Characterization of carbapenem-resistant Acinetobacter calcoaceticus–baumannii complex isolates from nosocomial bloodstream infections in southern Iran

Pourabbas, Bahman; Firouzi, R.; Pouladfar, Gholamreza

doi:10.1099/jmm.0.000219

Cited by 18 publications

(9 citation statements)

References 31 publications

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“…(100%), VRE (85.7%), and Enterobacteriaceae (74.2%). These numbers are in agreement with those in other studies investigating the etiology of nosocomial infections in Iran 3,36,37 . Infections caused by MDR bacteria are progressively growing in the care of solid organ transplant recipients worldwide and indeed, the emergence of various MDR pathogens all over the world represents a global threat 38 .…”

Section: Discussionsupporting

confidence: 90%

Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

Jafarpour

Pouladfar

Malek-Hosseini

et al. 2020

Microbiology and Immunology

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Liver transplantation (LT) is a potentially curative treatment for terminal stage hepatic diseases. Bacterial infections are the main causes of mortality and morbidity in the early period after LT. Identifying the risk factors could help in minimizing their development. We prospectively investigated the incidence, characteristics, and risk factors of bacterial infections among the recipients during hospitalization after LT and assigned a predictive score. All 389 consecutive adults who underwent LT at the main referral hospital of LT in Iran during 1 year were enrolled prospectively in a cohort study. Infection group consisted of 143 recipients (36.8%). Urinary tract and surgical site infections were the most frequent ones. Gram-negative bacteria were more prevalent than Gram-positive ones. Independent risk factors were female sex (relative risks = 2.13), age ≤ 43.5 years (3.70), hospital stay ≥ 9.5 days (5.22), abdominal reoperation (3.03), vancomycin-resistant Enterococci colonization (5.52), hospitalization 3 months prior to LT (3.25), mechanical ventilation ≥48 hr (4.93), and renal replacement therapies (13.40). We developed a risk score for the prediction of bacterial infections with an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.81-0.89) with sensitivity of 88% and specificity of 64%. In the infection group, mortality was higher than in controls (18.9% vs. 2.0%) with longer hospitalization (16 vs. 10 days; P < 0.001). We detected a high rate of bacterial infections leading to longer hospital stay and higher mortality rate. The formulated risk score can help predict bacterial infections; however, it requires clinical validation in further studies. K E Y W O R D S bacterial infections, Iran, liver transplantation, risk factors, scoring systems ---Abbreviations: AUC, area under the curve; CRRT, continuous renal replacement therapy; LT, liver transplantation; MDR, multidrug resistance; MELD, model for end-stage liver disease; ROC curve, receiver operating characteristic curve. | RESULTSDuring the study period, 399 LTs were performed on 389 adult patients. Ten (2.6%) patients received two transplants each: seven for post-transplant complications, two 408 | JAFARPOUR ET AL.

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Section: Discussionsupporting

confidence: 90%

Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

Jafarpour

Pouladfar

Malek-Hosseini

et al. 2020

Microbiology and Immunology

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“…could be attributed to its genome plasticity that allows the acquisition and loss of mobile genetic elements (plasmids, transposons) that modifies the organism’s genomic structure (Savari et al, 2017). As for non baumannii species, only one study reported the detection of OXA-23 and SPM producing Acinetobacter nosocomialis in patients with blood infections (Pourabbas et al, 2016). In P. aeruginosa , MBLs were the most common carbapenemases including: IMP (IMP-1 and IMP-55) and VIM variants (VIM-1, VIM-2) (Abiri et al, 2015; Lari et al, 2015; Mirbagheri et al, 2015; Moosavian and Rahimzadeh, 2015; Azizi et al, 2016; Saffari et al, 2016; Kazeminezhad et al, 2017; Dogonchi et al, 2018; Pournajaf et al, 2018; Rostami et al, 2018).…”

Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 99%

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

et al. 2019

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In the last decade, extended-spectrum cephalosporin and carbapenem resistant Gram-negative bacilli (GNB) have been extensively reported in the literature as being disseminated in humans but also in animals and the environment. These resistant organisms often cause treatment challenges due to their wide spectrum of antibiotic resistance. With the emergence of colistin resistance in animals and its subsequent detection in humans, the situation has worsened. Several studies reported the transmission of resistant organisms from animals to humans. Studies from the middle east highlight the spread of resistant organisms in hospitals and to a lesser extent in livestock and the environment. In view of the recent socio-economical conflicts that these countries are facing in addition to the constant population mobilization; we attempt in this review to highlight the gaps of the prevalence of resistance, antibiotic consumption reports, infection control measures and other risk factors contributing in particular to the spread of resistance in these countries. In hospitals, carbapenemases producers appear to be dominant. In contrast, extended spectrum beta lactamases (ESBL) and colistin resistance are becoming a serious problem in animals. This is mainly due to the continuous use of colistin in veterinary medicine even though it is now abandoned in the human sphere. In the environment, despite the small number of reports, ESBL and carbapenemases producers were both detected. This highlights the importance of the latter as a bridge between humans and animals in the transmission chain. In this review, we note that in the majority of the Middle Eastern area, little is known about the level of antibiotic consumption especially in the community and animal farms. Furthermore, some countries are currently facing issues with immigrants, poverty and poor living conditions which has been imposed by the civil war crisis. This all greatly facilitates the dissemination of resistance in all environments. In the one health concept, this work re-emphasizes the need to have global intervention measures to avoid dissemination of antibiotic resistance in humans, animals and the environment in Middle Eastern countries.

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“…The first three are implicated in infections, while the latter is rarely considered pathogenic. 8 It appears as Gram-negative coccobacillus in pairs ranging from 1 to 1.5 µm when observed under the microscope after gram staining. It often resists complete decolorization and can deceive as Gram-positive cocci.…”

Section: Introductionmentioning

confidence: 99%

Insight into <em>Acinetobacter baumannii</em>: pathogenesis, global resistance, mechanisms of resistance, treatment options, and alternative modalities

Asif

Alvi

Rehman

2018

IDR

253

224

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Acinetobacter baumannii, once considered a low-category pathogen, has emerged as an obstinate infectious agent. The scientific community is paying more attention to this pathogen due to its stubbornness to last resort antimicrobials, including carbapenems, colistin, and tigecycline, its high prevalence of infections in the hospital setting, and significantly increased rate of community-acquired infections by this organism over the past decade. It has given the fear of pre-antibiotic era to the world. To further enhance our understanding about this pathogen, in this review, we discuss its taxonomy, pathogenesis, current treatment options, global resistance rates, mechanisms of its resistance against various groups of antimicrobials, and future therapeutics.

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Characterization of carbapenem-resistant Acinetobacter calcoaceticus–baumannii complex isolates from nosocomial bloodstream infections in southern Iran

Cited by 18 publications

References 31 publications

Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

Insight into <em>Acinetobacter baumannii</em>: pathogenesis, global resistance, mechanisms of resistance, treatment options, and alternative modalities

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