Outbreak of nosocomial meningitis caused by Acinetobacter baumannii in neurosurgical patients

Wróblewska, Marta; Dijkshoorn, Lenie; Marchel, Halina; Barselaar, Maria van den; Swoboda-Kopeć, Ewa; Broek, P.J. van den; Łuczak, M.

doi:10.1016/j.jhin.2004.04.009

Cited by 60 publications

(33 citation statements)

References 32 publications

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“…The increase in the rate of Acinetobacter PCM has been extensively described in the years following 2000, although in the previous years it was reported as a rare occurrence. 4,5,18,22,28,32,36 The main issue with the Acinetobacter spp. is their increasing resistance to almost all antibiotic classes (including carbapenems), which has been a significant problem in the recent years.…”

Section: Meningitismentioning

confidence: 99%

“…is their increasing resistance to almost all antibiotic classes (including carbapenems), which has been a significant problem in the recent years. 1,4,10,16,22,25,30,36 Klebsiella spp. were the second most commonly isolated pathogens in this cohort, with the isolates carrying a high degree of resistance to third-generation cephalosporins and carbapenems (Table 4).…”

Section: Meningitismentioning

confidence: 99%

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Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Kourbeti¹,

Vakis²,

Ziakas

et al. 2015

JNS

141

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OBJECT The authors performed a prospective study to define the prevalence and microbiological characteristics of infections in patients undergoing craniotomy and to clarify the risk factors for post-craniotomy meningitis. METHODS Patients older than 18 years who underwent nonstereotactic craniotomies between January 2006 and December 2008 were included. Demographic, clinical, laboratory, and microbiological data were systemically recorded. Patient characteristics, craniotomy type, and pre- and postoperative variables were evaluated as risk factors for meningitis RESULTS Three hundred thirty-four procedures were analyzed (65.6% involving male patients). Traumatic brain injury was the most common reason for craniotomy. Almost 40% of the patients developed at least 1 infection. Ventilatorassociated pneumonia (VAP) was the most common infection recorded (22.5%) and Acinetobacter spp. were isolated in 44% of the cases. Meningitis was encountered in 16 procedures (4.8%), and CSF cultures were positive for microbial growth in 100% of these cases. Gram-negative pathogens (Acinetobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Enterobacter cloaceae, Proteus mirabilis) represented 88% of the pathogens. Acinetobacter and Klebsiella spp. demonstrated a high percentage of resistance in several antibiotic classes. In multivariate analysis, the risk for meningitis was independently associated with perioperative steroid use (OR 11.55, p = 0.005), CSF leak (OR 48.03, p < 0.001), and ventricular drainage (OR 70.52, p < 0.001). CONCLUSIONS Device-related postoperative communication between the CSF and the environment, CSF leak, and perioperative steroid use were defined as risk factors for meningitis in this study. Ventilator-associated pneumonia was the most common infection overall. The offending pathogens presented a high level of resistance to several antibiotics.

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Section: Meningitismentioning

confidence: 99%

Section: Meningitismentioning

confidence: 99%

Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Kourbeti¹,

Vakis²,

Ziakas

et al. 2015

JNS

141

View full text Add to dashboard Cite

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“…Various genotypic methods have been developed for the typing of acinetobacters, including ribotyping (11), macrorestriction analysis by pulsed-field gel electrophoresis (PFGE) (21), randomly amplified polymorphic DNA (RAPD) analysis (13), and total genomic fingerprinting by AFLP (amplified fragment length polymorphism analysis) (33). Among these, PFGE is regarded as the "gold standard" of epidemiological typing (26).…”

mentioning

confidence: 99%

Standardization and Interlaboratory Reproducibility Assessment of Pulsed-Field Gel Electrophoresis-Generated Fingerprints of Acinetobacter baumannii

et al. 2005

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A standard procedure for pulsed-field gel electrophoresis (PFGE) of macrorestriction fragments of Acinetobacter baumannii was set up and validated for its interlaboratory reproducibility and its potential for use in the construction of an Internet-based database for international monitoring of epidemic strains. The PFGE fingerprints of strains were generated at three different laboratories with ApaI as the restriction enzyme and by a rigorously standardized procedure. The results were analyzed at the respective laboratories and also centrally at a national reference institute. In the first phase of the study, 20 A. baumannii strains, including 3 isolates each from three well-characterized hospital outbreaks and 11 sporadic strains, were distributed blindly to the participating laboratories. The local groupings of the isolates in each participating laboratory were identical and allowed the identification of the epidemiologically related isolates as belonging to three clusters and identified all unrelated strains as distinct. Central pattern analysis by using the band-based Dice coefficient and the unweighted pair group method with mathematical averaging as the clustering algorithm showed 95% matching of the outbreak strains processed at each local laboratory and 87% matching of the corresponding strains if they were processed at different laboratories. In the second phase of the study, 30 A. baumannii isolates representing 10 hospital outbreaks from different parts of Europe (3 isolates per outbreak) were blindly distributed to the three laboratories, so that each laboratory investigated 10 epidemiologically independent outbreak isolates. Central computer-assisted cluster analysis correctly identified the isolates according to their corresponding outbreak at an 87% clustering threshold. In conclusion, the standard procedure enabled us to generate PFGE fingerprints of epidemiologically related A. baumannii strains at different locations with sufficient interlaboratory reproducibility to set up an electronic database to monitor the geographic spread of epidemic strains.Acinetobacter baumannii is a well-recognized opportunistic pathogen that gives rise to nosocomial infections and outbreaks, in particular, in the intensive care unit setting (1). The increasing rates of resistance of A. baumannii to the major antimicrobial drugs make early identification and control of hospital outbreaks mandatory. Recent data indicate that several successful epidemic A. baumannii strains (clones) circulate in Europe, and a better understanding of the diversity within the species and the emergence of epidemic clones is urgently needed (19,25,29). Molecular typing plays an important role in the study of the epidemiology of A. baumannii and in coping with its epidemic spread.Various genotypic methods have been developed for the typing of acinetobacters, including ribotyping (11), macrorestriction analysis by pulsed-field gel electrophoresis (PFGE) (21), randomly amplified polymorphic DNA (RAPD) analysis (13), and total genomic fingerpr...

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“…The outcome of these efforts by three of the centers to improve interlaboratory reproducibility was unsatisfactory. Nonetheless, PCR with standardized protocol, reagents, and primers (DAF4 and M13) produced unhindered banding patterns [39]. These patterns are strain specific; RAPD could therefore be a useful approach for epidemiological genotyping.…”

Section: Rapid Amplification Of Polymorphic Dna (Rapd)mentioning

confidence: 99%

Genotyping methods for monitoring the epidemic evolution of A. baumannii strains

Ahmed

Alp

2015

J Infect Dev Ctries

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Acinetobacter baumannii is clustered with other phenotypically similar species into what has commonly become known as the ACB complex: A. calcoaceticus, A. pittii and, A. nosocomialis. The ecology and pathology of most of these species are not well understood, mainly because current specific phenotypic techniques have, to date, been insufficient. This has inhibited both the precise identification of, as well as the ability to discriminate between, these clinically important and closely related Acinetobacter strains. However, new genotypic methods have greatly enhanced our capacity to identify the ACB complex. This has resulted in the implementation of more rational infection control programs. Several genotypic identification methods are explored in this study, including non-polymerase chain reaction (PCR)-based and PCR-based methods. These methods include ribotyping, pulsed-field gel electrophoresis, 16S rRNA identification, multilocus sequence typing, single locus sequence typing, restriction fragment length polymorphism analysis, restriction analysis of 16S-23S rRNA intergenic spacer sequences, rapid amplification of polymorphic DNA, and repetitive extragenic palindromic PCR; however, there is no current single ideal genotyping method. Each one has its own advantages and disadvantages. With this in mind we reviewed current and new genotyping methods used to characterize the Acinetobacter species.

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Outbreak of nosocomial meningitis caused by Acinetobacter baumannii in neurosurgical patients

Cited by 60 publications

References 32 publications

Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Standardization and Interlaboratory Reproducibility Assessment of Pulsed-Field Gel Electrophoresis-Generated Fingerprints of Acinetobacter baumannii

Genotyping methods for monitoring the epidemic evolution of A. baumannii strains

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