Clinical and microbiological characteristics of OXA-23- and OXA-143-producing Acinetobacter baumannii in ICU patients at a teaching hospital, Brazil

Autor: Stella Sala Soares Lima, Isabela Dias Paião, Roberta Maia de Castro Romanelli, Nilton Lincopan, Paulo Henrique Orlandi Mourão, Francelli Cordeiro Neves, Luciene F. Paiva, Wanessa Trindade Clemente, Vandack A. Nobre-Junior, Patrícia R. Neves
Rok vydání: 2016
Předmět:
0301 basic medicine
Microbiology (medical)
Acinetobacter baumannii
Male
Imipenem
medicine.medical_specialty
blaOXA-23
Genotype
Carbapenem resistance
blaOXA-143
030106 microbiology
lcsh:QR1-502
Tigecycline
Microbial Sensitivity Tests
lcsh:Microbiology
beta-Lactamases
lcsh:Infectious and parasitic diseases
Microbiology
Teaching hospital
03 medical and health sciences
Internal medicine
Intensive care
medicine
Humans
lcsh:RC109-216
Colonization
Prospective Studies
Hospitals
Teaching
Genotyping
Medicine(all)
Cross Infection
biology
biochemical phenomena
metabolism
and nutrition
Middle Aged
biology.organism_classification
INFECÇÃO HOSPITALAR
Anti-Bacterial Agents
Intensive Care Units
Infectious Diseases
Female
Multiplex Polymerase Chain Reaction
Polymyxin B
Brazil
medicine.drug
Acinetobacter Infections
Zdroj: Brazilian Journal of Infectious Diseases v.20 n.6 2016
Brazilian Journal of Infectious Diseases
Brazilian Society of Infectious Diseases (BSID)
instacron:BSID
Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
Brazilian Journal of Infectious Diseases, Vol 20, Iss 6, Pp 556-563 (2016)
Brazilian Journal of Infectious Diseases, Volume: 20, Issue: 6, Pages: 556-563, Published: DEC 2016
ISSN: 1678-4391
Popis: Background: Carbapenem-resistant Acinetobacter baumannii (CRAb) is an important cause of nosocomial infections especially in intensive care units. This study aimed to assess clinical aspects and the genetic background of CRAb among ICU patients at a Brazilian teaching hospital. Methods: 56 critically ill patients colonized or infected by CRAb, during ICU stay, were prospectively assessed. Based on imipenem MIC ≥ 4 μg/mL, 28 CRAB strains were screened for the presence of genes encoding metallo-β-lactamases and OXA-type β-lactamases. The blaOXA-type genes were characterized by PCR using primers targeting ISAba-1 or -3. Genetic diversity of blaOXA-positive strains was determined by ERIC-PCR analysis. Results: Patient's mean age (±SD) was 61 (±15.1), and 58.9% were male. Eighty-percent of the patients presented risk factors for CRAb colonization, mainly invasive devices (87.5%) and previous antibiotic therapy (77.6%). Thirty-three patients died during hospital stay (59.0%). Resistance to carbapenems was associated with a high prevalence of blaOXA-23 (51.2%) and/or blaOXA-143 (18.6%) genes. ERIC-PCR genotyping identified 10 clusters among OXA-producing CRAb. Three CRAb strains exhibited additional resistance to polymyxin B (MIC ≥ 4 μg/mL), whereas 10 CRAb strains showed tigecycline MICs > 2 μg/mL. Conclusions: In this study, clonally unrelated OXA-123- and OXA-143-producing A. baumannii strains in ICU patients were strongly correlated to colonization with infected patients being associated with a poor outcome. Keywords: Acinetobacter baumannii, Carbapenem resistance, blaOXA-23, blaOXA-143
Databáze: OpenAIRE
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