Phenotypic and molecular characterization of Acinetobacter baumannii isolates causing lower respiratory infections among ICU patients.


Journal

Microbial pathogenesis
ISSN: 1096-1208
Titre abrégé: Microb Pathog
Pays: England
ID NLM: 8606191

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 22 08 2018
revised: 16 11 2018
accepted: 11 12 2018
pubmed: 19 12 2018
medline: 20 3 2019
entrez: 19 12 2018
Statut: ppublish

Résumé

Multi-drug resistant Acinetobacter baumannii has emerged as important nosocomial pathogen associated with various infections including lower respiratory tract. Limited therapeutic options contribute to increased morbidity and mortality. Acinetobacter baumannii has the ability to persist in the environment for prolonged periods. Breach in infection control practices increases the chances of cross transmission between patients and inter/intraspecies transmission of resistance elements. The present prospective work was conducted among patients with lower respiratory tract infections (LRTI) in the intensive care unit (ICU) to study the etiology with special reference to Acinetobacter baumannii and the role of immediate patient environment in the ICU as possible source of infection. Acinetobacter baumannii were characterized for antimicrobial susceptibility, mechanism of carbapenem resistance and virulence determinants. Molecular typing of the clinical and environmental isolates was undertaken to study the probable modes of transmission. Appropriate respiratory samples from 107 patients with LRTI admitted to ICU during September 2016 to March 2017 were studied for likely bacterial pathogens. Environmental samples (n = 71) were also screened. All the samples were processed using conventional microbiological methods. Consecutive Acinetobacter spp. isolated from clinical and environmental (health care workers and environment from ICU) samples were included in the study. Antimicrobial susceptibility was performed as per CLSI guidelines. Carbapenem resistance, mediated by carbapenemase genes (bla The prevalence of Acinetobacter baumannii was 26.2% (28/107) and 11.26% (8/71) among patients with LRTI and environmental samples respectively. The carbapenem resistance was high, 96.42% (27/28) and 87.5% (7/8) in clinical and environmental isolates respectively. The most common carbapenemase associated with resistance was bla Carbapenem resistant Acinetobacter baumannii (CRAB) is an important cause of LRTI in the ICU. PFGE suggests spread of carbapenem resistant isolates via cross transmission among patients and the environment. The detection of bla

Sections du résumé

BACKGROUND BACKGROUND
Multi-drug resistant Acinetobacter baumannii has emerged as important nosocomial pathogen associated with various infections including lower respiratory tract. Limited therapeutic options contribute to increased morbidity and mortality. Acinetobacter baumannii has the ability to persist in the environment for prolonged periods. Breach in infection control practices increases the chances of cross transmission between patients and inter/intraspecies transmission of resistance elements. The present prospective work was conducted among patients with lower respiratory tract infections (LRTI) in the intensive care unit (ICU) to study the etiology with special reference to Acinetobacter baumannii and the role of immediate patient environment in the ICU as possible source of infection. Acinetobacter baumannii were characterized for antimicrobial susceptibility, mechanism of carbapenem resistance and virulence determinants. Molecular typing of the clinical and environmental isolates was undertaken to study the probable modes of transmission.
MATERIALS AND METHODS METHODS
Appropriate respiratory samples from 107 patients with LRTI admitted to ICU during September 2016 to March 2017 were studied for likely bacterial pathogens. Environmental samples (n = 71) were also screened. All the samples were processed using conventional microbiological methods. Consecutive Acinetobacter spp. isolated from clinical and environmental (health care workers and environment from ICU) samples were included in the study. Antimicrobial susceptibility was performed as per CLSI guidelines. Carbapenem resistance, mediated by carbapenemase genes (bla
RESULTS RESULTS
The prevalence of Acinetobacter baumannii was 26.2% (28/107) and 11.26% (8/71) among patients with LRTI and environmental samples respectively. The carbapenem resistance was high, 96.42% (27/28) and 87.5% (7/8) in clinical and environmental isolates respectively. The most common carbapenemase associated with resistance was bla
DISCUSSION CONCLUSIONS
Carbapenem resistant Acinetobacter baumannii (CRAB) is an important cause of LRTI in the ICU. PFGE suggests spread of carbapenem resistant isolates via cross transmission among patients and the environment. The detection of bla

Identifiants

pubmed: 30562602
pii: S0882-4010(18)31466-9
doi: 10.1016/j.micpath.2018.12.023
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0
Bacterial Proteins 0
Carbapenems 0
beta-Lactamases EC 3.5.2.6
beta-lactamase NDM-1 EC 3.5.2.6
beta-lactamase OXA-23, Acinetobacter baumannii EC 3.5.2.6
beta-lactamase OXA-24 EC 3.5.2.6
beta-lactamase OXA-58, Acinetobacter baumannii EC 3.5.2.6
carbapenemase EC 3.5.2.6
Colistin Z67X93HJG1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

75-81

Informations de copyright

Copyright © 2018. Published by Elsevier Ltd.

Auteurs

Manisha Jain (M)

Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.

Amit Sharma (A)

Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.

M K Sen (MK)

Department of Pulmonary, Critical Care & Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.

Vandana Rani (V)

Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.

Rajni Gaind (R)

Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India. Electronic address: rgaind5@hotmail.com.

J C Suri (JC)

Department of Pulmonary, Critical Care & Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.

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Classifications MeSH