Investigation of Oxacillinase Genes in Nosocomial Multidrug-Resistant Acinetobacter baumannii Isolates by Multiplex PCR and Evaluation of Their Clonal Relationship with Rep-PCR

Sarı, Berrin; Baran, İrmak; Alaçam, Sema; Mumcuoğlu, İpek; Kurşun, Şenol; Aksu, Neriman

doi:10.5578/mb.8884

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…In our study, CRAB was isolated from clinical samples, surveillance cultures and the environment. As a result of the analysis of these CRAB strains, all of them possessed the bla OXA-51 gene and bla OXA-23 gene, and none of them harboured the bla OXA-40 and bla OXA-58 genes, similar to previous studies from our region [21,22] . The bla OXA-51 gene is an intrinsic chromosomal gene naturally occurring in all A. baumannii strains [8,23] .…”

Section: Discussionsupporting

confidence: 88%

“…Among various mechanisms of carbapenem resistance OXA enzymes have become one of the main sources of resistance in recent years [7] . OXA-23 enzymes spread to many worldwide locations including Europe (including Turkey), Asia, and South America [22][23][24][25][26][27] . Between 1999 and 2009, CRAB isolates from several Mediterranean countries, including Greece, Turkey and Italy, predominantly carried the bla OXA-58 carbapenemase gene.…”

Section: Discussionmentioning

confidence: 99%

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Carbapenem-resistant Acinetobacter baumannii in Adult Intensive Care Units: Risk Factors for Colonization and Infection

Koca¹,

Baran²,

Yetkin³

et al. 2019

mjima

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Giriş: Karbapenem dirençli Acinetobacter baumannii (KDAB) izolatları yoğun bakım ünitelerinde (YBÜ) ciddi tehditlerdendir. Bu çalışmada yetişkin yoğun bakım hastalarında KDAB kolonizasyonu ve enfeksiyonu ile ilişkili risk faktörlerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Cerrahi/medikal YBÜ'de 48 saatten fazla hastaneye yatırılan hastalar KDAB edinimi için tarandı. Çevre kültürleri alındı. Tanımlama ve antibiyotik duyarlılığı Vitek 2 (bioMérieux, Fransa) ile belirlendi. bla OXA-23 , bla OXA-40 , bla OXA-51 ve bla OXA-58 genleri, bir multipleks polimeraz zincir reaksiyonu (Hyplex® CarbOxa ID, Almanya) ile araştırıldı. DiversiLab (bioMérieux, Fransa) klonal ilişki analizi için kullanıldı. Verilerin karşılaştırılması için ki-kare ve t-testi kullanıldı. Lojistik regresyon geriye LR modeli, YBÜ KDAB edinimi ile bağımsız olarak ilişkili faktörleri değerlendirmek için yapıldı. ÖzIntroduction: Carbapenem-resistant Acinetobacter baumannii (CRAB) isolates are serious threats in intensive care units (ICUs). In this study, we aimed to investigate the risk factors associated with CRAB colonization and infection among adult ICU patients. Materials and Methods: Patients hospitalized in the surgical/medical ICU for more than 48 hours were screened for CRAB acquisition. Environmental cultures were also performed. Identification and antibiotic susceptibility were determined with Vitek 2 (bioMérieux, France). bla OXA-23 , bla 0XA-40 , bla OXA-51 and bla OXA-58 genes were investigated by a multiplex polymerase chain reaction (Hyplex® CarbOxa ID, Germany). DiversiLab (bioMérieux, France) was used for clonal relationship analysis. Chi-square and t-test were used for comparison of data. Logistic regression backward LR model was performed to assess factors independently associated with ICU CRAB acquisition. Results: Three hundred and ten patients were screened and 103 (33.2%) were found to be colonized with CRAB. bla OXA-23 and bla OXA-51 genes were found to be positive in all. DiversiLab showed that majority of the isolates came from a single clone. Clinical infection versus asymptomatic carriage ratio was approximately 1:2. Status of unconsciousness [p=0.049, OR: 2.37 (95% CI: 1.35-4.14)], staying ≥15 days in ICU [p=0.000, OR: 6.55 (95% CI: 3.70-11.61)], and prior history of carbapenem use [p=0.003, OR: 2.45 (95% CI: 1.36-4.41) were found to be the independent risk factors for CRAB colonization. When multivariate analysis was performed for risk factors for A. baumannii infections, CRAB colonization [p=0.000, OR: 8.25 (95% CI: 3.51-19.40), mechanical ventilator use [p=0.016, OR: 3.38 (95% CI: 1.25-9.149)], staying ≥15 days in ICU [p=0.000, OR: 11.17 (95% CI: 3.59-34.71)], and prior history of carbapenem use [p=0.000, OR: 2.63 (95% CI: 1.19-5.86)] were detected as independent risk factors. Conclusion: CRAB colonization leads to infection. Taking the necessary precautions in ICUs before colonization is important. AbstractNeriman AKSU

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Carbapenem-resistant Acinetobacter baumannii in Adult Intensive Care Units: Risk Factors for Colonization and Infection

Koca¹,

Baran²,

Yetkin³

et al. 2019

mjima

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“…A renewed interest in the usage of polymyxins has been observed as these are the only treatment option left for multidrug-resistant (MDR) and pan-drug-resistant pathogens such as Acinetobacter baumannii , Klebsiella pneumoniae and Pseudomonas aeruginosa 1 2 . In recent years, A. baumannii has become a serious concern, especially in the Intensive Care Units (ICUs), because of the development of resistance to many antibiotics including carbapenems.…”

mentioning

confidence: 99%

Pharmacokinetics of colistin in patients with multidrug-resistant Gram-negative infections

Gautam¹,

Shafiq²,

Mouton³

et al. 2018

Indian Journal of Medical Research

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Background & objectives:There is little information concerning intravenously (i.v.) administered colistin in patients with multidrug-resistant (MDR) Gram-negative infections. Thus, this pilot prospective study was undertaken to characterize efficacy and pharmacokinetics of colistin in patients with MDR Gram-negative infections.Methods:Nine patients with age >12 yr and MDR Gram-negative infections were included, of whom six were given colistin at the doses of 2 MU, while three patients were given 1 MU i.v. dose every 8 h. Blood samples were collected at different time intervals. Determination of colistin concentration was done by a ultra-high-performance liquid chromatography/mass spectrometry/selected reaction monitoring assay.Results:The area under the plasma concentration-versus-time curve over eight hours (AUC0-8) for colistin after the 1st dose ranged from 3.3 to 16.4 mg×h/l (median, 4.59). After the 5th dose, AUC0-8 for colistin ranged from 4.4 to 15.8 mg×h/l (median, 6.0). With minimal inhibitory concentration (MIC) value of 0.125 mg/l, AUC0-8/MIC ranged from 26.7 to 131.4 (median, 36.7) and 35.5 to 126.0 (median, 48.0) after the 1st and the 5th doses of 2 MU every 8 h, respectively.Interpretation & conclusions:As there is a paucity of information on AUC/MIC for colistin, it may not be possible to conclude whether AUC/MIC values in our patients were adequate. There is a microbiological clearance of organism, which goes in favour of the dosing schedule being adequate. Further studies need to be done to understand the pharmacokinetics of colistin in patients with infections.

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“…Sarı ve ark. (20) , (20,21) . Çalışmamızda, tüm suşlarda OXA-51 benzeri enzimleri kodlayan genlerin varlığı belirlenmiş, şekil 2.…”

Section: Discussionunclassified

Molecular Epidemiology Of Clinical Isolates Of Carbapenem Resistant Acinetobacter spp.

Telli¹,

Eyigör²,

Korkmazgil³

et al. 2017

TMCD

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Investigation of Oxacillinase Genes in Nosocomial Multidrug-Resistant Acinetobacter baumannii Isolates by Multiplex PCR and Evaluation of Their Clonal Relationship with Rep-PCR

Cited by 8 publications

References 15 publications

Carbapenem-resistant Acinetobacter baumannii in Adult Intensive Care Units: Risk Factors for Colonization and Infection

Carbapenem-resistant Acinetobacter baumannii in Adult Intensive Care Units: Risk Factors for Colonization and Infection

Pharmacokinetics of colistin in patients with multidrug-resistant Gram-negative infections

Molecular Epidemiology Of Clinical Isolates Of Carbapenem Resistant Acinetobacter spp.

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