Clonal spread of carbapenem-resistant  Acinetobacter baumannii  in a neonatal intensive care unit

Maciel, Wirlaine Glauce; Silva, K E da; Croda, Júlio; Cayô, Rodrigo; Ramos, Ana Luísa; Sales, Romário Oliveira de; Souza, G de Almeida de H; Bampi, José Victor Bortolotto; Limiere, Letícia Cristina; Casagrande, Junior Cesar; Gales, Ana Cristina; Simionatto, Simone

doi:10.1016/j.jhin.2017.10.015

Cited by 22 publications

(16 citation statements)

References 9 publications

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“…Cholestasis, gestational age < 29 weeks, prematurity, low birth weight (70% < 1500 g), prolonged intubation, central venous catheters, use of imipenem for up to 5 days, mechanical ventilation, and prior carbapenem exposure are related to A. baumannii bacteremia in neonates 10,86,87 . Similar results were reported for colonization in neonates 88 . These studies pinpoint persistent endemic isolates in hospitals, highlighting the need to implement efficient control measures and prevent outbreaks.…”

Section: Risk Factors Related To a Baumanniisupporting

confidence: 89%

“…Cephalosporin-resistant A. baumannii and producers of extendedspectrum beta-lactamases (ESBL) were identified in a neonatal intensive care unit (NICU), causing septicemia in hospitalized neonates ( Table 3) 5 . A study in neonates described most isolates as belonging to ST1 and had ISAba1 upstream of the bla OXA-51 and bla OXA-23 genes 88 .…”

Section: Molecular Epidemiology Of a Baumannii In Brazilmentioning

confidence: 99%

See 1 more Smart Citation

Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Kurihara

Sales

Silva

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Introduction: The increase in the prevalence of multidrug-resistant Acinetobacter baumannii infections in hospital settings has rapidly emerged worldwide as a serious health problem. Methods: This review synthetizes the epidemiology of multidrug-resistant A. baumannii, highlighting resistance mechanisms. Conclusions: Understanding the genetic mechanisms of resistance as well as the associated risk factors is critical to develop and implement adequate measures to control and prevent acquisition of nosocomial infections, especially in an intensive care unit setting.

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Section: Risk Factors Related To a Baumanniisupporting

confidence: 89%

Section: Molecular Epidemiology Of a Baumannii In Brazilmentioning

confidence: 99%

Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Kurihara

Sales

Silva

et al. 2020

Rev. Soc. Bras. Med. Trop.

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“…Several outbreaks due to OXA-23-producing A . baumannii clones have previously been described[1,9,10],and these strains are an international public health concern[3]. Here, we performed a case-control study in an adult intensive care unit (ICU) in a tertiary teaching hospital in Brazil to identify the risk factors associated with OXA-23-producing A .…”

Section: Introductionmentioning

confidence: 99%

A high mortality rate associated with multidrug-resistant Acinetobacter baumannii ST79 and ST25 carrying OXA-23 in a Brazilian intensive care unit

et al. 2018

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The global spread of carbapenem-resistant Acinetobacter baumannii (A. baumannii) strains has restricted the therapeutic options available to treat infections due to this pathogen. Understanding the prevalence of such infections and the underlying genetic mechanisms of resistance may help in the implementation of adequate measures to control and prevent acquisition of nosocomial infections, especially in an intensive care unit setting. This study describes the molecular characteristics and risk factors associated with OXA-23-producing A. baumannii infections. A case-control study was undertaken from September/2013 to April/2015. Acquisition of OXA-23-producing A. baumannii was found to be associated with the use of nasogastric tubes, haemodialysis, and the use of cephalosporins. These isolates were only susceptible to amikacin, gentamicin, tigecycline, and colistin, and contained the ISAba1 insertion sequence upstream ofblaOXA-23 and blaOXA-51 genes. Twenty-six OXA-23-producing A. baumannii strains belonged to the ST79 (CC79) clonal group,and patients infected or colonised by these isolates had a higher mortality rate (34.6%). In conclusion, this study showed a dissemination of OXA-23-producing A. baumannii strains that was associated with several healthcare-related risk factors and high mortality rates among intensive care unit patients.

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“…This practice may have exerted selective pressures leading to the emergence of XDRAB and multiresistant strains, which in turn may have stimulated the acquisition of genes encoding resistance mechanisms via horizontal transfer mechanisms between environments. 22 After the diagnosis of the second case, the pediatric infectious diseases service was consulted, and antibiotic regimen for the cases was directed by isolated antimicrobial susceptibilities. Colistin combined with ciprofloxacin was effective in treating XDRAB bacteremia and meningitis in one neonate in our series.…”

Section: Discussionmentioning

confidence: 99%

Underlying Characteristics and Outcome of Extensively Resistant Acinetobacter baumannii Infection and Colonization in a Saudi Neonatal Intensive Care Unit

Alsubaie

Anwar²,

Alhadidi³

et al. 2019

JCS

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Extensively drug-resistant Acinetobacter baumannii (XDRAB) is a rapidly emerging pathogen causing threat to health care settings. The resultant morbidity and mortality rates are high due to limited therapeutic options. The present study demonstrates the characteristics of neonates, infected or colonized with XDRAB, antibiotic susceptibility patterns of the isolates, and neonatal outcomes. This retrospective study was conducted in the neonatal intensive care unit (NICU) of Dallah hospital, Riyadh, Saudi Arabia during the period January 2015 to December 2017. All neonates with positive XDRAB cultures from any location in the body were included, infected and colonized cases were compared. XDRAB was isolated from 16 neonates. Seventy-five percent of the affected neonates were preterm, with a median gestational age and birth weight of 32.5 weeks and 1,675 g, respectively. The median time to XDRAB infection/colonization for all cases was 14 days. Seventy-five percent of the cases had central venous catheters and 50 percent had surgery/procedure performed during stay in NICU. Half of the affected neonates had underlying congenital anomalies and chronic medical conditions. Fourteen affected neonates (87%) received prior courses of cefotaxime. In 15 of 16 cases, XDRAB infection manifested clinically as late-onset sepsis with bacteremia and ventilator-associated pneumonia (VAP). XDRAB isolates were resistant to all β-lactams and carbapenems. Resistance rate to other antibiotics was 93% for gentamicin and 50% for ciprofloxacin. All XDRAB isolates were susceptible to colistin. Seventy-five percent of the infected neonates died due to XDRAB sepsis, while 37% of the colonized group died of other underlying diseases. Fifty percent of the infected neonates died within 4 days of XDRAB infection. Prematurity, low birth weight, the use of vascular devices, and prior use of cefotaxime played a major role in XDRAB infection/colonization in our unit. It is crucial to consider early start of colistin, either alone or in combination therapy, especially for the neonates at high risk, for example, those with certain underlying chronic conditions who manifest with late-onset sepsis and/or VAP.

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Clonal spread of carbapenem-resistant Acinetobacter baumannii in a neonatal intensive care unit

Cited by 22 publications

References 9 publications

Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

A high mortality rate associated with multidrug-resistant Acinetobacter baumannii ST79 and ST25 carrying OXA-23 in a Brazilian intensive care unit

Underlying Characteristics and Outcome of Extensively Resistant Acinetobacter baumannii Infection and Colonization in a Saudi Neonatal Intensive Care Unit

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