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Clinical epidemiology and resistance mechanisms of carbapenem-resistant Acinetobacter baumannii, French Guiana, 2008-2014.
- Source :
-
International journal of antimicrobial agents [Int J Antimicrob Agents] 2016 Jul; Vol. 48 (1), pp. 51-55. Date of Electronic Publication: 2016 Apr 25. - Publication Year :
- 2016
-
Abstract
- 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.<br /> (Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.)
- Subjects :
- Acinetobacter baumannii enzymology
Acinetobacter baumannii genetics
Acinetobacter baumannii isolation & purification
Adult
Bacterial Proteins genetics
Cross Infection epidemiology
Cross Infection microbiology
Disk Diffusion Antimicrobial Tests
Electrophoresis, Gel, Pulsed-Field
Female
French Guiana epidemiology
Hospitals
Humans
Male
Middle Aged
Molecular Epidemiology
Multilocus Sequence Typing
Retrospective Studies
Young Adult
beta-Lactamases genetics
Acinetobacter Infections epidemiology
Acinetobacter Infections microbiology
Acinetobacter baumannii drug effects
Carbapenems pharmacology
Disease Outbreaks
beta-Lactam Resistance
Subjects
Details
- Language :
- English
- ISSN :
- 1872-7913
- Volume :
- 48
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of antimicrobial agents
- Publication Type :
- Academic Journal
- Accession number :
- 27236843
- Full Text :
- https://doi.org/10.1016/j.ijantimicag.2016.03.006