A hospital outbreak of antibiotic-resistant Acinetobacter anitratus: epidemiology and control

French, Gary; Casewell, M.W.; Aj, Roncoroni; Knight, S.; Phillips, Ian

doi:10.1016/0195-6701(80)90044-4

Cited by 112 publications

(36 citation statements)

References 18 publications

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“…calcoaceticus is increasing in importance as a nosocomial pathogen (CDC, 1979;Glew, Moellering & Kunz, 1977;Ramphal & Kluge, 1979;Rosenthal, 1978), and in some instances hand carriage of this organism by health care personnel, especially those with hand dermatitis, has resulted in nosocomial infection (Buxton et al 1978). French et al (1980, while investigating an outbreak of A. calcoaceticu8 var.…”

Section: Discussionmentioning

confidence: 99%

Hand carriage of aerobic Gram-negative rods by health care personnel

Adams

Marrie

1982

J. Hyg.

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SUMMARYA quantitative culture technique (hand washed in a glove containing broth for 30 s) was used to determine the frequency ofhand carriage ofaerobic Gram-negative rods by various groups of health care workers and 104 control subjects. Overall, 31 % of health care workers carried aerobic Gram-negative rods on their hands compared to 59 % of control subjects (P < 0-001). Enterobacter agglomerans accounted for 40 % of the isolates, and other Enterobacter spp. 7 %. Other organisms included Acinetobacter calcoaceticus 21 %, Serratia spp. 11 %, Klebsiella spp. 10 %, Moraxella spp. 3 %, Pseudomonas spp. 3 %, Proteus spp. 1V5 %, Escherichia coli 1 %; Morganella morganii, Citrobacter freundii, Aeromonas sp. and an isolate that was not speciated accounted for 0 5 % each. We conclude that endemic hand carriage ofaerobic Gram-negative rods by health care personnel is common, but significantly less than that of control subjects. Enterobacter agglomerans is found so frequently on the hands of control subjects that it must be considered part of the normal hand flora.

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Section: Discussionmentioning

confidence: 99%

Hand carriage of aerobic Gram-negative rods by health care personnel

Adams

Marrie

1982

J. Hyg.

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“…Lately, numerous outbreaks of nosocomial infections caused by A. baumannii have been reported (7-10, 16, 42, 47, 56, 57, 73), which are of particular concern because of the widespread and increasing antibiotic resistance of the isolated strains (17,30,32,33,40,41,48). Nevertheless, most infections have occurred in patients compromised by either antibiotic therapy, respiratory instrumentation and manipulations, dialysis, or surgery (18,19,39,70).…”

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confidence: 99%

“…anitratus (15), belongs to a bacterial species that is widely distributed throughout the environment (6). This microorganism can be isolated from the skin (3, 43) and respiratory tract (59) of healthy ambulatory adults as well as from hospital personnel and equipment (36,39,46,67).Lately, numerous outbreaks of nosocomial infections caused by A. baumannii have been reported (7-10, 16, 42, 47, 56, 57, 73), which are of particular concern because of the widespread and increasing antibiotic resistance of the isolated strains (17,30,32,33,40,41,48). Nevertheless, most infections have occurred in patients compromised by either antibiotic therapy, respiratory instrumentation and manipulations, dialysis, or surgery (18,19,39,70).…”

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Characterization of a high-affinity iron transport system in Acinetobacter baumannii

et al. 1992

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Analysis of a clinical isolate ofAcinetobacter baumannii showed that this bacterium was able to grow under iron-limiting conditions, using chemically defined growth media containing different iron chelators such as human transferrin, ethylenediaminedi-(o-hydroxyphenyl)acetic acid, nitrilotriacetic acid, and 2,2'-bipyridyl. This iron uptake-proficient phenotype was due to the synthesis and secretion of a catechol-type siderophore compound. Utilization bioassays using the SalmoneUla typhimurium iron uptake mutants enb-1 and enb-7 proved that this siderophore is different from enterobactin. This catechol siderophore was partially purified from culture supernatants by adsorption chromatography using an XAD-7 resin. The purified component exhibited a chromatographic behavior and a UV-visible light absorption spectrum different from those of 2,3-dihydroxybenzoic acid and other bacterial catechol siderophores. Furthermore, the siderophore activity of this extraceliular catechol was confirmed by its ability to stimulate energy-dependent uptake of 55Fe(M) as well as to promote the growth of A. baumannii bacterial cells under iron-deficient conditions imposed by 60 ,uM human transferrin. Polyacrylamide gel electrophoresis analysis showed the presence of iron-regulated proteins in both inner and outer membranes of this clinical isolate ofA. baumannii. Some of these membrane proteins may be involved in the recognition and internalization of the iron-siderophore complexes.Acinetobacter baumannii, formerly known asAcinetobacter calcoaceticus subsp. anitratus (15), belongs to a bacterial species that is widely distributed throughout the environment (6). This microorganism can be isolated from the skin (3, 43) and respiratory tract (59) of healthy ambulatory adults as well as from hospital personnel and equipment (36,39,46,67).Lately, numerous outbreaks of nosocomial infections caused by A. baumannii have been reported (7-10, 16, 42, 47, 56, 57, 73), which are of particular concern because of the widespread and increasing antibiotic resistance of the isolated strains (17,30,32,33,40,41,48). Nevertheless, most infections have occurred in patients compromised by either antibiotic therapy, respiratory instrumentation and manipulations, dialysis, or surgery (18,19,39,70). Thus, it was proposed that reduced host defenses and interaction with other bacterial species, rather than the expression of specific bacterial virulence factors (49), are the factors responsible for opportunistic infections caused by Acinetobacter species.Acinetobacter species are able to survive under restricted nutrient conditions, such as those imposed by the host. Iron is one of the essential bacterial nutrients that is tightly controlled by the host, through its chelation by the highaffinity binding glycoproteins transferrin (TF) and lactoferrin (23). Thus, bacteria have developed efficient iron uptake mechanisms that allow them to scavenge iron from these host proteins, either by direct interaction with the ironprotein complexes (34) or by the synthesis an...

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“…Several outbreaks of nosocomial infections caused by multiply resistant strains of Acinetobacter spp. have been documented (2,7,10,13,16,22,33). Many of these outbreaks have occurred in intensive care units in which extensive use of antibiotics can select for the emergence of multiply resistant strains (2,7,10,13,33).…”

mentioning

confidence: 99%

Mutation in the gyrA gene of quinolone-resistant clinical isolates of Acinetobacter baumannii

Vila

Ruiz

Goñi

et al. 1995

Antimicrob Agents Chemother

181

120

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The gyrA gene mutations associated with quinolone resistance were determined in 21 epidemiologically unrelated clinical isolates of Acinetobacter baumannii. Our studies highlight the conserved sequences in the quinolone resistance-determining region of the gyrA gene from A. baumannii and other bacteria. All 15 isolates for which the MIC of ciprofloxacin is Ն4 g/ml showed a change at Ser-83 to Leu. Six strains for which the MIC of ciprofloxacin is 1 g/ml did not show any change at Ser-83, although a strain for which the MIC of ciprofloxacin is 1 g/ml exhibited a change at Gly-81 to Val. Although it is possible that mutations in other locations of the gyrA gene, the gyrB gene, or in other genes may also contribute to the modulation of the MIC level, our results suggest that a gyrA mutation at Ser-83 is associated with quinolone resistance in A. baumannii.

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A hospital outbreak of antibiotic-resistant Acinetobacter anitratus: epidemiology and control

Cited by 112 publications

References 18 publications

Hand carriage of aerobic Gram-negative rods by health care personnel

Hand carriage of aerobic Gram-negative rods by health care personnel

Characterization of a high-affinity iron transport system in Acinetobacter baumannii

Mutation in the gyrA gene of quinolone-resistant clinical isolates of Acinetobacter baumannii

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