Diversity and Clinical Impact of Acinetobacter baumannii Colonization and Infection at a Military Medical Center
| Autor: | David M. You, Lenie Dijkshoorn, Beppie van Strijen, Suzanne C. Cannegieter, Andrew I. Philip, Britta S. Babel, Kyle Petersen, Tanny J. K. van der Reijden |
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| Rok vydání: | 2011 |
| Předmět: |
Acinetobacter baumannii
Adult Male Microbiology (medical) medicine.medical_specialty Genotype medicine.drug_class Antibiotics Polymerase Chain Reaction Severity of Illness Index beta-Lactamases blood-transfusion combat casualties united-states strains iraq care epidemiology clone resistance hospitals Microbiology Bacterial Proteins Epidemiology medicine Humans Amplified Fragment Length Polymorphism Analysis Aged Aged 80 and over biology APACHE II Genetic Variation Bacteriology Middle Aged Acinetobacter biology.organism_classification DNA Fingerprinting Hospitals Molecular Typing Military Personnel DNA profiling Female Amplified fragment length polymorphism Acinetobacter Infections |
| Zdroj: | Journal of Clinical Microbiology, 49(1), 159-166 |
| ISSN: | 1098-660X 0095-1137 |
| DOI: | 10.1128/jcm.00766-10 |
| Popis: | The epidemiology of Acinetobacter baumannii emerging in combat casualties is poorly understood. We analyzed 65 (54 nonreplicate) Acinetobacter isolates from 48 patients (46 hospitalized and 2 outpatient trainees entering the military) from October 2004 to October 2005 for genotypic similarities, time-space relatedness, and antibiotic susceptibility. Clinical and surveillance cultures were compared by amplified fragment length polymorphism (AFLP) genomic fingerprinting to each other and to strains of a reference database. Antibiotic susceptibility was determined, and multiplex PCR was performed for OXA-23-like, -24-like, -51-like, and -58-like carbapenemases. Records were reviewed for overlapping hospital stays of the most frequent genotypes, and risk ratios were calculated for any association of genotype with severity of Acute Physiology and Chronic Health Evaluation II (APACHE II) score or injury severity score (ISS) and previous antibiotic use. Nineteen genotypes were identified; two predominated, one consistent with an emerging novel international clone and the other unique to our database. Both predominant genotypes were carbapenem resistant, were present at another hospital before patients' admission to our facility, and were associated with higher APACHE II scores, higher ISSs, and previous carbapenem antibiotics in comparison with other genotypes. One predominated in wound and respiratory isolates, and the other predominated in wound and skin surveillance samples. Several other genotypes were identified as European clones I to III. Acinetobacter genotypes from recruits upon entry to the military, unlike those in hospitalized patients, did not include carbapenem-resistant genotypes. Acinetobacter species isolated from battlefield casualties are diverse, including genotypes belonging to European clones I to III. Two carbapenem-resistant genotypes were epidemic, one of which appeared to belong to a novel international clone. |
| Databáze: | OpenAIRE |
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