Repeated Colonization by Multi-Drug-Resistant<i>Acinetobacter calcoaceticus–A. baumannii</i>Complex and Changes in Antimicrobial Susceptibilities in Surgical Intensive Care Units

Ho, Cheng‐Maw; Ho, Mao‐Wang; Chi, Chih-Yu; Lin, Chia‐Der; Lin, Cheng‐Wen; Tseng, Sung-Pin; Teng, Lee‐Jene; Chang, Hsiao-Yun; Chang, Huilan; Chang, Ya-Fen; Lin, Hsiu-Hsien; Tien, Ni; Lu, Jang‐Jih; Lai, Chih‐Ho

doi:10.1089/sur.2012.044

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…baumannii, which is a gram-negative, non-fermentative coccobacillus of the family Moraxellaceae, is considered to be an important cause of ventilator-associated pneumonia, sepsis, urinary system infection and meningitis (11)(12)(13)(14)(15)(16)(17) (18). We speculated that this descrepency may be due to the strains selected in this study.…”

Section: Discussionmentioning

confidence: 87%

Active efflux pump adeB is involved in multidrug resistance of Acinetobacter baumannii induced by antibacterial agents

Zhang

Wang

Xie

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to investigate the resistance of Acinetobacter baumannii, which was induced by cefepime (FEP), cefoperazone-sulbactam (SCF), tazobactam (TZP), levofloxacin (LEV), amikacin (AK), imipenem (IPM), and ciprofloxacin (CIP), in vitro. Multi-step drug resistance selection of 16 A. baumannii strains was performed using seven antibacterial agents (FEP, TZP, CIP, AK, IPM, SCF, and LEV). The minimum inhibitory concentration (MIC) was determined using the agar dilution method. Random amplified polymorphic DNA polymerase chain reaction was performed to analyze the genotypes and the carrying rates of aac (3) (8-to 128-fold) were noted in the MIC and different genotypes were showed in RAPD of the strains before and after performing the drug resistant test. PCR data revealed significant differences (P<0.05) between the carrying rates of resistant genes before and after drug induction, with the exception of rmtA, OXA-24, TEM-1, and IMP. Significant increases were demonstrated in the comparative adeB grayscale in strains that underwent drug induction when compared with the sensitive strains (55.69±43.11% vs. 10.08±26.35%; P=0.001). Findings of the present study suggest that the active efflux pump, adeB, has an important role in multidrug resistance of the A. baumannii induced by antibacterial agents in vitro. IntroductionAlthough carbapenems antibiotics remain the backbone therapy for severe suspected bacterial infections, resistance to this antimicrobial treatment has been increasingly reported (1). Thus, therapeutic options have become limited. Multidrug-resistance to antibiotics currently available, in particular in Gram-negative bacteria, has created a critical global medical challenge (2). Acinetobacter baumannii is frequently observed as a nosocomial infection, which causes high mortality, morbidity and hospitalization cost (3). Crude mortality rate and attributable mortality of the infection were reported to be 52 and 10-35%, respectively (4). Multidrug-resistant A. baumannii is considered as a leading cause of nosocomial infection, particularly in critically ill patients (5). A. baumannii has been reported to be resistant to a broad range of antimicrobial agents, and the tendency for its epidemic spread has subsequently extended (6). An increasing drug resistance of A. baumannii to carbapenems has been demonstrated by the SENTRY Antimicrobial Surveillance Program, whose objective was to report antimicrobial susceptibility and pathogen occurrence data for >40,000 episodes of BSI in 72 medical centers representing 22 nations since January 1997 (7). The emergence of multidrug and pandrug-resistant A. baumannii has caused major threats to the infection control and treatment plans in clinical practices (8). According to our knowledge, drug resistance of A. baumannii is closely related with the application of antibacterial agents. However, few studies have been performed to investigate whether a single antibacterial agent was able to induce pandrug resistance of A. baumannii. In the...

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Section: Discussionmentioning

confidence: 87%

Active efflux pump adeB is involved in multidrug resistance of Acinetobacter baumannii induced by antibacterial agents

Zhang

Wang

Xie

et al. 2017

Experimental and Therapeutic Medicine

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“…Study of an outbreak caused by MDR Acinetobacter calcoaceticus-A. baumannii complex in a surgical intensive care unit showed that patients, healthcare workers as well as medical equipments carried the predominant strain responsible for the outbreak [5]. Various molecular methods like enterobacterial repetitive intergenic consensus (ERIC)-PCR, PFGE and multilocus sequence typing (MLST)-PCR have demonstrated the genetic similarity of A. baumannii isolates from patients and their immediate environments [10].…”

Section: Discussionmentioning

confidence: 99%

Contribution of Contaminated Environmental Surfaces to the Transmission of Multidrug-resistant Acinetobacter baumannii in Special Care Units of a Hospital in Tehran, Iran

Eftekhar

Torkanpoory

2018

JoMMID

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Acinetobacter baumannii is an important opportunistic pathogen and responsible for a wide range of nosocomial infections including pneumonia, bacteremia, meningitis, urinary tract, burn and wound infections. These infections often occur in critically ill patients and usually after a relatively extended hospitalization period in intensive care units (ICUs) [1-3]. Previous studies in some hospitals highlighted the critical role of environmental contaminated inanimate objects and surfaces such as supply carts, floors, infusion pumps and ventilator touch pads by A. baumannii in the transmission of the infection to patients [4-6]. The extraordinary ability of A. baumannii to adapt to variable conditions like tolerance to desiccation and its remarkable ability to develop resistance to various antibiotics has led to the emergence of multidrug-resistant (MDR) A. baumannii strains which contribute to the persistence of these organisms in the hospital environment for extended periods of times [7-9]. Hospital outbreaks caused by A. baumannii are known to be associated with contaminated environments as well as healthcare personnel [6, 8-10]. An estimated 20% to 40% of nosocomial infections were attributed to cross-contamination via the hands of healthcare personnel, as a result of direct contact with patients or indirectly by contaminated inanimate surfaces [6]. Here, we investigated the potential cross-contamination of A. baumannii between the patients and their environment in EbneSina Hospital, Tehran, Iran. We also compared the antibiotic resistance patterns and the genetic fingerprints of the isolates obtained from various surfaces as well as the A. baumannii-infected patients. MATERIAL AND METHODS Bacterial Isolates. Forty-one non-duplicate specimens were collected from sputum, wounds, urine, and catheters of patients hospitalized in ICU, Post-ICU, and CCU of EbneSina Hospital, Tehran, Iran from June 2015 to April 2016. Also, 28 environmental samples were randomly collected from various inanimate objects and surfaces of all three wards (patients' beds, bedrails, bedside tables, patients' file covers, ventilators, supply carts, nursing station and wash basins). The patients' specimens were swabbed and streaked on MacConkey agar plates (Merck, Germany) and incubated at 37 o C overnight. For the collection of environmental samples, moistened cotton Introduction: Acinetobacter baumannii is one of the major causes of nosocomial infections. We investigated the presence of A. baumannii among patients and the environment in special care units of a hospital in Tehran, Iran. Methods: Sixty-nine nonduplicate clinical and environmental samples were collected from ICU, Post-ICU, and CCU in EbneSina Hospital (Tehran, Iran) from June 2015 to April 2016. The isolates were identified using standard biochemical tests, and their identity was confirmed by detection of blaoxa51 gene. Susceptibility to 14 antibiotics was determined by the disc diffusion method, and genetic fingerprinting of the isolates was performed by random amplified poly...

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“…Sample preparation followed the protocol described previously [11,24]. Each isolated sample was collected into a sterile tube or container (except blood culture samples, which were inoculated immediately in blood culture-specific bottles (BD BACTEC TM ; Becton Dickinson, Franklin Lakes, NJ, USA), sent to the laboratory within two to three hours of collection, and maintained at room temperature.…”

Section: Bacterial Cultures and Identificationsmentioning

confidence: 99%

“…This development makes the treatment of patients infected with these pathogens difficult, and consequently increases morbidity and mortality [1,6]. Notably, although carbapenems have been used as the main antimicrobial therapy for multidrug-resistant (MDR)-ACB and MDR-P. aeruginosa [7,8], carbapenem resistance has also emerged in these two bacterial species and caused severe nosocomial outbreaks [9][10][11]. These lines of evidence indicate that an increase in antibiotic prescription is closely related to elevated antimicrobial resistance rates.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Surveillance of Antibiotic Prescriptions and the Prevalence of Antimicrobial Resistance in Non-Fermenting Gram-Negative Bacilli

Lai

Chi

et al. 2020

Microorganisms

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The increasing emergence of multidrug-resistant (MDR) bacteria has been recognized as a public health threat worldwide. Hospitalized patients and outpatients are commonly infected by non-fermenting Gram-negative bacilli (NFGNB), particularly the Acinetobacter calcoaceticus-Acinetobacter baumannii complex (ACB) and Pseudomonas aeruginosa. Antimicrobial agents are critical for treating the nosocomial infections caused by NFGNB. The aim of this study was to assess antimicrobial resistance and the use of antimicrobial agents. The bacterial isolates of 638,152 specimens from both inpatients and outpatients, retrieved from 2001 to 2008 at a medical center in central Taiwan, were examined for their susceptibility to various antimicrobial agents, including cefepime, imipenem, ciprofloxacin, gentamicin, amikacin, meropenem, and levofloxacin. Administrated prescriptions of the monitored antibiotics were analyzed using the Taiwan National Health Insurance Research Database (NHIRD). Our results show that the defined daily doses (DDDs) for cefepime, imipenem, and ciprofloxacin increased with time, and a trend toward reduced antimicrobial sensitivities of both ACB and P. aeruginosa was noticeable. In conclusion, the antimicrobial sensitivities of ACB and P. aeruginosa were reduced with the increased use of antibiotics. Continuous surveillance of antibiotic prescriptions and the prevalence of emerging resistance in nosocomial infections is warranted.

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Repeated Colonization by Multi-Drug-ResistantAcinetobacter calcoaceticus–A. baumanniiComplex and Changes in Antimicrobial Susceptibilities in Surgical Intensive Care Units

Cited by 6 publications

References 29 publications

Active efflux pump adeB is involved in multidrug resistance of Acinetobacter baumannii induced by antibacterial agents

Active efflux pump adeB is involved in multidrug resistance of Acinetobacter baumannii induced by antibacterial agents

Contribution of Contaminated Environmental Surfaces to the Transmission of Multidrug-resistant Acinetobacter baumannii in Special Care Units of a Hospital in Tehran, Iran

Long-Term Surveillance of Antibiotic Prescriptions and the Prevalence of Antimicrobial Resistance in Non-Fermenting Gram-Negative Bacilli

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