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Muzahid NH, Md Zoqratt MZH, Ten KE, Hussain MH, Su TT, Ayub Q, Tan HS, Rahman S. Genomic and phenotypic characterization of Acinetobacter colistiniresistens isolated from the feces of a healthy member of the community. Sci Rep 2023; 13:12596. [PMID: 37537198 PMCID: PMC10400646 DOI: 10.1038/s41598-023-39642-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023] Open
Abstract
Acinetobacter species are widely known opportunistic pathogens causing severe community and healthcare-associated infections. One such emerging pathogen, Acinetobacter colistiniresistens, is known to exhibit intrinsic resistance to colistin. We investigated the molecular characteristics of A. colistiniresistens strain C-214, isolated from the fecal sample of a healthy community member, as part of a cohort study being conducted in Segamat, Malaysia. Comparison of the whole genome sequence of C-214 with other A. colistiniresistens sequences retrieved from the NCBI database showed 95% sequence identity or more with many of the genome sequences representing that species. Use of the Galleria mellonella killing assay showed that C-214 was pathogenic in this model infection system. The strain C-214 had a colistin and polymyxin B MIC of 32 and 16 mg/L, respectively. Besides, it was resistant to cefotaxime, amikacin, and tetracycline and showed moderate biofilm-producing ability. Different genes associated with virulence or resistance to major classes of antibiotics were detected. We observed mutations in lpxA/C/D in C-214 and other A. colistiniresistens strains as probable causes of colistin resistance, but the biological effects of these mutations require further investigation. This study provides genomic insights into A. colistiniresistens, a potentially pathogenic bacterium isolated from a community member and notes the public health threat it may pose.
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Affiliation(s)
- Nazmul Hasan Muzahid
- School of Science, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia.
| | | | - Kah Ern Ten
- School of Science, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Md Hamed Hussain
- School of Science, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Qasim Ayub
- School of Science, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
- Monash University Malaysia Genomics Facility, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Hock Siew Tan
- School of Science, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
- Tropical Medicine & Biology Multidisciplinary Platform, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Sadequr Rahman
- School of Science, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia.
- Monash University Malaysia Genomics Facility, Bandar Sunway, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia.
- Tropical Medicine & Biology Multidisciplinary Platform, Monash University Malaysia, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
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2
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Petroli SBDP, Fávaro LDS, de Moura CF, Tognim MCB, Venâncio EJ, Marroni FEC. Molecular and phenotypic characteristics of a bla OXA-58-carrying Acinetobacter colistiniresistens bloodstream isolate from Brazil. J Glob Antimicrob Resist 2022; 28:264-266. [PMID: 35121162 DOI: 10.1016/j.jgar.2022.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/29/2021] [Accepted: 01/22/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Suelen Balero de Paula Petroli
- Laboratório Especial de Microbiologia Molecular e Resistência aos Antimicrobianos (LEMMRA), Departamento de Patologia, Análises Clínicas e Patológicas (PAC), Universidade Estadual de Londrina - UEL, Londrina PR, Brazil
| | - Larissa Dos Santos Fávaro
- Laboratório Especial de Microbiologia Molecular e Resistência aos Antimicrobianos (LEMMRA), Departamento de Patologia, Análises Clínicas e Patológicas (PAC), Universidade Estadual de Londrina - UEL, Londrina PR, Brazil
| | - Camila Felipe de Moura
- Laboratório Especial de Microbiologia Molecular e Resistência aos Antimicrobianos (LEMMRA), Departamento de Patologia, Análises Clínicas e Patológicas (PAC), Universidade Estadual de Londrina - UEL, Londrina PR, Brazil
| | - Maria Cristina Bronharo Tognim
- Laboratório de Microbiologia Médica, Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá - UEM, Maringá PR, Brazil
| | - Emerson José Venâncio
- Departamento de Ciências Patológicas, Universidade Estadual de Londrina - UEL, Londrina PR, Brazil
| | - Floristher Elaine Carrara Marroni
- Laboratório Especial de Microbiologia Molecular e Resistência aos Antimicrobianos (LEMMRA), Departamento de Patologia, Análises Clínicas e Patológicas (PAC), Universidade Estadual de Londrina - UEL, Londrina PR, Brazil.
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3
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Brasiliense D, Cayô R, Streling AP, Nodari CS, Souza C, Leal C, Gales AC. Outbreak of Acinetobacter colistiniresistens bloodstream infections in a neonatal intensive care unit. J Glob Antimicrob Resist 2021; 24:257-259. [PMID: 33482367 DOI: 10.1016/j.jgar.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/17/2020] [Accepted: 01/04/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Danielle Brasiliense
- Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ananindeua, Pará, Brazil.
| | - Rodrigo Cayô
- Universidade Federal de São Paulo (UNIFESP), Laboratório de Imunologia e Bacteriologia (LIB), Setor de Biologia Molecular, Microbiologia e Imunologia - Departamento de Ciências Biológicas (DCB), Instituto de Ciências Ambientais, Químicas e Farmacêuticas (ICAQF), Diadema, SP, Brazil; Universidade Federal de São Paulo (UNIFESP), Laboratório Alerta, Disciplina de Infectologia, Departamento de Medicina, Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil
| | - Ana Paula Streling
- Universidade Federal de São Paulo (UNIFESP), Laboratório Alerta, Disciplina de Infectologia, Departamento de Medicina, Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil
| | - Carolina S Nodari
- Universidade Federal de São Paulo (UNIFESP), Laboratório Alerta, Disciplina de Infectologia, Departamento de Medicina, Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil
| | - Cintya Souza
- Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ananindeua, Pará, Brazil
| | - Crislaine Leal
- Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ananindeua, Pará, Brazil
| | - Ana C Gales
- Universidade Federal de São Paulo (UNIFESP), Laboratório Alerta, Disciplina de Infectologia, Departamento de Medicina, Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil
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4
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Govender R, Amoah ID, Kumari S, Bux F, Stenström TA. Detection of multidrug resistant environmental isolates of acinetobacter and Stenotrophomonas maltophilia: a possible threat for community acquired infections? JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2020; 56:213-225. [PMID: 33378222 DOI: 10.1080/10934529.2020.1865747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 06/12/2023]
Abstract
Acinetobacter spp. and Stenotrophomonas maltophilia are bacteria commonly associated with infections at the clinical settings. Reports of infections caused by environmental isolates are rare. Therefore, this study focused on determination of the antibiotic resistance patterns, antibiotic resistance genes, efflux pumps and virulence signatures of Acinetobacter spp. and S. maltophilia recovered from river water, plant rhizosphere and river sediment samples. The isolates were identified and confirmed using biochemical tests and PCR. The antimicrobial resistance profiles of the isolates were determined using Kirby Bauer disk diffusion assay and presence of antibiotic resistance and virulence genes were detected using PCR. S. maltophilia was more frequent in plant rhizosphere and sediment samples than the water samples. Acinetobacter spp. were mostly resistant to trimethoprim-sulfamethoxazole (96% of isolates), followed by polymyxin b (86%), cefixime (54%), colistin (42%), ampicillin (35%) and meropenem (19%). The S. maltophilia isolates displayed total resistance (100%) to trimethoprim- sulfamethoxazole, meropenem, imipenem, ampicillin and cefixime, while 80% of the isolates were resistant to ceftazidime. Acinetobacter spp. contained different antibiotic resistance genes such as sul1 (24% of isolates), sul2 (29%), blaOXA 23/51 (21%) and blaTEM (29%), while S. maltophilia harbored sul1 (8%) and blaTEM (20%). Additionally, efflux pump genes were present in all S. maltophilia isolates. The presence of multidrug resistant Acinetobacter spp. and Stenotrophomonas maltophilia in surface water raises concerns for community-acquired infections as this water is directly been used by the community for various purposes. Therefore, there is the need to institute measures aimed at reducing the risks of these infections and the resulting burden this may have on the health care system within the study area.
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Affiliation(s)
- Reshme Govender
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa
| | - Isaac D Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa
| | - Sheena Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa
| | - Faizal Bux
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa
| | - Thor A Stenström
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa
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Lima WG, Brito JCM, da Cruz Nizer WS. Bee products as a source of promising therapeutic and chemoprophylaxis strategies against COVID-19 (SARS-CoV-2). Phytother Res 2020; 35:743-750. [PMID: 32945590 PMCID: PMC7536959 DOI: 10.1002/ptr.6872] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/13/2020] [Accepted: 08/24/2020] [Indexed: 11/13/2022]
Abstract
The emergence of novel coronavirus (SARS‐CoV‐2) in 2019 in China marked the third outbreak of a highly pathogenic coronavirus infecting humans. The novel coronavirus disease (COVID‐19) spread worldwide, becoming an emergency of major international concern. However, even after a decade of coronavirus research, there are still no licensed vaccines or therapeutic agents to treat the coronavirus infection. In this context, apitherapy presents as a promising source of pharmacological and nutraceutical agents for the treatment and/or prophylaxis of COVID‐19. For instance, several honeybee products, such as honey, pollen, propolis, royal jelly, beeswax, and bee venom, have shown potent antiviral activity against pathogens that cause severe respiratory syndromes, including those caused by human coronaviruses. In addition, the benefits of these natural products to the immune system are remarkable, and many of them are involved in the induction of antibody production, maturation of immune cells, and stimulation of the innate and adaptive immune responses. Thus, in the absence of specific antivirals against SARS‐CoV‐2, apitherapy could offer one hope toward mitigating some of the risks associated with COVID‐19.
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Affiliation(s)
- William G Lima
- Epidemiological, Economic and Pharmacological Studies of Arboviruses (EEPIFARBO), Marabá, Brazil.,Department of Clinical Analyses and Toxicology, Pharmacy School, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Júlio C M Brito
- Epidemiological, Economic and Pharmacological Studies of Arboviruses (EEPIFARBO), Marabá, Brazil.,Department of Research and Development, Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
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6
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Maboni G, Seguel M, Lorton A, Sanchez S. Antimicrobial resistance patterns of Acinetobacter spp. of animal origin reveal high rate of multidrug resistance. Vet Microbiol 2020; 245:108702. [PMID: 32456823 DOI: 10.1016/j.vetmic.2020.108702] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 01/12/2023]
Abstract
Antimicrobial resistance has been declared by the World Health Organization as one of the biggest threats to public health and Acinetobacter baumannii is a notable example. A. baumannii is an important human nosocomial pathogen, being along with other multidrug resistant (MDR) bacteria, one of the biggest public health concerns worldwide. In Veterinary Medicine, resistance patterns of Acinetobacter species other than A. baumanii are unclear, and the scarce information available is limited and fragmented. We applied a statistical modeling approach to investigate the occurrence, clinical relevance and antimicrobial resistant phenotypes of Acinetobacter spp. originated from animals. Seven Acinetobacter species were identified in clinical specimens of more than 15 different domestic, zoo and exotic animal species. We found a high rate of MDR A. baumannii of canine origin with some of these isolates originating from serious systemic or wound infections, which highlights their potential pathogenic profile and spread in the human environment. Data also revealed different antimicrobial resistance patterns of animal-origin Acinetobacter species, emphasizing the necessity to implement specific antimicrobial susceptibility recommendations for animal isolates as there are no such clinical breakpoints currently in place. This study provides substantial advancing in our understanding of Acinetobacter spp. in animal clinical specimens, and highlights the role of animals in the dynamics of multidrug resistance in bacteria. The data presented here is a valuable source of information for further establishment of clinical breakpoints for susceptibility testing of animal-associated Acinetobacter isolates.
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Affiliation(s)
- Grazieli Maboni
- Athens Veterinary Diagnostic Laboratory, University of Georgia, Athens, GA, USA.
| | - Mauricio Seguel
- Odum School of Ecology, University of Georgia, Athens, GA, USA
| | - Ana Lorton
- Athens Veterinary Diagnostic Laboratory, University of Georgia, Athens, GA, USA
| | - Susan Sanchez
- Athens Veterinary Diagnostic Laboratory, University of Georgia, Athens, GA, USA; Department of Infectious Diseases, College of Veterinary Medicine, The University of Georgia, Athens, GA, USA
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7
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Mantzarlis K, Makris D, Zakynthinos E. Risk factors for the first episode of Acinetobacter baumannii resistant to colistin infection and outcome in critically ill patients. J Med Microbiol 2020; 69:35-40. [PMID: 31647404 PMCID: PMC7440673 DOI: 10.1099/jmm.0.001094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction To identify risk factors for the first episode of Acinetobacter baumannii resistant to colistin (ABCR) infection in critically ill patients. Aim Prospective observational study. Methodology ICU patients who required mechanical ventilation for >48 h during a 36 month period. Clinical and microbiological data were studied; characteristics of patients infected with ABCR were compared with those of critically ill patients who presented infection due to A. baumannii sensitive to colistin (ABCS). Results Twenty patients presented with ABCR infection, and 57 patients ABCS infection. Compared to patients with ABCS infection, patients suffering from ABCR infection had received more frequent and/or for longer duration dosing of several antibiotics active against Gram-negative bacteria (P<.05). Moreover, the duration of mechanical ventilation, and the presence of invasive procedures and tracheostomy prior to infection were associated with ABCR infections. The duration of carbapenem administration was an independent risk factor for ABCR infection [odds ratio (OR), 1.21; 95 % confidence interval (95 %, CI), 1.00 to 1.45; P=.049]. Mortality rate for patients with ABCR infection was higher (85 vs 39 % for the ABCS group). Sequential organ failure assessment score on admission, Charlson score and ABCR infection were independent risk factors for mortality. Conclusion ABCR infection is a life-threatening infection, which might be more common in patients with previous use of antibiotics, especially carbapenems.
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Affiliation(s)
- Konstantinos Mantzarlis
- Department of Critical Care, School of Medicine, University of Thessaly, University Hospital of Larissa, Thessaly, Greece
| | - Demosthenes Makris
- Department of Critical Care, School of Medicine, University of Thessaly, University Hospital of Larissa, Thessaly, Greece
| | - Epaminondas Zakynthinos
- Department of Critical Care, School of Medicine, University of Thessaly, University Hospital of Larissa, Thessaly, Greece
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8
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Emergence of IMP-34- and OXA-58-Producing Carbapenem-Resistant Acinetobacter colistiniresistens. Antimicrob Agents Chemother 2019; 63:AAC.02633-18. [PMID: 30962333 DOI: 10.1128/aac.02633-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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9
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Oinuma KI, Suzuki M, Nakaie K, Sato K, Saeki K, Sakiyama A, Takizawa E, Niki M, Niki M, Yamada K, Shibayama K, Kakeya H, Kaneko Y. Genome-Based Epidemiological Analysis of 13 Acinetobacter Strains Isolated from Blood Cultures of Hospitalized Patients from a University Hospital in Japan. Jpn J Infect Dis 2019; 72:274-280. [PMID: 30814458 DOI: 10.7883/yoken.jjid.2018.403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The genus Acinetobacter comprises many species that can cause infectious diseases. Despite their importance as nosocomial pathogens, the clinical distributions of individual species or clones are not well understood. In this study, we aimed to characterize 13 Acinetobacter strains isolated from blood cultures from Osaka City University Hospital. We conducted whole-genome sequencing to reveal their genetic background. We also performed PCR-based open reading frame typing (POT) and compared the results with those of multilocus sequence typing (MLST) to confirm its reliability as a genotyping method. Although biochemical analysis suggested that most isolates were A. baumannii, genomic analysis revealed that the collection of Acinetobacter isolates comprised six different species, with non-baumannii Acinetobacter species representing the majority. All strains possessed an inherent ADC-type β-lactamase gene, whereas the distribution of OXA-type enzymes was limited to A. baumannii, A. pittii, and A. colistiniresistens. While MLST properly discriminated four A. baumannii strains as different clones, POT failed to distinguish three of the four A. baumannii strains from each other, highlighting a potential pitfall that may be encountered when applying POT to non-epidemiological A. baumannii strains.
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Affiliation(s)
- Ken-Ichi Oinuma
- Department of Bacteriology, Osaka City University Graduate School of Medicine.,Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases
| | - Kiyotaka Nakaie
- Department of Infection Control and Prevention, Osaka City University Hospital.,Department of Infection Control Science, Osaka City University Graduate School of Medicine
| | - Kanako Sato
- Department of Bacteriology, Osaka City University Graduate School of Medicine.,Department of Respiratory Medicine, Osaka City University Graduate School of Medicine
| | - Kozo Saeki
- Department of Bacteriology, Osaka City University Graduate School of Medicine.,Department of Medical Technology, Morinomiya University of Medical Sciences
| | - Arata Sakiyama
- Department of Bacteriology, Osaka City University Graduate School of Medicine
| | - Etsuko Takizawa
- Department of Laboratory Medicine, Osaka City University Hospital
| | - Makoto Niki
- Department of Bacteriology, Osaka City University Graduate School of Medicine.,Department of Laboratory Medicine, Osaka City University Hospital
| | - Mamiko Niki
- Department of Bacteriology, Osaka City University Graduate School of Medicine.,Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine
| | - Koichi Yamada
- Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine.,Department of Infection Control Science, Osaka City University Graduate School of Medicine
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases
| | - Hiroshi Kakeya
- Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine.,Department of Infection Control Science, Osaka City University Graduate School of Medicine
| | - Yukihiro Kaneko
- Department of Bacteriology, Osaka City University Graduate School of Medicine.,Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine
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Lowe M, Ehlers MM, Ismail F, Peirano G, Becker PJ, Pitout JDD, Kock MM. Acinetobacter baumannii: Epidemiological and Beta-Lactamase Data From Two Tertiary Academic Hospitals in Tshwane, South Africa. Front Microbiol 2018; 9:1280. [PMID: 29946315 PMCID: PMC6005857 DOI: 10.3389/fmicb.2018.01280] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/25/2018] [Indexed: 01/26/2023] Open
Abstract
Acinetobacter baumannii is an opportunistic pathogen that is increasingly responsible for hospital-acquired infections. The increasing prevalence of carbapenem resistant A. baumannii has left clinicians with limited treatment options. Last line antimicrobials (i.e., polymyxins and glycylcyclines) are often used as treatment options. The aim of this study was to determine the prevalence of selected β-lactamase genes from A. baumannii isolates obtained from patients with hospital-acquired infections and to determine the genetic relationship and epidemiological profiles among clinical A. baumannii isolates collected from two tertiary academic hospitals in the Tshwane region, South Africa (SA). Multiplex-PCR (M-PCR) assays were performed to detect selected resistance genes. The collected isolates’ genetic relatedness was determined by using pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). The acquired oxacillinase (OXA) genes, notably blaOXA-23-like were prevalent in the A. baumannii isolates. The M-PCR assays showed that the isolates collected from hospital A contained the OXA-23-like (96%; n = 69/72) genes and the isolates collected from hospital B contained the OXA-23-like (91%; n = 63/69) and OXA-58-like (4%; n = 3/69) genes. Colistin resistance was found in 1% of the isolates (n = 2/141) and tigecycline intermediate resistance was found in 6% of the isolates (n = 8/141). The A. baumannii isolates were genetically diverse. Molecular epidemiological data showed that specific sequence types (STs) (ST106, ST229, ST258 and ST208) were established in both hospitals, while ST848 was established in hospital A and ST502, ST339 and the novel ST1552 were established in hospital B. ST848 (established in hospital A) was predominately detected in ICU wards whereas ST208, ST339 and the novel ST1552 (established in hospital B) were detected in ICUs and the general wards. The origin of the A. baumannii isolates in the hospitals may be due to the dissemination and adaptation of a diverse group of successful clones. Poor infection control and prevention strategies and possibly the overuse of antimicrobials contributed to the establishment of these A. baumannii clones in the studied hospitals.
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Affiliation(s)
- Michelle Lowe
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Marthie M Ehlers
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa
| | - Farzana Ismail
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa
| | - Gisele Peirano
- Departments of Microbiology, Immunology, Infectious Diseases and Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Division of Microbiology, Calgary Laboratory Services, Calgary, AB, Canada
| | - Piet J Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Johann D D Pitout
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Departments of Microbiology, Immunology, Infectious Diseases and Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Division of Microbiology, Calgary Laboratory Services, Calgary, AB, Canada
| | - Marleen M Kock
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa
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11
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Nemec A, Radolfova-Krizova L, Maixnerova M, Sedo O. Acinetobacter colistiniresistens sp. nov. (formerly genomic species 13 sensu Bouvet and Jeanjean and genomic species 14 sensu Tjernberg and Ursing), isolated from human infections and characterized by intrinsic resistance to polymyxins. Int J Syst Evol Microbiol 2017; 67:2134-2141. [PMID: 28671519 DOI: 10.1099/ijsem.0.001903] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Strains of the genusAcinetobacter, classified as genomic species 13BJ/14TU have been previously associated with human infections and resistance to colistin. To clarify the taxonomy of this provisional group, we investigated 24 strains that have been isolated from humans since the 1960s in 10 countries. The genus-wide analysis of the rpoB and gyrB sequences of all strains and whole-genome sequences of strains representing different rpoB/gyrB genotypes showed that the 24 strains formed a distinct monophyletic group within the so-called haemolytic clade of the genus Acinetobacter. The distinctness of the group at the species level was supported by the results of the cluster analysis of the whole-cell protein fingerprints generated by matrix-assisted laser desorption ionization-time-of-flight MS. The 24 strains had very similar metabolic features and could be distinguished from other members of the genus by the combination of strong haemolytic and proteolytic activities and the ability to oxidize d-glucose and grow on phenylacetate and/or l-phenylalanine. The minimum inhibitory concentrations of the 24 strains to colistin and polymyxin B ranged from 16 to 64 mgl-1 and from 4 to 32 mgl-1, respectively, so uniformly reaching the current clinical resistance breakpoint (4 mg l-1) for these drugs. Genus-wide comparison revealed that such a consistently high level of resistance to polymyxins is a unique feature among species of the genus Acinetobacter,which occur in humans. We conclude that genomic species 13BJ/14TU represents a biologically meaningful and medically relevant species, for which the name Acinetobacter colistiniresistens sp. nov. is proposed. The type strain is NIPH 2036T (=CCM 8641T=CIP 110478T=CCUG 67966T=CNCTC 7573T).
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Affiliation(s)
- Alexandr Nemec
- Laboratory of Bacterial Genetics, National Institute of Public Health, Šrobárova 48, 100 42 Prague, Czech Republic
| | - Lenka Radolfova-Krizova
- Laboratory of Bacterial Genetics, National Institute of Public Health, Šrobárova 48, 100 42 Prague, Czech Republic
| | - Martina Maixnerova
- Laboratory of Bacterial Genetics, National Institute of Public Health, Šrobárova 48, 100 42 Prague, Czech Republic
| | - Ondrej Sedo
- Research Group Proteomics, Central European Institute of Technology and National Centre for Biomolecular Research, Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
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12
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Comparison of biomarker based Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) and conventional methods in the identification of clinically relevant bacteria and yeast. BMC Microbiol 2017; 17:128. [PMID: 28545528 PMCID: PMC5445374 DOI: 10.1186/s12866-017-1037-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/22/2017] [Indexed: 12/20/2022] Open
Abstract
Background MALDI-TOF MS is an analytical method that has recently become integral in the identification of microorganisms in clinical laboratories. It relies on databases that majorly employ pattern recognition or fingerprinting. Biomarker based databases have also been developed and there is optimism that these may be superior to pattern recognition based databases. This study compared the performance of ribosomal biomarker based MALDI-TOF MS and conventional methods in the identification of selected bacteria and yeast. Methods The study was a cross sectional study identifying clinically relevant bacteria and yeast isolated from varied clinical specimens submitted to a clinical laboratory. The identification of bacteria using conventional Vitek 2™ automated system, serotyping and MALDI-TOF MS was performed as per standard operating procedures. Comparison of sensitivities were then carried out using Pearson Chi-Square test and p-value of <0.05 was considered statistically significant. Secondary outcomes analyzed included the major and minor error rates. Results Of the 383 isolates MALDI-TOF MS and conventional methods identified 97.6 and 95.7% (p = 0.231) to the genus level and 97.4 and 88.0% (p = 0.000) to the species level respectively. Biomarker based MALDI-TOF MS was significantly superior to Vitek 2™ in the identification of Gram negative bacteria and Gram positive bacteria to the species level. For the Gram positive bacteria, significant difference was observed in the identification of Coagulase negative Staphylococci (p = 0.000) and Enterococcus (p = 0.008). Significant difference was also observed between serotyping and MALDI-TOF MS (p = 0.005) and this was attributed to the lack of identification of Shigella species by MALDI-TOF MS. There was no significant difference observed in the identification of yeast however some species of Candida were unidentified by MALDI-TOF MS. Conclusion Biomarker based MALDI-TOF MS had good performance in a clinical laboratory setting with high sensitivities in the identification of clinically relevant microorganisms.
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Yakut N, Kepenekli EK, Karaaslan A, Atici S, Akkoc G, Demir SO, Soysal A, Bakir M. Bacteremia due to Acinetobacter ursingii in infants: Reports of two cases. Pan Afr Med J 2016; 23:193. [PMID: 27347282 PMCID: PMC4907768 DOI: 10.11604/pamj.2016.23.193.8545] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 04/03/2016] [Indexed: 11/11/2022] Open
Abstract
Acinetobacter ursingii is an aerobic, gram-negative, opportunistic microorganism which is rarely isolated among Acinetobacter species. We present two immunocompetent infants who developed bacteremia due to A. ursingii. The first patient is a two -month- old boy who had been hospitalized in pediatric surgery unit for suspected tracheo-esophageal fistula because of recurrent aspiration pneumonia unresponsive to antibiotic therapy. The second patient is a fourteen -month- old boy with prolonged vomiting and diarrhea. A. ursingii was isolated from their blood cultures. They were successfully treated with ampicillin-sulbactam. Although A. ursingii has recently been isolated from a clinical specimen; reports of infection with A. ursingii in children are rare. A. ursingii should be kept in mind as an opportunistic microorganism in children.
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Affiliation(s)
- Nurhayat Yakut
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Eda Kadayifci Kepenekli
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Ayse Karaaslan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Serkan Atici
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Gulsen Akkoc
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Sevliya Ocal Demir
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Ahmet Soysal
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Mustafa Bakir
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey
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Takizawa E, Yamada K, Oinuma KI, Sato K, Niki M, Namikawa H, Fujimoto H, Asai K, Kaneko Y, Kakeya H. An Intrinsic Strain of Colistin-resistant Acinetobacter Isolated from a Japanese Patient. Intern Med 2016; 55:2301-6. [PMID: 27523013 DOI: 10.2169/internalmedicine.55.6807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report the first domestic case of bacteremia caused by an intrinsic strain of colistin-resistant Acinetobacter. The Acinetobacter species was detected in the hemocultures in a febrile patient. The patient was a 65-year-old-man who was admitted to our hospital for laparotomic gastrostomy. The patient's antimicrobial susceptibility patterns were atypical; they were colistin resistant but not multiple drug resistant. A sequence analysis of rpoB identified the bacterium as an Acinetobacter genomic species 13BJ/14TU, which had only been previously reported in South Korea. He had never traveled to South Korea but frequently had contact with the South Korean community. We therefore demonstrated that infection with this species could occur in domestic cases.
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Affiliation(s)
- Etsuko Takizawa
- Department of Laboratory Medicine, Osaka City University Hospital, Japan
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15
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Lowings M, Ehlers MM, Dreyer AW, Kock MM. High prevalence of oxacillinases in clinical multidrug-resistant Acinetobacter baumannii isolates from the Tshwane region, South Africa - an update. BMC Infect Dis 2015; 15:521. [PMID: 26573617 PMCID: PMC4647659 DOI: 10.1186/s12879-015-1246-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/27/2015] [Indexed: 01/28/2023] Open
Abstract
Background Acinetobacter baumannii is an important hospital-acquired pathogen in healthcare facilities that frequently causes bacteraemia and ventilator-associated pneumonia in intensive care units. Acinetobacter baumannii can be isolated from various sites in the hospital environment like medical equipment, bed linen, medical personnel and indwelling catheters. It is difficult to treat A. baumannii infections because of their highly resistant antimicrobial profiles. The purpose of this study was to determine the prevalence of β-lactamase genes in multidrug-resistant (MDR) clinical A. baumannii isolates using Multiplex-PCR (M-PCR) assays. Methods One hundred MDR A. baumannii isolates were collected from the diagnostic division of the Department of Medical Microbiology after routine analysis of the submitted specimens. All collected isolates were identified and tested for susceptibility using the VITEK 2® system (bioMérieux, France). Six isolates were excluded from this study because the isolates were incorrectly identified as A. baumannii with the VITEK 2® system (bioMérieux, France). Molecular tests, namely M-PCR assays, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed. MLST analyses were performed on representative isolates from the four major pulsotypes (≥5 isolates with 80 % similarity) and selective isolates from each minor pulsotype. Results All the A. baumannii isolates showed 100 % resistance to ampicillin, amoxicillin, cefuroxime, cefuroximine axetil, cefoxitin, cefotaxime and nitrofurantoin. Seven percent of the isolates were resistant to amikacin. Two percent of the isolates were classified as having intermediate susceptibility to tigecycline. A. baumannii isolates showed an antibiotic resistance profile of 67 % and higher to antibiotics, such as ceftazidime, cefepime, imipenem, meropenem, gentamicin, ciprofloxacin and trimethoprim/sulfamethoxazole. None of the isolates were resistant to colistin. The M-PCR assays showed that 99 % of the isolates contained the OXA-51 gene and 77 % contained the OXA-23 gene. None of the isolates contained the GES, GIM, IMP, KPC, NDM, OXA-24, OXA-58, PER, SIM, SPM, VEB and VIM genes. Representative A. baumannii isolates were grouped into five existing sequence types (ST): ST106, ST258, ST339, ST502, ST758 and ST848. Isolates belonging to the pan-European clonal lineages I and II (EUI and EUII) were identified. Conclusion The high prevalence of MDR A. baumannii isolates has a severe impact on available treatment choices and this in return impacts on treatment outcomes in the studied healthcare facilities. The most dominant ST among the collected isolates was ST758, member of the EUI group. The presence of the OXA-23 gene was not restricted to a specific ST. Continuous research and surveillance is necessary to monitor the circulating β-lactamase genes in clinical settings to guide infection control policies in order to try and curb the spread of this bacterium.
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Affiliation(s)
- Michelle Lowings
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.
| | - Marthie Magdaleen Ehlers
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa. .,National Health Laboratory Service, Tshwane Academic Division, Pretoria, South Africa.
| | - Andries William Dreyer
- Centre for Tuberculosis, National Institute for Communicable Diseases, Johannesburg, South Africa.
| | - Marleen Magdalena Kock
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa. .,National Health Laboratory Service, Tshwane Academic Division, Pretoria, South Africa.
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16
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Differentiation of Acinetobacter Genomic Species 13BJ/14TU from Acinetobacter haemolyticus by Use of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). J Clin Microbiol 2015. [PMID: 26224844 DOI: 10.1128/jcm.03468-14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Trevino SE, Kollef MH. Management of Infections with Drug-Resistant Organisms in Critical Care: An Ongoing Battle. Clin Chest Med 2015; 36:531-41. [PMID: 26304289 DOI: 10.1016/j.ccm.2015.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Infections with multidrug-resistant organisms (MDROs) are common in critically ill patients and are challenging to manage appropriately. Strategies that can be used in the treatment of MDRO infections in the intensive care unit (ICU) include combination therapy, adjunctive aerosolized therapy, and optimization of pharmacokinetics with higher doses or extended-infusion therapy as appropriate. Rapid diagnostic tests could assist in improving timely appropriate antimicrobial therapy for MDRO infections in the ICU.
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Affiliation(s)
- Sergio E Trevino
- Pulmonary and Critical Care Division, Washington University School of Medicine, 660 South Euclid Avenue #8052, St Louis, MO 63110, USA
| | - Marin H Kollef
- Pulmonary and Critical Care Division, Washington University School of Medicine, 660 South Euclid Avenue #8052, St Louis, MO 63110, USA.
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18
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Henry R, Crane B, Powell D, Deveson Lucas D, Li Z, Aranda J, Harrison P, Nation RL, Adler B, Harper M, Boyce JD, Li J. The transcriptomic response of Acinetobacter baumannii to colistin and doripenem alone and in combination in an in vitro pharmacokinetics/pharmacodynamics model. J Antimicrob Chemother 2015; 70:1303-13. [PMID: 25587995 DOI: 10.1093/jac/dku536] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/01/2014] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Colistin remains a last-line treatment for MDR Acinetobacter baumannii and combined use of colistin and carbapenems has shown synergistic effects against MDR strains. In order to understand the bacterial responses to these antibiotics, we analysed the transcriptome of A. baumannii following exposure to each. METHODS RNA sequencing was employed to determine changes in the transcriptome following treatment with colistin and doripenem, both alone and in combination, using an in vitro pharmacokinetics (PK)/pharmacodynamics model to mimic the PK of both antibiotics in patients. RESULTS After treatment with colistin (continuous infusion at 2 mg/L), >400 differentially regulated genes were identified, including many associated with outer membrane biogenesis, fatty acid metabolism and phospholipid trafficking. No genes were differentially expressed following treatment with doripenem (Cmax 25 mg/L, t1/2 1.5 h) for 15 min, but 45 genes were identified as differentially expressed after 1 h of growth under this condition. Treatment of A. baumannii with both colistin and doripenem together for 1 h resulted in >450 genes being identified as differentially expressed. More than 70% of these gene expression changes were also observed following colistin treatment alone. CONCLUSIONS These data suggest that colistin causes gross damage to the outer membrane, facilitates lipid exchange between the inner and outer membrane and alters the normal asymmetric outer membrane composition. The transcriptional response to colistin was highly similar to that observed for an LPS-deficient strain, indicating that many of the observed changes are responses to outer membrane instability resulting from LPS loss.
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Affiliation(s)
- Rebekah Henry
- Department of Microbiology, Monash University, Clayton, Australia
| | - Bethany Crane
- Department of Microbiology, Monash University, Clayton, Australia
| | - David Powell
- Victorian Bioinformatics Consortium, Monash University, Clayton, Australia
| | | | - Zhifeng Li
- Department of Microbiology, Monash University, Clayton, Australia State Key Laboratory of Microbial Technology, School of Life Science, Shandong University, Jinan, 250100, Shandong, P. R. China
| | - Jesús Aranda
- Department of Microbiology, Monash University, Clayton, Australia
| | - Paul Harrison
- Victorian Bioinformatics Consortium, Monash University, Clayton, Australia
| | - Roger L Nation
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Ben Adler
- Department of Microbiology, Monash University, Clayton, Australia Australian Research Council Centre of Excellence in Structural and Functional Microbial Genomics, Monash University, Clayton, Australia
| | - Marina Harper
- Department of Microbiology, Monash University, Clayton, Australia Australian Research Council Centre of Excellence in Structural and Functional Microbial Genomics, Monash University, Clayton, Australia
| | - John D Boyce
- Department of Microbiology, Monash University, Clayton, Australia
| | - Jian Li
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
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Lee SY, Shin JH, Kim SH, Shin MG, Suh SP, Ryang DW. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry-based VITEK MS system for the identification of Acinetobacter species from blood cultures: comparison with VITEK 2 and MicroScan systems. Ann Lab Med 2014; 35:62-8. [PMID: 25553282 PMCID: PMC4272967 DOI: 10.3343/alm.2015.35.1.62] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/30/2014] [Accepted: 10/19/2014] [Indexed: 11/19/2022] Open
Abstract
Background Acinetobacter species are the leading cause of bloodstream infection (BSI), but their correct identification is challenging. We evaluated the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based VITEK MS (bioMérieux, France), and two automated systems, VITEK 2 (bioMérieux) and MicroScan (Siemens, USA) for identification of Acinetobacter BSI isolates. Methods A total of 187 BSI isolates recovered at a university hospital in Korea between 2010 and 2012 were analyzed. The identification results obtained using VITEK MS and two automated systems were compared with those of rpoB sequencing. Results Of 187 isolates analyzed, 176 were identified to the species level by rpoB sequencing: the Acinetobacter baumannii group (ABG; 101 A. baumannii, 43 A. nosocomialis, 10 A. pittii isolates) was most commonly identified (82.4%), followed by Acinetobacter genomic species 13BJ/14TU (5.3%), A. ursingii (2.1%), A. soli (2.1%), A. bereziniae (1.1%), and A. junii (1.1%). Correct identification rates to the species group (ABG) level or the species level was comparable among the three systems (VITEK MS, 90.3%; VITEK 2, 89.2%; MicroScan, 86.9%). However, VITEK MS generated fewer misidentifications (0.6%) than VITEK 2 (10.8%) and MicroScan (13.1%) (P<0.001). In addition, VITEK MS demonstrated higher specificity (100%) for discrimination between ABG and non-ABG isolates than the other systems (both, 31.8%) (P<0.001). Conclusions The VITEK MS system is superior to the VITEK 2 and MicroScan systems for identification of Acinetobacter BSI isolates, with fewer misidentifications and better discrimination between the ABG and non-ABG isolates.
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Affiliation(s)
- Seung Yeob Lee
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soon Pal Suh
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Wook Ryang
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
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20
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Kim UJ, Kim HK, An JH, Cho SK, Park KH, Jang HC. Update on the Epidemiology, Treatment, and Outcomes of Carbapenem-resistant Acinetobacter infections. Chonnam Med J 2014; 50:37-44. [PMID: 25229014 PMCID: PMC4161759 DOI: 10.4068/cmj.2014.50.2.37] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 07/18/2014] [Accepted: 07/28/2014] [Indexed: 11/12/2022] Open
Abstract
Carbapenem-resistant Acinetobacter species are increasingly recognized as major nosocomial pathogens, especially in patients with critical illnesses or in intensive care. The ability of these organisms to accumulate diverse mechanisms of resistance limits the available therapeutic agents, makes the infection difficult to treat, and is associated with a greater risk of death. In this review, we provide an update on the epidemiology, resistance mechanisms, infection control measures, treatment, and outcomes of carbapenem-resistant Acinetobacter infections.
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Affiliation(s)
- Uh Jin Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Kyung Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Hwan An
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Kyung Cho
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung-Hwa Park
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Hee-Chang Jang
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
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