Global evolution of multidrug-resistant Acinetobacter baumannii clonal lineages

Zarrilli, Raffaele; Pournaras, Spyros; Giannouli, Maria; Tsakris, Athanassios

doi:10.1016/j.ijantimicag.2012.09.008

Cited by 439 publications

(426 citation statements)

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“…Of the seven bla OXA-23 producers of 3LST ST101, five isolates were tigecycline resistant and two were colistin resistant. The 3LST ST101 (ompA-csuE-bla OXA-51 -like allelic profile: 1-1-1; ST group 1) corresponds to the international clone II, which has previously been associated with divergent bla OXA-23 -producing strains in several countries worldwide, including Greece (Liakopoulos et al, 2012;Turton et al, 2007;Zarrilli et al, 2013); thus, the acquisition of tigecycline and colistin resistance in strains of this clone is worrying for the therapeutic options and infection control policies for MDR A. baumannii.…”

Section: Resultsmentioning

confidence: 99%

“…The rapid expansion of MDR A. baumannii and the apparent predominance of a few successful MDR lineages worldwide underline the importance of surveillance, epidemiological and evolutionary studies for this organism (Zarrilli et al, 2013). In Greece, an increase in carbapenem resistance was observed from 2005 onwards accompanied by a shift of the incidence of the predominant STs among bla OXA-58 producers, whereas bla OXA-23 producers emerged and replaced the previously predominant bla OXA-58 -positive A. baumannii strains during 2011 (Liakopoulos et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

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Molecular identification of tigecycline- and colistin-resistant carbapenemase-producing Acinetobacter baumannii from a Greek hospital from 2011 to 2013

Mavroidi¹,

Likousi²,

Palla³

et al. 2015

Journal of Medical Microbiology

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An alarming increase in the resistance rates of tigecycline and colistin among carbapenemaseproducing Acinetobacter baumannii recovered from a Greek hospital over a 3-year period (2011-2013) was investigated. The antimicrobial resistance profiles and carbapenemase gene content were determined for a collection of colistin-and/or tigecycline-resistant carbapenemase-producing A. baumannii isolates (n542), which were recovered consecutively during the study period. A gradual increase in the incidence of bla OXA-23 producers was observed from 2011 to 2013. A cluster of 21 isolates comprised tigecycline-resistant bla OXA-23 producers displayed a single antimicrobial resistance pattern. The emergence of two bla OXA-23 producers resistant to both tigecycline and colistin was documented. Furthermore, determination of the mechanisms of colistin and tigecycline resistance and molecular typing by the tri-locus sequence typing (3LST) scheme for nine isolates recovered from bloodstream infections were performed. Out of nine isolates, five tigecycline-and two colistin-resistant isolates were bla OXA-23 producers of 3LST ST101 corresponding to the international clone II recovered during 2012-2013. All nine isolates were positive for the presence of the adeB gene of the AdeABC efflux pump. Three colistin-resistant isolates possessed novel substitutions in PmrB, which may be implicated in colistin resistance. To the best of our knowledge, this is the first report of the acquisition of tigecycline and colistin resistance among bla OXA-23 -producing A. baumannii of 3LST ST101 in Greece; thus, continuous surveillance and molecular characterization, prudent use of antibiotics and implementation of infection control measures for A. baumannii are urgent.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Molecular identification of tigecycline- and colistin-resistant carbapenemase-producing Acinetobacter baumannii from a Greek hospital from 2011 to 2013

Mavroidi¹,

Likousi²,

Palla³

et al. 2015

Journal of Medical Microbiology

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“…The fi nding that competition exists between Acinetobacter baumannii and Enterobacter was unexpected, however, because a previous study in our hospital found that the incidences of both agents (A. baumannii and Enterobacter spp.) are seasonal, with peaks during the warmer months of the year 7 . The negative association between A. baumannii and other, low-incidence gram-negative pathogens was only perceptible when the latter were grouped together, due to a lack of statistical power when they were considered individually.…”

Section: Ethical Considerationsmentioning

confidence: 99%

“…Acinetobacter baumannii infections are an interesting example of HAIs, with a high incidence in tropical climates 5 , seasonality 6 and an increasing incidence of multidrug resistance 7 . Acinetobacter baumannii is one of the most common agents found in HAIs in Brazilian hospitals and poses a particular threat for patients in high-risk units 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Ecological competition and the incidence of Acinetobacter baumannii bloodstream infections in a teaching hospital in Southeastern Brazil

Lastoria

Caldeira

Moreira

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction: Recently, pathogen ecology has been recognized as an important epidemiological determinant of healthcareassociated infections (HAIs). Acinetobacter baumannii is one of the most important agents known to cause HAIs. It is widespread in healthcare settings and exhibits seasonal variations in incidence. Little is known about the impact of competition with other hospital pathogens on the incidence of A. baumannii infection. Methods: We conducted an ecological study, enrolling patients who presented with healthcare-associated bloodstream infections (HA-BSIs) from 2005 to 2010 at a 450-bed teaching hospital in Brazil. HA-BSIs were said to be present when bacteria or fungi were recovered from blood cultures collected at least three days after admission. Monthly incidence rates were calculated for all HA-BSIs (overall or caused by specifi c pathogens or groups of pathogens). Multivariate Poisson regression models were used to identify the impacts of the incidence of several pathogens on the incidence of A. baumannii. Results: The overall incidence rate of HA-BSI caused by A. baumannii was 2.5 per 10,000 patient-days. In the multivariate analysis, the incidence of HA-BSI caused by A. baumannii was negatively associated with the incidence rates of HA-BSI due to Staphylococcus aureus (rate ratio [RR]=0.88; 95% confi dence interval [CI]=0.80-0.97), Enterobacter spp. (RR=0.84; 95%CI=0.74-0.94) and a pool of less common gram-negative pathogens. Conclusions: Our results suggest that competition between pathogens infl uences the etiology of HA-BSIs. It would be benefi cial to take these fi ndings into account in infection control policies.

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“…The strain of microbe infecting a patient anywhere now and the resistance gene blocking its treatment were rarely there a few years or decades earlier (20)(21)(22)(23)(24)(25)(26). Each had emerged somewhere, with its early global spread perhaps recorded unnoticed in some laboratory files, but then spread widely largely untracked and uncontained for lack of fully integrated real-time surveillance with alerting of responders (3,(27)(28)(29)(30).…”

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confidence: 99%

Los laboratorios de microbiología del mundo pueden convertirse en una red de detección microbiana

O’Brien

Stelling

2013

biomedica

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The microbes that infect us spread in global and local epidemics, and the resistance genes that block their treatment spread within and between them. All we can know about where they are to track and contain them comes from the only places that can see them, the world's microbiology laboratories, but most report each patient's microbe only to that patient's caregiver. Sensors, ranging from instruments to birdwatchers, are now being linked in electronic networks to monitor and interpret algorithmically in real-time ocean currents, atmospheric carbon, supply-chain inventory, bird migration, etc. To so link the world's microbiology laboratories as exquisite sensors in a truly lifesaving real-time network their data must be accessed and fully subtyped. Microbiology laboratories put individual reports into inaccessible paper or mutually incompatible electronic reporting systems, but those from more than 2,200 laboratories in more than 108 countries worldwide are now accessed and translated into compatible WHONET files. These increasingly webbased files could initiate a global microbial sensor network. Unused microbiology laboratory byproduct data, now from drug susceptibility and biochemical testing but increasingly from new technologies (genotyping, MALDI-TOF, etc.), can be reused to subtype microbes of each genus/species into sub-groupings that are discriminated and traced with greater sensitivity. Ongoing statistical delineation of subtypes from global sensor network data will improve detection of movement into any patient of a microbe or resistance gene from another patient, medical center or country. Growing data on clinical manifestations and global distributions of subtypes can automate comments for patient's reports, select microbes to genotype and alert responders. Los laboratorios de microbiología del mundo pueden convertirse en una red de detección microbiana Los microbios que nos afectan se diseminan por epidemias locales y globales, y los genes resistentes que bloquean los tratamientos disponibles para combatirlos se reproducen dentro de ellos y se transmiten de unos a otros. Todo lo que sabemos sobre dónde rastrearlos y cómo contenerlos proviene de los únicos lugares en donde es posible examinarlos: los laboratorios de microbiología del mundo. Sin embargo, la mayoría de estos laboratorios reportan el microorganismo que afecta a cada paciente específico solamente a los responsables de la atención de ese paciente en particular. Los sensores, que van desde instrumentos hasta observadores de aves, se encuentran hoy conectados por redes electrónicas destinadas a monitorizar e interpretar por medio de algoritmos y en tiempo real las corrientes oceánicas, el carbono de la atmósfera, los inventarios de las cadenas de suministro, la migración de las aves, etc. La vinculación de los laboratorios de microbiología del mundo para que actúen como refinados detectores en una red dedicada a salvar vidas, requiere, no obstante, que sus hallazgos sean sometidos a subtipificación y que sus datos se puedan consultar sin re...

show abstract

Global evolution of multidrug-resistant Acinetobacter baumannii clonal lineages

Cited by 439 publications

References 104 publications

Molecular identification of tigecycline- and colistin-resistant carbapenemase-producing Acinetobacter baumannii from a Greek hospital from 2011 to 2013

Molecular identification of tigecycline- and colistin-resistant carbapenemase-producing Acinetobacter baumannii from a Greek hospital from 2011 to 2013

Ecological competition and the incidence of Acinetobacter baumannii bloodstream infections in a teaching hospital in Southeastern Brazil

Los laboratorios de microbiología del mundo pueden convertirse en una red de detección microbiana

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