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Nageeb WM, AlHarbi N, Alrehaili AA, Zakai SA, Elfadadny A, Hetta HF. Global genomic epidemiology of chromosomally mediated non-enzymatic carbapenem resistance in Acinetobacter baumannii: on the way to predict and modify resistance. Front Microbiol 2023; 14:1271733. [PMID: 37869654 PMCID: PMC10587612 DOI: 10.3389/fmicb.2023.1271733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/05/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Although carbapenemases are frequently reported in resistant A. baumannii clinical isolates, other chromosomally mediated elements of resistance that are considered essential are frequently underestimated. Having a wide substrate range, multidrug efflux pumps frequently underlie antibiotic treatment failure. Recognizing and exploiting variations in multidrug efflux pumps and penicillin-binding proteins (PBPs) is an essential approach in new antibiotic drug discovery and engineering to meet the growing challenge of multidrug-resistant Gram-negative bacteria. Methods A total of 980 whole genome sequences of A. baumannii were analyzed. Nucleotide sequences for the genes studied were queried against a custom database of FASTA sequences using the Bacterial and Viral Bioinformatics Resource Center (BV-BRC) system. The correlation between different variants and carbapenem Minimum Inhibitory Concentrations (MICs) was studied. PROVEAN and I-Mutant predictor suites were used to predict the effect of the studied amino acid substitutions on protein function and protein stability. Both PsiPred and FUpred were used for domain and secondary structure prediction. Phylogenetic reconstruction was performed using SANS serif and then visualized using iTOL and Phandango. Results Exhibiting the highest detection rate, AdeB codes for an important efflux-pump structural protein. T48V, T584I, and P660Q were important variants identified in the AdeB-predicted multidrug efflux transporter pore domains. These can act as probable targets for designing new efflux-pump inhibitors. Each of AdeC Q239L and AdeS D167N can also act as probable targets for restoring carbapenem susceptibility. Membrane proteins appear to have lower predictive potential than efflux pump-related changes. OprB and OprD changes show a greater effect than OmpA, OmpW, Omp33, and CarO changes on carbapenem susceptibility. Functional and statistical evidence make the variants T636A and S382N at PBP1a good markers for imipenem susceptibility and potential important drug targets that can modify imipenem resistance. In addition, PBP3_370, PBP1a_T636A, and PBP1a_S382N may act as potential drug targets that can be exploited to counteract imipenem resistance. Conclusion The study presents a comprehensive epidemiologic and statistical analysis of potential membrane proteins and efflux-pump variants related to carbapenem susceptibility in A. baumannii, shedding light on their clinical utility as diagnostic markers and treatment modification targets for more focused studies of candidate elements.
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Affiliation(s)
- Wedad M. Nageeb
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nada AlHarbi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amani A. Alrehaili
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Shadi A. Zakai
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Elfadadny
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhour University, Damanhour, El-Beheira, Egypt
| | - Helal F. Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Fonseca ÉL, Morgado SM, Freitas F, Oliveira PPC, Monteiro PM, Lima LS, Santos BP, Sousa MAR, Assunção AO, Mascarenhas LA, Vicente ACP. Persistence of a carbapenem-resistant Acinetobacter baumannii (CRAB) International Clone II (ST2/IC2) sub-lineage involved with outbreaks in two Brazilian clinical settings. J Infect Public Health 2023; 16:1690-1695. [PMID: 37639945 DOI: 10.1016/j.jiph.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/18/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Acinetobacter baumannii international clone II (IC2) is a widespread pandemic clone, however, it is rarely described in South America. The present study reported an outbreak caused by XDR IC2 strains in a clinical setting in Rio de Janeiro in 2022. METHODS Molecular epidemiology analysis was conducted with MLST to determine the clonal relationship and to assign a sequence type. The antimicrobial resistance profile of A. baumannii strains was assessed by the disk-diffusion method and MIC determination, and the presence of antibiotic resistance genes was determined by PCR and Sanger sequencing. The whole genome of one representative strain (AB91) was sequenced to prospect its resistome and virulome. RESULTS The MLST revealed that all strains belonged to the ST2 (Pasteur scheme) that corresponded to the pandemic IC2 lineage. They presented the XDR phenotype, which was compatible with their resistome composed of several acquired resistance genes and altered housekeeping genes. Additionally, an expressive virulome was revealed in AB91 genome. Genomic comparison with the unique other available IC2 genome from Brazil revealed that outbreaks occurring during (São Paulo - 2020/2021) and after (Rio de Janeiro - 2022) COVID-19 pandemics were caused by the same IC2 lineage. CONCLUSIONS This study suggests that the presence of a huge arsenal of resistance and virulence genes may have contributed to the persistence and the successful establishment of IC2 in Brazilian clinical settings during and after the COVID-19 pandemics in response to a series of events, such as the antibiotic overused during that period.
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Affiliation(s)
- Érica Lourenço Fonseca
- Instituto Oswaldo Cruz, Laboratório de Genética Molecular de Microrganismos, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Sérgio Mascarenhas Morgado
- Instituto Oswaldo Cruz, Laboratório de Genética Molecular de Microrganismos, FIOCRUZ, Rio de Janeiro, Brazil
| | - Fernanda Freitas
- Instituto Oswaldo Cruz, Laboratório de Genética Molecular de Microrganismos, FIOCRUZ, Rio de Janeiro, Brazil
| | - Priscila P C Oliveira
- Hospital Infection Control Committee, Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil
| | - Priscila M Monteiro
- Hospital Infection Control Committee, Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil
| | - Lorena S Lima
- Hospital Infection Control Committee, Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil
| | - Bianca P Santos
- Hospital Infection Control Committee, Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil
| | - Maria Aparecida R Sousa
- Hospital Infection Control Committee, Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil
| | - Adriana O Assunção
- Hospital Infection Control Committee, Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil
| | - Luís Affonso Mascarenhas
- Hospital Infection Control Committee, Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil
| | - Ana Carolina Paulo Vicente
- Instituto Oswaldo Cruz, Laboratório de Genética Molecular de Microrganismos, FIOCRUZ, Rio de Janeiro, Brazil
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Kurihara MNL, Sales ROD, Silva KED, Silva GD, Mansano MCT, Mahmoud FF, Simionatto S. High lethality rate of carbapenem-resistant Acinetobacter baumannii in Intensive Care Units of a Brazilian hospital: An epidemiologic surveillance study. Rev Soc Bras Med Trop 2022; 55:e05292021. [PMID: 35522809 PMCID: PMC9070061 DOI: 10.1590/0037-8682-0529-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/16/2022] [Indexed: 05/31/2023] Open
Abstract
Background: Methods: Results: Conclusions:
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Vasconcelos NG, Mallmann V, Costa ÉR, Simionatto E, Coutinho EJ, De Lara Da Silva RC, Ribeiro SM, Franco OL, Migliolo L, Croda J, Simionatto S. Antibacterial activity and synergism of the essential oil of Nectandra megapotamica (L.) flowers against OXA-23-producing Acinetobacter baumannii. JOURNAL OF ESSENTIAL OIL RESEARCH 2020. [DOI: 10.1080/10412905.2020.1740802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Nathalie Gaebler Vasconcelos
- Laboratório de Pesquisa Em Ciências da Saúde, Universidade Federal da Grande Dourados – UFGD, Dourados, Brazil
- Hospital Universitário de Dourados, Universidade Federal da Grande Dourados - UFGD, Dourados, Brazil
| | - Viviane Mallmann
- Programa de Pós-graduação em Recursos Naturais, Universidade Estadual de Mato Grosso Do Sul - UEMS, Naviraí, Brazil
| | - Érica Rodrigues Costa
- Programa de Pós-graduação em Recursos Naturais, Universidade Estadual de Mato Grosso Do Sul - UEMS, Naviraí, Brazil
| | - Euclésio Simionatto
- Programa de Pós-graduação em Recursos Naturais, Universidade Estadual de Mato Grosso Do Sul - UEMS, Naviraí, Brazil
| | - Eduardo João Coutinho
- Programa de Pós-graduação em Recursos Naturais, Universidade Estadual de Mato Grosso Do Sul - UEMS, Naviraí, Brazil
| | | | - Suzana Meira Ribeiro
- Laboratório de Pesquisa Em Ciências da Saúde, Universidade Federal da Grande Dourados – UFGD, Dourados, Brazil
- Universidade Católica Dom Bosco – UCDB, Campo Grande, Mato Grosso Do Sul, Brazil
| | - Octávio Luiz Franco
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, Brazil
- S-inova Biotech, Programa de Pós-Graduação Em Biotecnologia, Universidade Católica Dom Bosco – UCDB, Campo Grande, Brazil
| | - Ludovico Migliolo
- Universidade Católica Dom Bosco – UCDB, Campo Grande, Mato Grosso Do Sul, Brazil
| | - Júlio Croda
- Laboratório de Pesquisa Em Ciências da Saúde, Universidade Federal da Grande Dourados – UFGD, Dourados, Brazil
- Fundação Oswaldo Cruz, Rua Gabriel Abrão, Campo Grande, Brazil
- Universidade Federal do Mato Grosso do Sul - UFMS, Campo Grande, Brazil
| | - Simone Simionatto
- Laboratório de Pesquisa Em Ciências da Saúde, Universidade Federal da Grande Dourados – UFGD, Dourados, Brazil
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Genteluci GL, Gomes DBC, Pereira D, Neves MDC, de Souza MJ, Rangel K, Villas Bôas MHS. Multidrug-resistant Acinetobacter baumannii: differential adherence to HEp-2 and A-549 cells. Braz J Microbiol 2020; 51:657-664. [PMID: 32180159 DOI: 10.1007/s42770-020-00252-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/28/2020] [Indexed: 12/16/2022] Open
Abstract
Acinetobacter baumannii has been associated with antimicrobial resistance and ability to form biofilms. Furthermore, its adherence to host cells is an important factor to the colonization process. Therefore, this study intended to identify some virulence factors that can explain the success of A. baumannii in causing nosocomial infections. We studied 92 A. baumannii isolates collected from hospitals in Rio de Janeiro, Brazil. Isolates were identified and the susceptibility to antimicrobials was determined. Oxacilinase type β-lactamase encoding genes were amplified by polymerase chain reaction, and genetic diversity was investigated by pulsed-field gel electrophoresis (PFGE). In addition, biofilm formation on polystyrene plates using crystal violet staining was quantified, and adherence to human cell lines was evaluated. Eighty-six isolates were multidrug-resistant, of which 93% were carbapenem-resistant. All isolates had the blaOXA-51 gene and 94% had the blaOXA-23 gene, other searched blaOXA genes were not detected. PFGE typing showed two predominant clones, and biofilm production was observed in 79% of isolates. A. baumannii isolates adhered better to HEp-2 cell compared with A-549 cell. Clones A, B, E, and F showed a significantly increased adherence to HEp-2 compared with adherence to A-549 cell. Our findings revealed that A. baumannii isolates had high frequencies of resistance to antimicrobial agents, ability to form biofilm, and capacity to adhere to HEp-2 cells.
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Affiliation(s)
- Gabrielle Limeira Genteluci
- Department of Microbiology, National Institute of Quality Control in Heath, Fiocruz, Rio de Janeiro, Brazil.
- Post-Graduation Program in Health Surveillance, Fiocruz, National Institute of Quality Control in Heath, Rio de Janeiro, Brazil.
| | - Daniela Betzler Cardoso Gomes
- Department of Microbiology, National Institute of Quality Control in Heath, Fiocruz, Rio de Janeiro, Brazil
- Post-Graduation Program in Health Surveillance, Fiocruz, National Institute of Quality Control in Heath, Rio de Janeiro, Brazil
| | - Daniella Pereira
- Department of Microbiology, National Institute of Quality Control in Heath, Fiocruz, Rio de Janeiro, Brazil
| | - Marta de Campos Neves
- Department of Microbiology, National Institute of Quality Control in Heath, Fiocruz, Rio de Janeiro, Brazil
| | | | - Karyne Rangel
- Department of Microbiology, National Institute of Quality Control in Heath, Fiocruz, Rio de Janeiro, Brazil
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High Prevalence of Extensively Drug-resistant Acinetobacter baumannii at a Children Hospital in Bolivia. Pediatr Infect Dis J 2018; 37:1118-1123. [PMID: 29474260 DOI: 10.1097/inf.0000000000001962] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Acinetobacter baumannii causes serious hospital-acquired infections and has been positioned as a priority organism by the World Health Organization. This study includes 36 A. baumannii isolates from a children hospital recovered between March 2014 and May 2015 in Cochabamba. The majority of the isolates were recovered from blood cultures (n = 10, 31.3%) and respiratory samples (n = 11, 34.4%); 53% of the patients were younger than 1 month old. Most of these isolates (n = 30, 80.6%) were extremely drug resistant and 8.3% were multidrug resistant. The circulation of 2 predominant clones including 25 isolates was determined by pulsed-field gel electrophoresis; 9 of the isolates were considered sporadic strains. The isolates grouped in the predominant clones and 5 of the unrelated sporadic strains were single-locus variant or double locus variant of clonal complex (CC110), belonging to international clone 7; the rest of the isolates were single-locus variant or double locus variant of another clonal complex. All the carbapenem-resistant isolates (88.9%) carried the blaOXA-23-like in a similar structure to Tn2008 located on the chromosome, and the aac(3)-IIa gene was present in all the aminoglycoside-resistant isolates (86.1%). Strong biofilm producers were found among these isolates, being the strongest ones those recovered from the hospital environment, catheter, blood and cerebrospinal fluid (CSF) all of them belonged to the unrelated sporadic strains. The present study demonstrated the predominance and spread of closely related extremely drug-resistant A. baumannii isolates, what confers increasing risk to children and is of major concern because of the kind of infections and the lack of therapeutic alternatives to treat them.
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Schuertz KF, Tuon FF, Palmeiro JK, Conte D, Telles JPM, Trevisoli LE, Dalla-Costa LM. Bacteremia and meningitis caused by OXA-23-producing Acinetobacter baumannii - molecular characterization and susceptibility testing for alternative antibiotics. Braz J Microbiol 2018; 49 Suppl 1:199-204. [PMID: 29720352 PMCID: PMC6328846 DOI: 10.1016/j.bjm.2018.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 04/02/2018] [Accepted: 04/03/2018] [Indexed: 11/29/2022] Open
Abstract
Background Carbapenem-resistant Acinetobacter baumannii infection is a concern in developing countries due to high incidence, few therapeutic options, and increasing costs. Objective Characterize and analyze the antibiotic susceptibility patterns of carbapenem-resistant A. baumannii isolates and evaluate clinical data of meningitis and bacteremia caused by this microorganism. Methods Twenty-six A. baumannii isolates from 23 patients were identified by MALDI-TOF and automated methods and genotyped using pulsed field genotyping electrophoresis. Clinical data and outcomes were evaluated. Susceptibility of isolates to colistin, tigecycline, meropenem, imipenem, and doxycycline was determined. Results Mortality due to A. baumannii infections was 73.91%; all patients with meningitis and 7/8 patients with ventilator-associated pneumonia died. All isolates were susceptibility to polymyxin (100%; MIC50, MIC90: 1 μg/mL, 1 μg/mL) and colistin (100%; MIC50, MIC90: 2 μg/mL, 2 μg/mL), and 92% were susceptible to tigecycline (MIC50, MIC90: 1 μg/mL, 1 μg/mL) and doxycycline (MIC50, MIC90: 2 μg/mL, 2 μg/mL). blaOXA-23 was identified in 24 isolates. Molecular typing showed 8 different patterns: 13 isolates belonged to pattern A (50%). Conclusion Carbapenem-resistant A. baumannii infections mortality is high. Alternative antimicrobial therapy (doxycycline) for selected patients with carbapenem-resistant A. baumannii infection should be considered.
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Affiliation(s)
| | - Felipe Francisco Tuon
- Pontifícia Universidade Católica do Paraná, Escola de Medicina, Curitiba, PR, Brazil.
| | | | - Danieli Conte
- Instituto de Pesquisa Pele Pequeno Principe, Curitiba, PR, Brazil
| | | | | | - Libera Maria Dalla-Costa
- Instituto de Pesquisa Pele Pequeno Principe, Curitiba, PR, Brazil; Universidade Federal do Paraná, Hospital de Clinicas, Curitiba, PR, Brazil
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Escandón-Vargas K, Reyes S, Gutiérrez S, Villegas MV. The epidemiology of carbapenemases in Latin America and the Caribbean. Expert Rev Anti Infect Ther 2016; 15:277-297. [PMID: 27915487 DOI: 10.1080/14787210.2017.1268918] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Enterobacteriaceae, Pseudomonas spp., and Acinetobacter spp. infections are major causes of morbidity and mortality, especially due to the emergence and spread of β-lactamases. Carbapenemases, which are β-lactamases with the capacity to hydrolyze or inactivate carbapenems, have become a serious concern as they have the largest hydrolytic spectrum and therefore limit the utility of most β-lactam antibiotics. Areas covered: Here, we present an update of the current status of carbapenemases in Latin America and the Caribbean. Expert commentary: The increased frequency of reports on carbapenemases in Latin America and the Caribbean shows that they have successfully spread and have even become endemic in some countries. Countries such as Brazil, Colombia, Argentina, and Mexico account for the majority of these reports. Early suspicion and detection along with implementation of antimicrobial stewardship programs in all healthcare settings are crucial for the control and prevention of carbapenemase-producing bacteria.
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Affiliation(s)
- Kevin Escandón-Vargas
- a Bacterial Resistance and Hospital Epidemiology Unit , International Center for Medical Research and Training (CIDEIM) , Cali , Colombia
| | - Sergio Reyes
- a Bacterial Resistance and Hospital Epidemiology Unit , International Center for Medical Research and Training (CIDEIM) , Cali , Colombia
| | - Sergio Gutiérrez
- a Bacterial Resistance and Hospital Epidemiology Unit , International Center for Medical Research and Training (CIDEIM) , Cali , Colombia
| | - María Virginia Villegas
- a Bacterial Resistance and Hospital Epidemiology Unit , International Center for Medical Research and Training (CIDEIM) , Cali , Colombia.,b Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics , Universidad El Bosque , Bogotá , Colombia
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Diversity of mechanisms conferring resistance to β-lactams among OXA-23–producing Acinetobacter baumannii clones. Diagn Microbiol Infect Dis 2016; 85:90-7. [DOI: 10.1016/j.diagmicrobio.2016.01.018] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/18/2016] [Accepted: 01/25/2016] [Indexed: 11/16/2022]
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Mahamat A, Bertrand X, Moreau B, Hommel D, Couppie P, Simonnet C, Kallel H, Demar M, Djossou F, Nacher M. Clinical epidemiology and resistance mechanisms of carbapenem-resistant Acinetobacter baumannii, French Guiana, 2008-2014. Int J Antimicrob Agents 2016; 48:51-55. [PMID: 27236843 DOI: 10.1016/j.ijantimicag.2016.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/20/2016] [Accepted: 03/23/2016] [Indexed: 12/21/2022]
Abstract
This study investigated the clinical epidemiology and resistance mechanisms of Acinetobacter baumannii and characterised the clonal diversity of carbapenem-resistant A. baumannii (CRAB) during an ICU-associated outbreak at Cayenne Hospital, French Guiana. All non-duplicate A. baumannii isolates from 2008 to 2014 were tested for antibiotic susceptibility by disk diffusion. Multilocus sequence typing, pulsed-field gel electrophoresis (PFGE) and characterisation of carbapenemase-encoding genes were performed on CRAB. Of the 441 A. baumannii isolates, most were from males (54.0%) and were detected mainly from the ICU (30.8%) and medicine wards (21.8%). In the ICU, strains were mainly isolated from the respiratory tract (44.1%) and bloodstream (14.0%), whereas in medicine wards they mainly were from wound/drainage (36.5%) and bloodstream (25.0%). A. baumannii showed the greatest susceptibility to piperacillin/tazobactam (92.7%), imipenem (92.5%), colistin (95.6%) and amikacin (97.2%), being lower in the ICU and medicine wards compared with other wards. An outbreak of OXA-23-producing CRAB occurred in the 13-bed ICU in 2010. CRAB strains were more co-resistant to other antimicrobials compared with non-CRAB. Molecular genetics analysis revealed five sequence types [ST78, ST107 and ST642 and two new STs (ST830 and ST831)]. Analysis of PFGE profiles indicated cross-transmissions of CRAB within the ICU, between the ICU and one medicine ward during transfer of patients, and within that medicine ward. This study provides the first clinical and molecular data of A. baumannii from French Guiana and the Amazon basin. The ICU was the highest risk unit of this nosocomial outbreak of OXA-23-producing CRAB, which could subsequently disseminate within the hospital.
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Affiliation(s)
- Aba Mahamat
- Infection Control Unit, Infectious Diseases and Tropical Medicine, Centre hospitalier de Cayenne, Cayenne, French Guiana; EPAT EA 3595, Université de Guyane, Cayenne, French Guiana.
| | - Xavier Bertrand
- Service d'hygiène hospitalière, Centre hospitalier universitaire de Besançon, Besançon Cedex, France
| | - Brigitte Moreau
- Laboratoire de biologie polyvalente, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Didier Hommel
- Service de réanimation adulte, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Pierre Couppie
- EPAT EA 3595, Université de Guyane, Cayenne, French Guiana; Service de dermatologie, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Christine Simonnet
- Laboratoire de biologie polyvalente, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Hatem Kallel
- Service de réanimation adulte, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Magalie Demar
- Infection Control Unit, Infectious Diseases and Tropical Medicine, Centre hospitalier de Cayenne, Cayenne, French Guiana; EPAT EA 3595, Université de Guyane, Cayenne, French Guiana
| | - Felix Djossou
- Infection Control Unit, Infectious Diseases and Tropical Medicine, Centre hospitalier de Cayenne, Cayenne, French Guiana; EPAT EA 3595, Université de Guyane, Cayenne, French Guiana
| | - Mathieu Nacher
- EPAT EA 3595, Université de Guyane, Cayenne, French Guiana; Centre d'Investigation Clinique Epidémiologie Clinique CIC-EC CIE 802, Centre hospitalier de Cayenne, Cayenne, French Guiana
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Tanita MT, Carrilho CMDDM, Garcia JP, Festti J, Cardoso LTQ, Grion CMC. Parenteral colistin for the treatment of severe infections: a single center experience. Rev Bras Ter Intensiva 2015; 25:297-305. [PMID: 24553511 PMCID: PMC4031873 DOI: 10.5935/0103-507x.20130051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 12/13/2013] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To describe a single center experience involving the administration of colistin to treat nosocomial infections caused by multidrug-resistant Gram-negative bacteria and identify factors associated with acute kidney injury and mortality. METHODS This retrospective longitudinal study evaluates critically ill patients with infections caused by multidrug-resistant Gram-negative bacteria. All adult patients who required treatment with intravenous colistin (colistimethate sodium) from January to December 2008 were considered eligible for the study. Data include demographics, diagnosis, duration of treatment, presence of acute kidney injury and 30-day mortality. RESULTS Colistin was used to treat an infection in 109 (13.8%) of the 789 patients admitted to the intensive care unit. The 30-day mortality observed in these patients was 71.6%. Twenty-nine patients (26.6%) presented kidney injury prior to colistin treatment, and six of these patients were able to recover kidney function even during colistin treatment. Twenty-one patients (19.2%) developed acute kidney injury while taking colistin, and 11 of these patients required dialysis. The variable independently associated with the presence of acute kidney injury was the Sequential Organ Failure Assessment at the beginning of colistin treatment (OR 1.46; 95%CI 1.20-1.79; p<0.001). The factors age (OR 1.03; 95%CI 1.00-1.05; p=0.02) and vasopressor use (OR 12.48; 95%CI 4.49-34.70; p<0.001) were associated with death in the logistic-regression model. CONCLUSIONS Organ dysfunction at the beginning of colistin treatment was associated with acute kidney injury. In a small group of patients, we were able to observe an improvement of kidney function during colistin treatment. Age and vasopressor use were associated with death.
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Affiliation(s)
- Marcos Toshyiuki Tanita
- Universidade Estadual de Londrina, Programa de Pós-Graduação, LondrinaPR, Brasil, Programa de Pós-Graduação, Universidade Estadual de Londrina - UEL - Londrina (PR), Brasil
| | - Claudia Maria Dantas de Maio Carrilho
- Universidade Estadual de Londrina, Departamento de Clínica Médica, LondrinaPR, Brasil, Departamento de Clínica Médica, Universidade Estadual de Londrina - UEL - Londrina (PR), Brasil
| | - Joseani Pascual Garcia
- Universidade Estadual de Londrina, Hospital Universitário, Comitê de Controle de Infecções Hospitalares, LondrinaPR, Brasil, Comitê de Controle de Infecções Hospitalares, Hospital Universitário, Universidade Estadual de Londrina - UEL - Londrina (PR), Brasil
| | - Josiane Festti
- Universidade Estadual de Londrina, Departamento de Clínica Médica, LondrinaPR, Brasil, Departamento de Clínica Médica, Universidade Estadual de Londrina - UEL - Londrina (PR), Brasil
| | - Lucienne Tibery Queiroz Cardoso
- Universidade Estadual de Londrina, Departamento de Clínica Médica, LondrinaPR, Brasil, Departamento de Clínica Médica, Universidade Estadual de Londrina - UEL - Londrina (PR), Brasil
| | - Cintia Magalhães Carvalho Grion
- Universidade Estadual de Londrina, Departamento de Clínica Médica, LondrinaPR, Brasil, Departamento de Clínica Médica, Universidade Estadual de Londrina - UEL - Londrina (PR), Brasil
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High Endemic Rates of OXA-23-Producing Carbapenem-Resistant Acinetobacter baumannii Isolates Caused by the Persistence of Major Clones in Hospitals in a Brazilian City 5 Years After an Outbreak. Infect Control Hosp Epidemiol 2015; 36:860-2. [DOI: 10.1017/ice.2015.52] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Global assessment of antimicrobial susceptibility among Gram-negative organisms collected from pediatric patients between 2004 and 2012: results from the Tigecycline Evaluation and Surveillance Trial. J Clin Microbiol 2015; 53:1286-93. [PMID: 25653413 DOI: 10.1128/jcm.03184-14] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The Tigecycline Evaluation and Surveillance Trial (TEST) was designed to monitor susceptibility to commonly used antimicrobial agents among important pathogens. We report here on susceptibility among Gram-negative pathogens collected globally from pediatric patients between 2004 and 2012. Antimicrobial susceptibility was determined using guidelines published by the Clinical and Laboratory Standards Institute (CLSI). Most Enterobacteriaceae showed high rates of susceptibility (>95%) to amikacin, tigecycline, and the carbapenems (imipenem and meropenem); 90.8% of Acinetobacter baumannii isolates were susceptible to minocycline, and susceptibility rates were highest in North America, Europe, and Asia/Pacific Rim. Amikacin was the most active agent against Pseudomonas aeruginosa (90.4% susceptibility), with susceptibility rates being highest in North America. Extended-spectrum β-lactamases (ESBLs) were reported for 11.0% of Escherichia coli isolates and 24.2% of Klebsiella pneumoniae isolates globally, with rates reaching as high as 25.7% in the Middle East and >43% in Africa and Latin America, respectively. Statistically significant (P<0.01) differences in susceptibility rates were noted between pediatric age groups (1 to 5 years, 6 to 12 years, or 13 to 17 years of age), globally and in some regions, for all pathogens except Haemophilus influenzae. Significant (P<0.01) differences were reported for all pathogens globally and in most regions, considerably more frequently, when pediatric and adult susceptibility results were compared. Amikacin, tigecycline, and the carbapenems were active in vitro against most Gram-negative pathogens collected from pediatric patients; A. baumannii and P. aeruginosa were susceptible to fewer antimicrobial agents. Susceptibility rates among isolates from pediatric patients were frequently different from those among isolates collected from adults.
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First report of NDM-1-producing Acinetobacter baumannii sequence type 25 in Brazil. Antimicrob Agents Chemother 2014; 58:7592-4. [PMID: 25288087 DOI: 10.1128/aac.03444-14] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
New Delhi metallo-β-lactamase 1 (NDM-1) was first identified in Brazil in Enterobacter hormaechei and Providencia rettgeri in 2013. Here, we describe the first case of NDM-1-producing Acinetobacter baumannii sequence type 25 isolated from the urinary tract of a 71-year-old man who died of multiple complications, including A. baumannii infection. The NDM-1 gene was detected by quantitative PCR, and its sequence confirmed its presence in an ∼ 100-kb plasmid.
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Labarca JA, Salles MJC, Seas C, Guzmán-Blanco M. Carbapenem resistance in Pseudomonas aeruginosa and Acinetobacter baumannii in the nosocomial setting in Latin America. Crit Rev Microbiol 2014; 42:276-92. [PMID: 25159043 DOI: 10.3109/1040841x.2014.940494] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Increasing prevalence of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii strains in the nosocomial setting in Latin America represents an emerging challenge to public health, as the range of therapeutic agents active against these pathogens becomes increasingly constrained. We review published reports from 2002 to 2013, compiling data from throughout the region on prevalence, mechanisms of resistance and molecular epidemiology of carbapenem-resistant strains of P. aeruginosa and A. baumannii. We find rates of carbapenem resistance up to 66% for P. aeruginosa and as high as 90% for A. baumannii isolates across the different countries of Latin America, with the resistance rate of A. baumannii isolates greater than 50% in many countries. An outbreak of the SPM-1 carbapenemase is a chief cause of resistance in P. aeruginosa strains in Brazil. Elsewhere in Latin America, members of the VIM family are the most important carbapenemases among P. aeruginosa strains. Carbapenem resistance in A. baumannii in Latin America is predominantly due to the oxacillinases OXA-23, OXA-58 and (in Brazil) OXA-143. Susceptibility of P. aeruginosa and A. baumannii to colistin remains high, however, development of resistance has already been detected in some countries. Better epidemiological data are needed to design effective infection control interventions.
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Affiliation(s)
- Jaime A Labarca
- a Department of Infectious Diseases , School of Medicine, Pontificia Universidad Católica de Chile , Lira , Santiago , Chile
| | | | - Carlos Seas
- c Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia , Lima , Perú , and
| | - Manuel Guzmán-Blanco
- d Hospital Privado Centro Médico de Caracas and Hospital Vargas de Caracas , Caracas , Venezuela
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Obeidat N, Jawdat F, Al-Bakri AG, Shehabi AA. Major biologic characteristics of Acinetobacter baumannii isolates from hospital environmental and patients' respiratory tract sources. Am J Infect Control 2014; 42:401-4. [PMID: 24679567 DOI: 10.1016/j.ajic.2013.10.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 10/11/2013] [Accepted: 10/14/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND This prospective study investigated major biologic characteristics of Acinetobacter baumannii isolates from hospital environment and respiratory tract samples of patients admitted to adult intensive care units (ICUs) at the Jordan University Hospital. METHODS A baumannii isolates from both sources were examined for antimicrobial susceptibility and for presence of specific metallo-β-lactamase genes (VIM-2, IMP-1) and OXA-type β-lactamase genes (OXA-type) using polymerase chain reaction and biofilm formation and surviving under various temperatures and pH conditions. RESULTS The majority of A baumannii isolates from environmental and patients sources was multidrug resistant (MDR), except for colistin and tigecycline. All A baumannii examined carried a blaOXA51-like gene, 58% has a blaOXA23-like gene, and 38.8% has a blaOXA24-like gene. Representative MDR A baumannii isolates from both sources were capable to form biofilm. A baumannii environmental isolates were capable to survive for a longer time in tap, normal saline, and distilled water than respiratory tract isolates with pH range of 4.5 to 8 and temperature between 18°C to 37°C. CONCLUSIONS This study demonstrates that A baumannii isolates from the patients' respiratory tract and hospital environment carried much similar multidrug resistance patterns and biologic characteristics. In conclusion, this study shows that all MDR A baumannii strains survived well in the hospital environment, especially in water and moist environment and produced biofilm, which might be responsible for high colonization in the respiratory tract of patients in ICU.
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Maya JJ, Ruiz SJ, Blanco VM, Gotuzzo E, Guzman-Blanco M, Labarca J, Salles M, Quinn JP, Villegas MV. Current status of carbapenemases in Latin America. Expert Rev Anti Infect Ther 2014; 11:657-67. [PMID: 23879607 DOI: 10.1586/14787210.2013.811924] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Enterobacteriaceae and non fermenting Gram-negative bacilli have become a threat to public health, in part due to their resistance to multiple antibiotic classes, which ultimately have led to an increase in morbidity and mortality. β-lactams are currently the mainstay for combating infections caused by these microorganisms, and β-lactamases are the major mechanism of resistance to this class of antibiotics. Within the β-lactamases, carbapenemases pose one of the gravest threats, as they compromise one of our most potent lines of defense, the carbapenems. Carbapenemases are being continuously identified worldwide; and in Latin America, numerous members of these enzymes have been reported. In this region, the high incidence of reports implies that carbapenemases have become a menace and that they are an issue that must be carefully studied and analyzed.
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Affiliation(s)
- Juan J Maya
- CIDEIM International Center for Medical Research and Training, Cali, Colombia
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Molecular epidemiology characterization of OXA-23 carbapenemase-producing Acinetobacter baumannii isolated from 8 Brazilian hospitals using repetitive sequence–based PCR. Diagn Microbiol Infect Dis 2013; 77:337-40. [DOI: 10.1016/j.diagmicrobio.2013.07.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 07/27/2013] [Accepted: 07/31/2013] [Indexed: 11/24/2022]
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Emergence of Acinetobacter baumannii international clone II in Brazil: reflection of a global expansion. INFECTION GENETICS AND EVOLUTION 2013; 20:378-80. [PMID: 24121023 DOI: 10.1016/j.meegid.2013.09.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/26/2013] [Accepted: 09/30/2013] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the occurrence of carbapenem-resistant Acinetobacter baumannii international clones (IC) in Curitiba, Brazil, using multilocus sequence typing and trilocus PCR-based typing schemes. IC2 was the first emerging clone. This IC was detected in an isolate from 2003 of a PFGE type spread in at least two hospitals since 1999. Subsequently, IC2 waned while IC1 and clonal complex 15/104 prevailed. This is the first description of IC2 in Brazil and Latin America.
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Gurjar M, Saigal S, Baronia AK, Rao BP, Azim A, Poddar B, Singh RK. Carbapenem-resistant Acinetobacter ventilator-associated pneumonia: Clinical characteristics and outcome. Indian J Crit Care Med 2013; 17:129-34. [PMID: 24082608 PMCID: PMC3777365 DOI: 10.4103/0972-5229.117036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To study the clinical characteristics and 28-days mortality in patients with ventilator-associated pneumonia (VAP) due to carbapenem-resistant Acinetobacter (CRA). Design: Retrospective, observational, cohort study. Setting: Intensive care unit (ICU) of a university hospital. Materials and Methods: Microbiologically confirmed VAP due to CRA infection. Intervention: None. Results: Out of 87 patients with VAP due to CRA, 60 (69%) were male; whose median age was 51 years; 73 (84%) patients were medical; 26 (30%) had history of hospitalization in last 3 months; median acute physiology and chronic health evaluation (APACHE) II was 15 and median SOFA 9 at admission; primary reason for ICU admission was respiratory failure (34%); 46 (53%) patients had more than 2 organ failure at ICU admission; median length of ICU stay was 19 days; 66 (76%) patients need vasoactive agents during ICU stay, whereas 55 (63%) patients had renal failure; median duration of mechanical ventilation was 17 days; 22 (25%) patients had acute respiratory distress syndrome (ARDS) during ICU stay; 72 (83%) patients had exposure to carbapenem before inclusion in the study; 33 (38%) patients had same organism at other sites. In the follow-up, 47 (54%) patient survived at 28 days after having VAP; whereas only 40 (46%) patients were discharged from the hospital. Conclusions: CRA-VAP has high crude mortality. Advanced age; severity of illness and presence of pneumonia at ICU admission; and presence of shock, ARDS and renal failure have impact on outcome in these patients.
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Affiliation(s)
- Mohan Gurjar
- Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Brust FR, Massi L, Cantarelli VV, Zavascki AP. Direct detection of blaOXA-23 gene from endotracheal aspirates by real time PCR. Braz J Infect Dis 2013; 17:493-4. [PMID: 23665011 PMCID: PMC9428053 DOI: 10.1016/j.bjid.2012.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 11/21/2012] [Indexed: 11/25/2022] Open
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Martins N, Martins IS, de Freitas WV, de Matos JA, Girão VBDC, Coelho-Souza T, Maralhães ACDG, Cacci LC, de Figueiredo MP, Dias RCS, Costa-Lourenço APR, Ferreira ALP, Dalla-Costa L, Nouér SA, Santoro-Lopes G, Riley LW, Moreira BM. Imported and intensive care unit-born Acinetobacter baumannii clonal complexes: one-year prospective cohort study in intensive care patients. Microb Drug Resist 2013; 19:216-23. [PMID: 23336529 DOI: 10.1089/mdr.2012.0174] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The main objective of this study was to assess the frequency and possible sources of colonization and infection by Acinetobacter in the intensive care unit (ICU) of a university hospital in Rio de Janeiro, Brazil, and characterize the isolates for relatedness to internationally and locally disseminated lineages. Patients consecutively admitted to the ICU from April 2007 to April 2008 were screened for colonization and infection. Species were identified by rpoB sequencing. The presence of acquired and intrinsic carbapenemase genes was assessed by polymerase chain reaction (PCR). Strains were typed by random amplification of polymorphic DNA (RAPD)-PCR, pulsed-field gel electrophoresis, and multilocus sequence typing (MLST) using the schemes hosted at the University of Oxford (UO) and Institut Pasteur (IP). Of 234 patients, 98 (42%) had at least one specimen positive for the Acinetobacter isolate, and 24 (10%) had infection. A total of 22 (92%) infections were caused by Acinetobacter baumannii and one each (4%) by Acinetobacter nosocomialis and Acinetobacter berezinae. A. baumannii isolates from 60 patients belonged to RAPD types that corresponded to MLST clonal complexes (CCs) 109/1 (UO/IP scheme, known as International Clone I), CC 110/110 (UO/IP), CC 113/79 (UO/IP), and CC 104/15 (UO/IP). Most CCs were carbapenem resistant and carried the bla(OXA-23)-like gene. Strains were introduced by patients transferred from other wards of the same hospital (11 patients, 18%) or acquired from cross-transmission within the ICU (49 patients, 82%). A. nosocomialis lineage sequence type 260 colonized 10% of the whole study population. A. baumannii have become established in this hospital as a part of a global epidemic of successful clones. Once introduced into the hospital, such clones have become entrenched among patients in the ICU.
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Affiliation(s)
- Natacha Martins
- Institute of Microbiology, Federal University of Rio de Janeiro, Brazil
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Antimicrobial resistance patterns and their encoding genes among Acinetobacter baumannii strains isolated from burned patients. Burns 2012; 38:1198-203. [DOI: 10.1016/j.burns.2012.04.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Revised: 03/09/2012] [Accepted: 04/15/2012] [Indexed: 11/20/2022]
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Detection of blaOXA-23 in Acinetobacter spp. isolated from patients of a university hospital. Braz J Infect Dis 2012; 16:521-6. [DOI: 10.1016/j.bjid.2012.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022] Open
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25
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Martins N, Martins IS, de Freitas WV, de Matos JA, Magalhães ACG, Girão VBC, Dias RCS, de Souza TC, Pellegrino FLPC, Costa LD, Boasquevisque CHR, Nouér SA, Riley LW, Santoro-Lopes G, Moreira BM. Severe infection in a lung transplant recipient caused by donor-transmitted carbapenem-resistant Acinetobacter baumannii. Transpl Infect Dis 2011; 14:316-20. [PMID: 22168176 DOI: 10.1111/j.1399-3062.2011.00701.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 07/22/2011] [Accepted: 09/25/2011] [Indexed: 01/12/2023]
Abstract
We describe a case of proven donor transmission of carbapenem-resistant Acinetobacter baumannii, which resulted in severe infectious complications after lung transplantation. A single bla(OXA-23) positive strain, belonging to a new multilocus sequence type (ST231), was isolated from donor and recipient, who died 65 days after transplantation. This report highlights the current challenges associated with the potential transmission of multidrug-resistant infections through organ transplantation.
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Affiliation(s)
- N Martins
- Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Antimicrobial activity of doripenem against Gram-negative pathogens: results from INVITA-A-DORI Brazilian Study. Braz J Infect Dis 2011; 15:513-20. [DOI: 10.1016/s1413-8670(11)70244-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 11/04/2011] [Indexed: 11/24/2022] Open
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Cereda RF, Azevedo HD, Girardello R, Xavier DE, Gales AC. Antimicrobial activity of ceftobiprole against Gram-negative and Gram-positive pathogens: results from INVITA-A-CEFTO Brazilian study. Braz J Infect Dis 2011. [DOI: 10.1016/s1413-8670(11)70202-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Class 2 integrons in multidrug-resistant Acinetobacter baumannii circulating in different Brazilian geographic regions. Int J Antimicrob Agents 2011; 38:95-6. [PMID: 21550785 DOI: 10.1016/j.ijantimicag.2011.03.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 03/16/2011] [Indexed: 11/20/2022]
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Nosocomial bloodstream infections in Brazilian hospitals: analysis of 2,563 cases from a prospective nationwide surveillance study. J Clin Microbiol 2011; 49:1866-71. [PMID: 21411591 DOI: 10.1128/jcm.00376-11] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. Data from a nationwide, concurrent surveillance study, Brazilian SCOPE (Surveillance and Control of Pathogens of Epidemiological Importance), were used to examine the epidemiology and microbiology of nBSIs at 16 Brazilian hospitals. In our study 2,563 patients with nBSIs were included from 12 June 2007 to 31 March 2010. Ninety-five percent of BSIs were monomicrobial. Gram-negative organisms caused 58.5% of these BSIs, Gram-positive organisms caused 35.4%, and fungi caused 6.1%. The most common pathogens (monomicrobial) were Staphylococcus aureus (14.0%), coagulase-negative staphylococci (CoNS) (12.6%), Klebsiella spp. (12.0%), and Acinetobacter spp. (11.4%). The crude mortality was 40.0%. Forty-nine percent of nBSIs occurred in the intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 622 patients (24.3%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (70.3%). Methicillin resistance was detected in 157 S. aureus isolates (43.7%). Of the Klebsiella sp. isolates, 54.9% were resistant to third-generation cephalosporins. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 55.9% and 36.8%, respectively, were resistant to imipenem. In our multicenter study, we found high crude mortality and a high proportion of nBSIs due to antibiotic-resistant organisms.
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High prevalence of carbapenem-resistant Acinetobacter baumannii carrying the blaOXA-143 gene in Brazilian hospitals. Antimicrob Agents Chemother 2010; 55:1322-3. [PMID: 21149618 DOI: 10.1128/aac.01102-10] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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