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Rodríguez-Baño J, Martí S, Soto S, Fernández-Cuenca F, Cisneros JM, Pachón J, Pascual A, Martínez-Martínez L, McQueary C, Actis LA, Vila J. Biofilm formation in Acinetobacter baumannii: associated features and clinical implications. Clin Microbiol Infect 2008; 14:276-8. [PMID: 18190568 DOI: 10.1111/j.1469-0691.2007.01916.x] [Citation(s) in RCA: 166] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Biofilm formation in 92 unrelated strains of Acinetobacter baumannii isolated in a multicentre cohort study was investigated using a microtitre plate assay. Fifty-six (63%) isolates formed biofilm. These isolates were less frequently resistant to imipenem or ciprofloxacin than were non-biofilm-forming isolates (25% vs. 47%, p 0.04; and 66% vs. 94%, p 0.004, respectively). All catheter-related urinary or bloodstream infections and the sole case of shunt-related meningitis were caused by biofilm-forming strains. Multivariate analysis revealed that treatment in an intensive care unit, ciprofloxacin resistance and isolation from a respiratory sample were associated with non-biofilm-forming isolates, while previous aminoglycoside use was associated with biofilm-forming isolates.
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102
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Beceiro A, Fernández-Cuenca F, Ribera A, Martínez-Martínez L, Pascual A, Vila J, Rodríguez-Baño J, Cisneros JM, Pachón J, Bou G. False extended-spectrum beta-lactamase detection in Acinetobacter spp. due to intrinsic susceptibility to clavulanic acid. J Antimicrob Chemother 2007; 61:301-8. [PMID: 18065824 DOI: 10.1093/jac/dkm461] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There are some reports showing the susceptibility of some strains of Acinetobacter baumannii to the beta-lactamase inhibitor clavulanic acid. To address this issue, we determined the MIC of clavulanic acid for a broad collection of Acinetobacter spp. isolates collected in a multicentre study. In addition, we showed the consequences of this susceptibility to yield false extended-spectrum beta-lactamase (ESBL) detection in this genus. METHODS The strains used were 244 isolates of Acinetobacter (226 A. baumannii, 15 Acinetobacter genomic species 3 and 3 unidentified Acinetobacter spp.) and several A. baumannii as positive controls. The isolates were subjected to molecular typing. One isolate of each genotype was subjected to clavulanic acid MIC analysis. As no breakpoints for clavulanic acid are available, we arbitrarily established three categories of susceptibility: < or = 16, 32-128 and > or = 256 mg/L. The presence of ESBL in Acinetobacter spp. was analysed by using microdilution, double disc diffusion, combined discs, Etest and isoelectric focusing. RESULTS A total of 100 different genotypes were detected. Among them, 44, 26 and 30 genotypes were inhibited by < or = 16, 32-128 and > or = 256 mg/L clavulanic acid, respectively. Representative isolates of each group were tested for ESBL production. Only those with the lower clavulanic acid MICs yielded a false-positive ESBL test with all methods tested with the exception of the double disc diffusion assay. CONCLUSIONS Forty-four per cent of the genotypes tested were inhibited by < or = 16 mg/L clavulanic acid and these Acinetobacter isolates yielded a false ESBL-positive test. These results may have implications for susceptibility testing in routine microbiology laboratories.
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103
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Rodríguez-Baño J, Navarro MD, Romero L, Muniain MA, Cueto MD, Gálvez J, Perea EJ, Pascual A. Risk-factors for emerging bloodstream infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Clin Microbiol Infect 2007; 14:180-3. [PMID: 18005358 DOI: 10.1111/j.1469-0691.2007.01884.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Risk-factors for bloodstream infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli were investigated using an exploratory case-double control study in which 43 cases (70% producing CTX-M enzymes) were compared with: (i) 86 patients with bacteraemia caused by non-ESBL-producing E. coli; and (ii) 86 hospitalised patients. Previous follow-up as an outpatient, urinary catheterisation and use of oxyimino-beta-lactams or fluoroquinolones were independent risk-factors for ESBL-producing E. coli among patients with E. coli bacteraemia, and previous use of oxyimino-beta-lactams or fluoroquinolones were also independent risk-factors among hospitalised patients. These findings may help in identifying patients at greater risk for bloodstream infection caused by ESBL-producing E. coli in endemic areas.
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104
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Avilés C, Cerrillo M, Martínez E, Pascual A, Losa E, González G. Mixoma de ovario. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2007. [DOI: 10.1016/s0210-573x(07)74507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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105
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Ruiz M, Marti S, Fernandez-Cuenca F, Pascual A, Vila J. High prevalence of carbapenem-hydrolysing oxacillinases in epidemiologically related and unrelated Acinetobacter baumannii clinical isolates in Spain. Clin Microbiol Infect 2007; 13:1192-8. [PMID: 17850347 DOI: 10.1111/j.1469-0691.2007.01825.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Carbapenem-hydrolysing oxacillinases are reported increasingly in Acinetobacter baumannii. This study investigated the role of these beta-lactamases in causing resistance to carbapenems in 83 epidemiologically related and unrelated imipenem-resistant A. baumannii clinical isolates. The isolates were also analysed for the presence of ISAba1 in the promoter region of the bla(OXA-51)-like gene in order to investigate the role of ISAba1 in OXA-51 expression. All clinical isolates contained a bla(OXA-51)-like gene, 20% contained a bla(OXA-58)-like gene, and 42% contained a bla(OXA-40)-like gene; bla(OXA-23)-like, bla(IMP) and bla(VIM) genes were not detected in any of the isolates investigated. ISAba1 was found in 24 (82.7%) of 28 pulsetypes, and was located in the promoter region of the bla(OXA-51)-like gene in five (20.8%) of these pulsetypes. Expression of bla(OXA-51) was detected in the five isolates with ISAba1 located in the promoter region, but was not detected in an isogenic imipenem-susceptible A. baumannii isolate that did not have ISAba1 located in the promoter region. It was concluded that there is a high prevalence of oxacillinases with activity against carbapenems among genetically unrelated A. baumannii clinical isolates from Spain, and that concomitant expression of two carbapenemases (OXA-51-like and either OXA-40-like or OXA-58-like) may take place. Insertion of an ISAba1-like element in the promoter of the bla(OXA-51)-like gene promotes the expression of this gene, although this did not seem to play a major role in carbapenem resistance.
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106
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Rodríguez-Martínez JM, Velasco C, García I, Cano ME, Martínez-Martínez L, Pascual A. Characterisation of integrons containing the plasmid-mediated quinolone resistance gene qnrA1 in Klebsiella pneumoniae. Int J Antimicrob Agents 2007; 29:705-9. [PMID: 17368003 DOI: 10.1016/j.ijantimicag.2007.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2006] [Revised: 02/01/2007] [Accepted: 02/01/2007] [Indexed: 11/28/2022]
Abstract
The aim of this study was to determine the structural relationships of qnrA1 and other resistance genes in four integrons contained in four clinical isolates of Klebsiella pneumoniae. In the four integrons, the sequences surrounding qnrA1 were similar to those described for pMG252 (accession no. AY070235). The four integrons carried a class 1 integrase gene belonging to the complex class 1 integron. Three of the strains contained an identical integron coding for resistance to beta-lactams, aminoglycosides, chloramphenicol and trimethoprim. The fourth strain contained a different integron coding for resistance to beta-lactams, aminoglycosides and chloramphenicol. Downstream of the last integron, copies of IS6100 and IS26 were present. We describe two new and different integrons containing qnrA1. These integrons code for resistance to different groups of antimicrobial agents from K. pneumoniae clinical strains isolated in the USA.
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107
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Gueguen N, Lourel M, Pascual A. La méta-analyse en psychologie sociale: principe, méthode et illustration. PRAT PSYCHOL 2007. [DOI: 10.1016/j.prps.2007.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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108
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Rodríguez-Martínez JM, Velasco C, García I, Cano ME, Martínez-Martínez L, Pascual A. Mutant prevention concentrations of fluoroquinolones for Enterobacteriaceae expressing the plasmid-carried quinolone resistance determinant qnrA1. Antimicrob Agents Chemother 2007; 51:2236-9. [PMID: 17404007 PMCID: PMC1891403 DOI: 10.1128/aac.01444-06] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The influence of qnrA1 on the development of quinolone resistance in Enterobacteriaceae was evaluated by using the mutant prevention concentration parameter. The expression of qnrA1 considerably increased the mutant prevention concentration compared to strains without this gene. In the presence of qnrA1, mutations in gyrA and parC genes were easily selected to produce high levels of quinolone resistance.
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Rodriguez-Martinez J, Velasco C, Garcia I, Conejo M, Pascual A. O261 Role of the pentapeptidic proteins from Gram-positive bacteria as a possible source of Qnr-like quinolone resistance determinants. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70169-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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110
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Picon E, Rodriguez-Bano J, Gijon P, Hernandez J, Ruiz M, Pena C, Almirante B, Almela M, Canton R, Guerrero A, Gimenez M, Oliver A, Horcajada J, Navarro G, Coloma A, Pascual A. P1652 Susceptibility of extended-spectrum β-lactamase-producing Escherichia coli strains causing nosocomially- and community-acquired bacteraemia. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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111
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Rodriguez-Martinez J, Ballesta S, Pascual A. P622 Penetration and activity of fosfomycin, ciprofioxacin, amoxicillin plus clavulanic acid and cotrimoxazol in Escherichia coli and Pseudomonas aeruginosa biofilms. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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112
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Rodríguez-Baño J, Navarro M, López-Cerero L, Morillo C, Muniain M, Pascual A. O433 Faecal carriage of extended-spectrum b -lactamase-producing Escherichia coli: prevalence and risk factors in different populations. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70287-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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113
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Pascual A, Llorca I, Canut A. Use of ozone in food industries for reducing the environmental impact of cleaning and disinfection activities. Trends Food Sci Technol 2007. [DOI: 10.1016/j.tifs.2006.10.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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114
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Pascual A, Pariente M, Godínez JM, Sánchez-Prieto R, Atienzar M, Segura M, Poblet E. High prevalence of human papillomavirus 16 in penile carcinoma. Histol Histopathol 2006; 22:177-83. [PMID: 17149690 DOI: 10.14670/hh-22.177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In order to analyze the incidence and prevalence of Human Papillomavirus (HPV) in penile carcinoma, we studied 49 patients with penile carcinoma. Formalin-fixed, paraffin-embedded tissue samples were collected from 64 samples of penile carcinoma from the Hospital General Universitario (Albacete, Spain). Cases were histologically classified and the polymerase chain reaction (PCR) method was used to detect the presence of HPV. Two sets of consensus primers were used, the My09/My11, and the GP5+/GP6+. All positive cases were sequenced in order to establish the implicated genotype. Our results showed that 38 of the 49 cases were positive for HPV (77,5%). HPV16 appeared in 32 (84,2 %) of the 38 positive cases and HPV18 in 4 (10,5%). Our data demonstrate that the My09/My11 primers are more sensitive than GP5+/GP6+ primers, although the combination of the two sets of primers notably increased the total number of HPV positive cases detected.
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115
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Casanova B, Bosca I, Parra S, Pascual A, Coret F. Early abnormalities in evoked potentials and future disability in patients with multiple sclerosis. Mult Scler 2006; 12:521-2. [PMID: 16900770 DOI: 10.1191/135248506ms1351xx] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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116
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Rodríguez-Martínez JM, Velasco C, Pascual A, García I, Martínez-Martínez L. Correlation of quinolone resistance levels and differences in basal and quinolone-induced expression from three qnrA-containing plasmids. Clin Microbiol Infect 2006; 12:440-5. [PMID: 16643520 DOI: 10.1111/j.1469-0691.2006.01389.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study investigated the effect of copy number and transcriptional level of the qnrA gene on plasmid-mediated quinolone resistance, and the effect of quinolones on qnrA expression, in three clinical isolates of Klebsiella pneumoniae and the corresponding Escherichia coli transconjugants. The copy number of plasmids containing qnrA was analysed and transcriptional studies were performed on transconjugants grown in the presence or absence of ciprofloxacin or moxifloxacin. None of the three clinical isolates was porin-deficient. One isolate contained a mutation in the quinolone resistance-determining region of the gyrA gene (Ser83Phe), but no gyrA mutations were present in the other two isolates, and no mutations were found in parC. Differences in qnrA copy number were observed in K. pneumoniae, but not in the corresponding E. coli transconjugants, although the qnrA gene was located in plasmids with similar mobility and Southern blot RFLP pattern. Differences in qnrA transcription, both at the basal level and following induction by quinolones, were observed among transconjugants. Expression of the qnrA gene correlated well with the level of quinolone (ciprofloxacin and moxifloxacin) resistance in E. coli transconjugants. These data suggest that the main factor determining the resistance level in the transconjugants analysed was the different levels of qnrA expression.
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117
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Donadio S, Pascual A, Dugas M, Ronin C. Standardisation des immunodosages de la TSH : production de nouveaux calibrateurs et harmonisation des tests. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.immbio.2005.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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118
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de Cueto M, López L, Hernández JR, Morillo C, Pascual A. In vitro activity of fosfomycin against extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae: comparison of susceptibility testing procedures. Antimicrob Agents Chemother 2006; 50:368-70. [PMID: 16377714 PMCID: PMC1346795 DOI: 10.1128/aac.50.1.368-370.2006] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The agar dilution, broth microdilution, and disk diffusion methods were compared to determine the in vitro susceptibility of 428 extended-spectrum-beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae to fosfomycin. Fosfomycin showed very high activity against all ESBL-producing strains. Excellent agreement between the three susceptibility methods was found for E. coli, whereas marked discrepancies were observed for K. pneumoniae.
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119
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Ballesta S, Conejo MC, García I, Rodríguez-Martínez JM, Velasco C, Pascual A. Survival and resistance to imipenem of Pseudomonas aeruginosa on latex gloves. J Antimicrob Chemother 2006; 57:1010-2. [PMID: 16531426 DOI: 10.1093/jac/dkl072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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120
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Baquero F, Cercenado E, Cisterna R, de la Rosa M, García-Rodríguez JA, Gobernado M, Pérez JL, Manchado P, Martín R, Pascual A, Picazo J, Prats G, Rubio C, Snyder TA, Sanz-Rodríguez C. [Patterns of susceptibility to antibiotics of Enterobacteriaceae causing intra-abdominal infection in Spain: SMART 2003 study outcomes]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2006; 19:51-9. [PMID: 16688292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
SMART (Study for Monitoring Antimicrobial Resistance Trends) is an ongoing global antimicrobial surveillance program focused on clinical isolates from intra-abdominal infections. The objective of this subanalysis was to assess antimicrobial susceptibility patterns among Entero-bacteriaceae recovered at 13 participating Spanish sites during 2003. Antimicrobial susceptibility testing was performed using broth microdilution techniques according to the CLSI (formerly NCCLS) guidelines for MIC testing. The presence of extended-spectrum beta-lactamases (ESBL) was confirmed in isolates with a MIC of ceftriaxone, ceftazidime, or cefepime>or=2 mg/l by comparing cefepime MICs with and with-out clavulanate. A total of 981 Enterobacteriaceae recovered from 840 patients were tested, of which 398 (41%) were community-acquired. Escherichia coli was the most common isolate (571 isolates; 58%), followed by Klebsiella spp. (153; 16% Enterobacter spp. (97; 10%), and Proteus spp. (63; 6%). A total of 191 isolates (19%) from 176 patients produced inducible beta-lactamases. The carbapenems and amikacin were the most consistently active agents against the Enterobacteriaceae (susceptibility>or=99%). Resistance rates for ceftazidime, cipro-floxacin, and levofloxacin exceeded 10%. ESBLs were detected phenotypically in 61 (6%) isolates, being the most common E. coli (61%), Klebsiella spp. (20%), and Enterobacter spp. (8%). Antimicrobial resistance among Enterobacteriaceae isolated from intra-abdominal infections is a problem in Spain. A significant proportion of inducible beta-lactamase and ESBL-producing Enterobacteriaceae causing intra-abdominal infection were acquired in the community. The carbapenems ertapenem, imipenem and meropenem and the aminoglycoside amikacin were highly active in vitro against Enterobacteriaceae isolated from intra-abdominal sites, including ESBL-producing organisms.
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121
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Pascual A, Castra D, Guéguen N. L'impact des conditions de choix d'un emploi sur l'insertion professionnelle de publics « précaires » : une application de la théorie de l'engagement. PSYCHOLOGIE DU TRAVAIL ET DES ORGANISATIONS 2006. [DOI: 10.1016/j.pto.2005.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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122
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Fernandez-Cuenca F, Martinez-Martinez L, Amblar G, Biedenbach DJ, Jones RN, Pascual A. Susceptibility to amoxycillin–clavulanate among clinical isolates of Escherichia coli resistant to cefoxitin. Clin Microbiol Infect 2006; 12:197-8. [PMID: 16441464 DOI: 10.1111/j.1469-0691.2005.01315.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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123
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Rodríguez-Martínez JM, López L, García I, Pascual A. Characterization of a clinical isolate of Haemophilus influenzae with a high level of fluoroquinolone resistance. J Antimicrob Chemother 2006; 57:577-8. [PMID: 16431860 DOI: 10.1093/jac/dki488] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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124
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Rodríguez-Martinez JM, Conejo MC, Martínez-Martínez L, Cano ME, Velasco C, Pascual A. Evaluation of antimicrobial susceptibility of bacteria containing the qnr gene and FOX-5 beta-lactamase by four automated systems. Clin Microbiol Infect 2005; 11:402-4. [PMID: 15819868 DOI: 10.1111/j.1469-0691.2005.01097.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The accuracy and performance of four automated instruments (BD Phoenix, MicroScan WalkAway, VITEK-2 and Wider) were evaluated for susceptibility testing of fluoroquinolones and beta-lactams with four clinical isolates of Klebsiella pneumoniae and the corresponding Escherichia coli transconjugants containing a plasmid carrying the qnr gene and coding for FOX-5 production. No major or very major errors were detected with the MicroScan system. Many of the minor errors for both quinolones and beta-lactams clustered around the intermediate breakpoints.
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125
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Cisneros JM, Rodríguez-Baño J, Fernández-Cuenca F, Ribera A, Vila J, Pascual A, Martínez-Martínez L, Bou G, Pachón J. Risk-factors for the acquisition of imipenem-resistant Acinetobacter baumannii in Spain: a nationwide study. Clin Microbiol Infect 2005; 11:874-9. [PMID: 16216101 DOI: 10.1111/j.1469-0691.2005.01256.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Potential risk-factors for the acquisition of imipenem-resistant Acinetobacter baumannii were investigated in a cohort study in 25 Spanish hospitals. The clonal relationship among isolates was determined by pulsed-field gel electrophoresis (PFGE). In total, A. baumannii was isolated from 203 patients, with imipenem-resistant (MIC(90) 128 mg/L) isolates being obtained from 88 patients (43%), and imipenem-susceptible isolates from 115 patients (57%). A wide clonal distribution was observed among the imipenem-resistant isolates, but spread of the same clone among centres was not demonstrated. The results indicated that imipenem-resistant A. baumannii is a widely distributed nosocomial pathogen in Spain and reaches an alarming frequency in some centres. Independent risk-factors for the acquisition of imipenem-resistant A. baumannii were a hospital size of >500 beds (multivariate OR, 6.5; 95% CI, 1.8--23), previous antimicrobial treatment (multivariate OR, 4.3; 95% CI, 1.6--11), a urinary catheter (multivariate OR, 2.7; 95% CI, 1.1--6.7) and surgery (multivariate OR, 2; 95% CI, 1.07--3.8).
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