2015 to November 2017. Myroides sp identification was based on colony morphology, biochemical properties and partial sequence of 16S rDNA, revealing the presence of M. odoratus. Antibiogram profiles showed almost all Myroides sp strains from in-patients (n = 11) were resistant to 13 antibiotics tested except for 50% that were intermediate resistant to tigecycline, whereas strains from out-patients (n = 4) were susceptible or intermediate susceptible. However, all Myroides sp strains lacked the six carbapenem resistance genes examined. Pulse-field gel-electrophoresis demonstrated clonality among four strains from in-patients. Clinical features of five in-patients and two outpatients isolates were believed to be due to Myroides infection and were treated accordingly; however, two died. Two out-patients believed to be infected recovered completely upon treatment. Ten in-patients had renal problems and all outpatients had urological problems or chronic renal failure. Myroides spp caused infection in both immunocompromised and immunocompetent patients in our study. Although tigecycline was used as first line treatment for Myroides-infected in-patients at this hospital, antibiograms of Myroides spp cultured from both in-and out-patients at other hospitals should be maintained to assist in prescribing appropriate antibiotics. Although Myroides infection is rare, its innate multi-drug resistance and propensity among patients with renal and urological problems warrants microbiological attention.