Pandrug-resistant Acinetobacter Baumannii Causing Nosocomial Infections in a University Hospital, Taiwan

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2002 Jul 27

PMID 12141969

Citations 73

Authors

Po-Ren Hsueh

Lee-Jene Teng

Cheng-Yi Chen

Wen-Hwei Chen

Chong-Jen Yu

Shen-Wu Ho

Kwen-Tay Luh

Affiliations

Soon will be listed here.

Abstract

The rapid emergence (from 0% before 1998 to 6.5% in 2000) of pandrug-resistant Acinetobacter baumannii (PDRAB) was noted in a university hospital in Taiwan. To understand the epidemiology of these isolates, we studied 203 PDRAB isolates, taken from January 1999 to April 2000: 199 from 73 hospitalized patients treated at different clinical settings in the hospital and 4 from environmental sites in an intensive-care unit. Pulsed-field gel electrophoresis analysis and random amplified polymorphic DNA (RAPD) generated by arbitrarily primed polymerase chain reaction of these 203 isolates showed 10 closely related genotypes (10 clones). One (clone 5), belonging to pulsotype E and RAPD pattern 5, predominated (64 isolates, mostly from patients in intensive care). Increasing use of carbapenems and ciprofloxacin (selective pressure) as well as clonal dissemination might have contributed to the wide spread of PDRAB in this hospital.

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References

Clark R . Imipenem resistance among Acinetobacter baumannii: association with reduced expression of a 33-36 kDa outer membrane protein. J Antimicrob Chemother. 1996; 38(2):245-51. DOI: 10.1093/jac/38.2.245. View

Silva G, Leitao G, Peixe L . Emergence of carbapenem-hydrolyzing enzymes in Acinetobacter baumannii clinical isolates. J Clin Microbiol. 1999; 37(6):2109-10. PMC: 85053. DOI: 10.1128/JCM.37.6.2109-2110.1999. View

Corbella X, Montero A, Pujol M, Dominguez M, Ayats J, Argerich M . Emergence and rapid spread of carbapenem resistance during a large and sustained hospital outbreak of multiresistant Acinetobacter baumannii. J Clin Microbiol. 2000; 38(11):4086-95. PMC: 87546. DOI: 10.1128/JCM.38.11.4086-4095.2000. View

Garner J, Jarvis W, Emori T, Horan T, Hughes J . CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988; 16(3):128-40. DOI: 10.1016/0196-6553(88)90053-3. View

Pandey A, Kapil A, Sood S, Goel V, Das B, Seth P . In vitro activities of ampicillin-sulbactam and amoxicillin-clavulanic acid against Acinetobacter baumannii. J Clin Microbiol. 1998; 36(11):3415-6. PMC: 105346. DOI: 10.1128/JCM.36.11.3415-3416.1998. View

Cisneros J, Reyes M, Pachon J, Becerril B, Caballero F, Garcia-Garmendia J . Bacteremia due to Acinetobacter baumannii: epidemiology, clinical findings, and prognostic features. Clin Infect Dis. 1996; 22(6):1026-32. DOI: 10.1093/clinids/22.6.1026. View

Go E, Urban C, Burns J, Kreiswirth B, Eisner W, Mariano N . Clinical and molecular epidemiology of acinetobacter infections sensitive only to polymyxin B and sulbactam. Lancet. 1994; 344(8933):1329-32. DOI: 10.1016/s0140-6736(94)90694-7. View

Cappelletty D, Rybak M . Comparison of methodologies for synergism testing of drug combinations against resistant strains of Pseudomonas aeruginosa. Antimicrob Agents Chemother. 1996; 40(3):677-83. PMC: 163179. DOI: 10.1128/AAC.40.3.677. View

Fridkin S, Steward C, Edwards J, Pryor E, McGowan Jr J, Archibald L . Surveillance of antimicrobial use and antimicrobial resistance in United States hospitals: project ICARE phase 2. Project Intensive Care Antimicrobial Resistance Epidemiology (ICARE) hospitals. Clin Infect Dis. 1999; 29(2):245-52. DOI: 10.1086/520193. View

10.

Hsueh P, Chen M, Sun C, Chen W, Pan H, Chang S . Antimicrobial drug resistance in pathogens causing nosocomial infections at a university hospital in Taiwan, 1981-1999. Emerg Infect Dis. 2001; 8(1):63-8. PMC: 2730256. View

11.

Hsueh P, Teng L, Yang P, Chen Y, Ho S, Luh K . Persistence of a multidrug-resistant Pseudomonas aeruginosa clone in an intensive care burn unit. J Clin Microbiol. 1998; 36(5):1347-51. PMC: 104826. DOI: 10.1128/JCM.36.5.1347-1351.1998. View

12.

Marques M, Brookings E, Moser S, Sonke P, Waites K . Comparative in vitro antimicrobial susceptibilities of nosocomial isolates of Acinetobacter baumannii and synergistic activities of nine antimicrobial combinations. Antimicrob Agents Chemother. 1997; 41(5):881-5. PMC: 163819. DOI: 10.1128/AAC.41.5.881. View

13.

Jean S, Teng L, Hsueh P, Ho S, Luh K . Antimicrobial susceptibilities among clinical isolates of extended-spectrum cephalosporin-resistant Gram-negative bacteria in a Taiwanese University Hospital. J Antimicrob Chemother. 2001; 49(1):69-76. DOI: 10.1093/jac/49.1.69. View

14.

Tankovic J, Legrand P, De Gatines G, Chemineau V, Brun-Buisson C, Duval J . Characterization of a hospital outbreak of imipenem-resistant Acinetobacter baumannii by phenotypic and genotypic typing methods. J Clin Microbiol. 1994; 32(11):2677-81. PMC: 264141. DOI: 10.1128/jcm.32.11.2677-2681.1994. View

15.

Pfaller M, Jones R . MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) results from the Americas: resistance implications in the treatment of serious infections. MYSTIC Study Group (Americas). J Antimicrob Chemother. 2000; 46 Suppl T2:25-37. View

16.

Hsueh P, Liu C, Luh K . Current status of antimicrobial resistance in Taiwan. Emerg Infect Dis. 2002; 8(2):132-7. PMC: 3369580. DOI: 10.3201/eid0802.010244. View

17.

Bajaksouzian S, Visalli M, Jacobs M, Appelbaum P . Activities of levofloxacin, ofloxacin, and ciprofloxacin, alone and in combination with amikacin, against acinetobacters as determined by checkerboard and time-kill studies. Antimicrob Agents Chemother. 1997; 41(5):1073-6. PMC: 163853. DOI: 10.1128/AAC.41.5.1073. View

18.

Yan J, Hsueh P, Ko W, Luh K, Tsai S, Wu H . Metallo-beta-lactamases in clinical Pseudomonas isolates in Taiwan and identification of VIM-3, a novel variant of the VIM-2 enzyme. Antimicrob Agents Chemother. 2001; 45(8):2224-8. PMC: 90635. DOI: 10.1128/AAC.45.8.2224-2228.2001. View

19.

Afzal-Shah M, Livermore D . Worldwide emergence of carbapenem-resistant Acinetobacter spp. J Antimicrob Chemother. 1998; 41(5):576-7. DOI: 10.1093/jac/41.5.576. View

20.

Klastersky J, Prevost J . Significance of antimicrobial synergism for the outcome of gram negative sepsis. Am J Med Sci. 1977; 273(2):157-67. DOI: 10.1097/00000441-197703000-00005. View