Outbreak of drug-resistant Acinetobacter baumannii ST219 caused by oral care using tap water from contaminated hand hygiene sinks as a reservoir

Umezawa, Kazuo; Asai, Satoshi; Ohshima, Toshio; Iwashita, Hideo; Ohashi, Maya; Sasaki, Mika; Kaneko, Akihiro; Inokuchi, Sadaki; Miyachi, Hayato

doi:10.1016/j.ajic.2015.06.016

Cited by 40 publications

(31 citation statements)

References 7 publications

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“…Besides, contaminated environments and mechanical equipment (e.g., nasogastric tubes, tracheostomy tubes, and urinary catheters) may accelerate the colonisation by nosocomial pathogens specifically those showing vigorous biofilm production. An outbreak of AMR A. baumannii due to the utilisation of contaminated tap water from hygiene sinks for oral care in an intensive care unit was reported [46]. The greater the advanced disability patients have, the more assistance and interaction with care-workers and medical-device operators are required, consequently facilitating the propagation of such microorganisms.…”

Section: Discussionmentioning

confidence: 99%

Oral colonisation by antimicrobial-resistant Gram-negative bacteria among long-term care facility residents: prevalence, risk factors, and molecular epidemiology

Kayama

Yoshikawa

et al. 2020

Antimicrob Resist Infect Control

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Background: For residents of long-term care facilities (LTCFs), antimicrobial-resistant bacteria (ARB) are a risk factor, yet their oral colonisation, potentially leading to aspiration pneumonia, remains unclear. This study was undertaken to survey the prevalence, phenotypic characteristics, and molecular epidemiology of antimicrobial-resistant Gramnegative bacteria in the oral cavity of LTCF residents, and to analyse the risk factors for such carriers. Methods: This study involved 98 residents of a LTCF in Hiroshima City, Japan, aged between 55 and 101 years. Oropharyngeal swabs were collected and plated on screening media for ESBL-producing and carbapenem-resistant bacteria; isolates were identified and tested for antibiotic susceptibility; biofilm formation was tested in vitro; identification of epidemic clones were pre-determined by PCR; resistance genes, sequence types, and wholegenome comparison of strains were conducted using draft genome sequences. Demographic data and clinical characterisations were collected and risk factors analysed. Results: Fifty-four strains from 38% of the residents grew on screening media and comprised predominantly of Acinetobacter spp. (35%), Enterobacteriaceae spp. (22%), and Pseudomonas spp. (19%). All Escherichia coli isolates carried CTX-M-9 group and belonged to the phylogroup B2, O25:H4 ST131 fimH30 lineage. Six Acinetobacter baumannii isolates presented identical molecular characteristics and revealed more biofilm production than the others, strongly suggesting their clonal lineage. One Acinetobacter ursingii isolate displayed extensive resistance to various ß-lactams due to multiple acquired resistance genes. One Pseudomonas aeruginosa isolate showed exceptional resistance to all ßlactams including carbapenems, aminoglycosides, and a new quinolone, showing a multidrug-resistant Pseudomonas aeruginosa (MDRP) phenotype and remarkable biofilm formation. Genome sequence analysis revealed this isolate was the bla IMP-1 -positive clone ST235 in Japan. Strokes (cerebral infarction or cerebral haemorrhage) and percutaneous endoscopic gastrostomy tubes were recognised as risk factors for oral colonisation by ARB in the LTCF residents. Conclusions: ARB, as defined by growth on screening agar plates, which carried mobile resistance genes or elements or conferred high biofilm formation, were already prevalent in the oral cavity of LTCF residents. Health-care workers involved in oral care should be aware of antimicrobial resistance and pay special attention to transmission prevention and infection control measures to diminish ARB or mobile resistance elements dissemination in LTCFs.

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Section: Discussionmentioning

confidence: 99%

Oral colonisation by antimicrobial-resistant Gram-negative bacteria among long-term care facility residents: prevalence, risk factors, and molecular epidemiology

Kayama

Yoshikawa

et al. 2020

Antimicrob Resist Infect Control

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“…Presence of Acinetobacter in rural drinking water systems dates back to 1989 (Bifulco et al ., 1989). Since then, there are several reports of its presence in drinking water sources (Towner, 2006; Krizova et al ., 2015; Radolfova-Krizova et al ., 2016) and transmission of drug-resistant Acientobacter through oral route (Umezawa et al ., 2015). Principle component analysis (Fig.…”

Section: Discussionmentioning

confidence: 99%

First report on Bacterial Diversity of Potable Spring water of Indian Himalayan Region

Singh

et al. 2018

Preprint

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16Water quality of a region directly corroborates with the health index of people. People in the 17 Himalayan hills mainly depend upon the spring water for potability. To determine the microbial 18 ecology of the spring waters of Sikkim, the variable region of 16S rRNA has been sequenced 19 using Illumina MiSeq. Phylum wise annotation showed the East and North district are mostly 20 dominated by Proteobacteria (41% and 35.80%), whereas West and South district is dominated 21 by Planctomycetes (38.46%) and Verrucomicrobia (33%). The consistent dominance phyla in 22 the all the four districts were Bacteriodetes (34-24%) which was highest dominancy in North 23 district and lowest in wets district. Genus wise distribution showed the abundance of Brevifolis, 24 2 Flavobacterium, Verrucomicrobia subdivision3, Emticica, Cytophaga, Prosthecobacter, 25 Planctomycetes, Varivorax, Arcicella, Isosphera, Sedimunibacterium etc. The East district 26 showed highest dominancy of genus Emticicia whereas Planctomycetes in the West district. The 27North district was mainly dominated by genus Arcicella and Brevifollis in the South district. 28North on the antonymous showed totally different sets of microbial diversity. North district 29 showed an abundance of Arcicella, Planctomycetes, Schlerensia and Azohydromonas. The heat 30 map produced by Bray Curtis distance method produced three clusters which showed the close 31 relationship between West and East district microbiome that further related to South district. The 32 sample of North district formed out group that showed different community structure from other 33 three districts. The principle component analysis was showed that the east and South district 34 samples are closely related and distantly correlated to the west Sikkim, but the North district 35 showed completely different microbial community. The canonical correspondence analysis 36 showed correlation between bacterial diversity and hydrochemistry and it was found that the 37 bacterial diversity was influenced by the concentration of different metallic ions like sodium, 38 calcium, barium and iron. This is a first report from the Eastern Himalayan region of India and it 39 largely enhances our knowledge about the microbial structure of potable spring water of Eastern 40 Himalayan. This study is useful for Government of India as well as the state government to adopt 41 the different strategic treatment procedures to improve the quality of water that is supplied to the 42 community resides in the Himalayan regions and solely dependent on this untreated spring water. 43 44 45 46 47 48Microbial communities are the key members of many ecosystems on the earth 49 (Lagkouvardos et al., 2016). The word microbial communities can be described in the terms 50 of richness or evenness as well as composition i.e. abundance of taxa and genes in the sample 51 (Rothschild, 1991). They play a significant role in crucial biological functions ranging from 52 nitrogen and carbon cycles in the environment to regulation of metabolic...

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“…Among them, 4 strains were isolated from the patients hospitalized in EICU, and others were isolated from the environment, such as air, computer mouse, ambulance and mechanical ventilator. Recently, some studies demonstrated that tapwater contaminated by Acinetobacter baumannii was the important transmission route [10]. Therefore, these results suggested that we should thoroughly disinfect environment contaminated by Acinetobacter baumannii once this pathogen was observed in hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, many STs were involved in the outbreak of Acinetobacter baumannii, such as Acinetobacter baumannii ST208 was a predominant prevalence clone in Sichuan and Zhejiang provinces of China [24]. ST219 infection was observed in a hospital in Japan [10]. The clonal spread of ST417 occurred in one hospital in Mexico, and some novel STs, such as ST758, ST762 and ST777 were also reported [5].…”

Section: Discussionmentioning

confidence: 99%

“…The bla OXA−type resistance genes, including bla OXA−23−like and bla OXA−72 genes, are mainly responsible for this event due to their ability of hydrolyzing carbapenems, which further facilitates the spread of Acinetobacter baumannii worldwide and increases the challenge for infection control [5][6][7]. To date, outbreaks of bla OXA−type -producing MDR Acinetobacter baumannii have been reported throughout the world, and different sequence type (ST) have been observed in various outbreaks throughout Asia [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Extensively Drug Resistant Acinetobacter baumannii ST369 Infection in Emergency Intensive Care Unit in Shandong Province, China

Jiang¹,

L²,

S³

et al. 2020

Preprint

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Background: Acinetobacter baumannii is a significant nosocomial infectious pathogen worldwide. The aim of this study is to characterize the molecular epidemiology of Acinetobacter baumannii isolated from the clinical infection, providing the epidemiology data for prevention and control. Four patients hospitalized in EICU on January 31st, 2014, and then Acinetobacter baumannii infection was observed.Antimicrobial resistance and resistance genes were analyzed by antimicrobial susceptibility testing and PCR sequencing. Pulse field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used to analyze these strains' clonal relatedness.Results: Sixteen strains were recovered, of which 4 strains were isolated from 4 patients, and others were from environment in EICU, such as air, phone and ventilator. All strains belonged to clonal pulsotype A and ST369. Sixteen antibiotics were used to perform the susceptibility testing, and all strains were extensively drug resistant (XDR) Acinetobacter baumannii, they were only susceptible to tigecycline and polymyxin B, but resistant to others, including carbapenems and aminoglycoside antibiotics. Furthermore, all strains carried blaOXA-23-like carbapenemases gene with ISAba1 insertion sequence in the upstream, aminoglycoside resistance genes ant(3″)-I, 16S rRNA methylase gene armA and disinfectant resistant gene qacE△1, which were mainly responsible for the spread of antimicrobial resistance. Fortunately, enhanced control measures were immediately implemented after this infection, and new strains were no longer detected for consecutive three months.Conclusions: molecular epidemiology of blaOXA-23-like carbapenemase-producing Acinetobacter baumannii ST369 in EICU of a hospital was characterized. Routine monitoring should be strengthen to prevent outbreaks of this disease.

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Outbreak of drug-resistant Acinetobacter baumannii ST219 caused by oral care using tap water from contaminated hand hygiene sinks as a reservoir

Cited by 40 publications

References 7 publications

Oral colonisation by antimicrobial-resistant Gram-negative bacteria among long-term care facility residents: prevalence, risk factors, and molecular epidemiology

Oral colonisation by antimicrobial-resistant Gram-negative bacteria among long-term care facility residents: prevalence, risk factors, and molecular epidemiology

First report on Bacterial Diversity of Potable Spring water of Indian Himalayan Region

Extensively Drug Resistant Acinetobacter baumannii ST369 Infection in Emergency Intensive Care Unit in Shandong Province, China

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