Molecular investigation of an outbreak of multidrug-resistant Acinetobacter baumannii, with characterisation of class 1 integrons

Antibiotic resistance determinants in nosocomial strains of multidrug-resistant Acinetobacter baumannii

“…The finding of ISAba1 upstream of two different genes in the same bacteria suggests that under a selective pressure it is able to transpose, providing a strong promoter sequence for multiple resistance genes. The bla OXA-23 gene has previously been isolated in conjunction with the same integron described in the present study from A. baumannii outbreak strains from pan-Europe, 27 Greece 28 and previously from Australia. 2 The integron array found in this study, together with the gene bla OXA-23 , has also been described in an A. baumannii outbreak clone in the UK, designated OXA-23 clone 2.…”

Risk factors for carbapenem-resistant Gram-negative bacteremia in intensive care unit patients

“…This study, as other clinical studies [28,31,32], cannot separate these two modes of CR Gram-negative pathogens acquisition because clonality of strains was not evaluated. During two earlier epidemic outbreaks of multidrug resistant A. baumannii [33] and pandrugresistant P. aeruginosa [34] in our unit, cross-transmission had been confirmed. However, regardless of any mode of transmission, this study clearly shows the impact of carbapenem exposure on carbapenem resistance acquisition in ICU and confirms the common knowledge in an unquestionable infection, such as bacteremia.…”

Carbapenem-resistant versus carbapenem-susceptible Acinetobacter baumannii bacteremia in a Greek intensive care unit: risk factors, clinical features and outcomes

“…Following an outbreak of multidrug-resistant A. baumannii in our unit in 2003 [23], an increased incidence of CRAB infections was observed [24]. The purpose of this study was to identify the incidence of and potential risk factors for bacteremia caused by CRAB versus CSAB in our critically ill patients and to determine their effect on patients' outcome.…”