1887

Abstract

An outbreak of 95 clinical infections with imipenem-resistant in a Chinese hospital was investigated and the carbapenemase-encoding genes and their relationship with IS of these and a further 16 isolates recovered from the intensive care unit (ICU) environment were analysed. Almost all isolates were resistant to a wide range of antimicrobials; the lowest resistance rates were found for polymyxin E (17.1 %), cefoperazone/sulbactam (30.6 %) and ampicillin/sulbactam (67.6 %). Six pattern types defined by DNA macrorestriction patterns were distinguished among the clinical isolates with dissemination of pattern A (50 isolates) to patients in seven hospital units and pattern B (35 isolates) to eight units; the environmental isolates from ICUs were also of pattern A. All isolates were positive for the and genes. The OXA-23-encoding gene was located 34 bp downstream of IS. No plasmids were detected and conjugal transfer of resistance was not demonstrated. The probe hybridized with 200 and 220 kb I chromosomal fragments for type patterns A and B, respectively.

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2007-08-01
2020-10-31
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References

  1. Afzal-Shah M., Woodford N., Livermore D. M. 2001; Characterization of OXA-25, OXA-26, and OXA-27, molecular class D β -lactamases associated with carbapenem resistance in clinical isolates of Acinetobacter baumannii . Antimicrob Agents Chemother 45:583–586 [CrossRef]
    [Google Scholar]
  2. Bergogne-Bérézin E., Towner K. J. 1996; Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Microbiol Rev 9:148–165
    [Google Scholar]
  3. Brown S., Amyes S. 2006; OXA β -lactamases in Acinetobacter : the story so far. J Antimicrob Chemother 57:1–3
    [Google Scholar]
  4. Brown S., Young H. K., Amyes S. G. 2005; Characterisation of OXA-51, a novel class D carbapenemase found in genetically unrelated clinical strains of Acinetobacter baumannii from Argentina. Clin Microbiol Infect 11:15–23
    [Google Scholar]
  5. Chang H. C., Wei Y. F., Dijkshoorn L., Vaneechoutte M., Tang C. T., Chang T. C. 2005; Species-level identification of isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex by sequence analysis of the 16S-23S rRNA gene spacer region. J Clin Microbiol 43:1632–1639 [CrossRef]
    [Google Scholar]
  6. Chastre J., Trouillet J. L. 2000; Problem pathogens ( Pseudomonas aeruginosa and Acinetobacter ). Semin Respir Infect 15:287–298 [CrossRef]
    [Google Scholar]
  7. Chu Y. W., Afzal-Shah M., Houang E. T., Palepou M., Lyon D. J., Woodford N., Livermore D. M. 2001; IMP-4, a novel metallo- β -lactamase from nosocomial Acinetobacter spp . collected in Hong Kong between 1994 and 1998. Antimicrob Agents Chemother 45:710–714 [CrossRef]
    [Google Scholar]
  8. CLSI 2006 Performance Standards for Antimicrobial Susceptibility Testing ; Sixteenth Informational Supplement M100–S16 Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  9. Dalla Costa L. M., Coelho J. M., Souza H. A., Castro M. E. S., Stier C. J. N., Bragagnolo K. L., Rea-Nato A., Penteado-Filho S. R., Livermore D. M., Woodford N. 2003; Outbreak of carbapenem-resistant Acinetobacter baumannii producing OXA-23 enzymes in Curitiba. Brazil. J Clin Microbiol 41:3403–3406 [CrossRef]
    [Google Scholar]
  10. Donald H. M., Scaife W., Amyes S. G., Young H. K. 2000; Sequence analysis of ARI-1, a novel OXA β -lactamase, responsible for imipenem resistance in Acinetobacter baumannii 6B92. Antimicrob Agents Chemother 44:196–199 [CrossRef]
    [Google Scholar]
  11. Gouby A., Carles-Nurit M. J., Bouziges N., Bourg G., Mesnard R., Bouvet P. J. 1992; Use of pulsed-field gel electrophoresis for investigation of hospital outbreaks of Acinetobacter baumannii . J Clin Microbiol 30:1588–1591
    [Google Scholar]
  12. Ikonomidis A., Pournaras S., Markogiannakis A., Maniatis A. N., Manolis E. N., Tsakris A. 2006; Low genetic diversity of the intrinsic OXA-51-like class D carbapenemases among Acinetobacter baumannii clinical isolates in Greece. Epidemiol Infect in press
    [Google Scholar]
  13. Jawad A., Seifert H., Snelling A. M., Heritage J., Hawkey P. M. 1998; Survival of Acinetobacter baumannii on dry surfaces: comparison of outbreak and sporadic isolates. J Clin Microbiol 36:1938–1941
    [Google Scholar]
  14. Jeon B. C., Jeong S. H., Bae I. K., Kwon S. B., Lee K., Young D., Lee J. H., Song J. S., Lee S. H. 2005; Investigation of a nosocomial outbreak of imipenem-resistant Acinetobacter baumannii producing the OXA-23 β -lactamase in Korea. J Clin Microbiol 43:2241–2245 [CrossRef]
    [Google Scholar]
  15. Lee K., Lim Y. S., Yong D., Yum J. H., Chong Y. 2003; Evaluation of the Hodge test and the imipenem-EDTA double-disk synergy test for differentiating metallo- β -lactamase-producing isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol 41:4623–4629 [CrossRef]
    [Google Scholar]
  16. Lee K., Yum J. H., Yong D., Lee H. M., Kim H. D., Docquier J. D., Rossolini G. M., Chong Y. 2005; Novel acquired metallo- β -lactamase gene, bla SIM-1, in a class 1 integron from Acinetobacter baumannii clinical isolates from Korea. Antimicrob Agents Chemother 49:4485–4491 [CrossRef]
    [Google Scholar]
  17. Levin A. S., Levy C. E., Manrique A. E., Medeiros E. A., Costa S. F. 2003; Severe nosocomial infections with imipenem-resistant Acinetobacter baumannii treated with ampicillin/sulbactam. Int J Antimicrob Agents 21:58–62 [CrossRef]
    [Google Scholar]
  18. Li J., Nation R. L., Milne R. W., Turnidge J. D., Coulthard K. 2005; Evaluation of colistin as an agent against multiresistant Gram-negative bacteria. Int J Antimicrob Agents 25:11–25 [CrossRef]
    [Google Scholar]
  19. Livermore D. M. 2002; The impact of carbapenemases on antimicrobial development and therapy. Curr Opin Investig Drugs 3:218–224
    [Google Scholar]
  20. Lolans K., Rice T. W., Munoz-Price L. S., Quinn J. P. 2006; Multicity outbreak of carbapenem-resistant Acinetobacter baumannii isolates producing the carbapenemase OXA-40. Antimicrob Agents Chemother 50:2941–2945 [CrossRef]
    [Google Scholar]
  21. Poirel L., Nordmann P. 2006a; Genetic structures at the origin of the acquisition and expression of the carbapenem-hydrolyzing oxacillinase gene bla OXA-58 in Acinetobacter baumannii . Antimicrob Agents Chemother 50:1442–1448 [CrossRef]
    [Google Scholar]
  22. Poirel L., Nordmann P. 2006b; Carbapenem resistance in Acinetobacter baumannii : mechanisms and epidemiology. Clin Microbiol Infect 12:826–836 [CrossRef]
    [Google Scholar]
  23. Tenover F. C., Arbeit R. D., Goering R. V., Mickelsen P. A., Murray B. E., Persing D. H., Swaminathan B. 1995; Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial isolate typing. J Clin Microbiol 33:2233–2239
    [Google Scholar]
  24. Towner K. J. 2000; Acinetobacter in intensive care units. CPD Infect 1:99–102
    [Google Scholar]
  25. Turton J. F., Ward M. E., Woodford N., Kaufmann M. E., Pike R., Livermore D. M., Pitt T. L. 2006; The role of IS Aba1 in expression of OXA carbapenemase genes in Acinetobacter baumannii . FEMS Microbiol Lett 258:72–77 [CrossRef]
    [Google Scholar]
  26. Walther-Rasmussen J., Hoiby N. 2006; OXA-type carbapenemases. J Antimicrob Chemother 57:373–383 [CrossRef]
    [Google Scholar]
  27. Woodford N., Ellington M. J., Coelho J. M., Turton J. F., Ward M. F., Brown S., Amyes S. G., Livermore D. M. 2006; Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int J Antimicrob Agents 27:351–353 [CrossRef]
    [Google Scholar]
  28. Yan J. J., Wu S. M., Tsai S. H., Wu J. J., Su I. J. 2000; Prevalence of SHV-12 among clinical isolates of Klebsiella pneumoniae producing extended-spectrum β -lactamases and identification of a novel AmpC enzyme (CMY-8) in Southern Taiwan. Antimicrob Agents Chemother 44:1438–1442 [CrossRef]
    [Google Scholar]
  29. Yu Y. S., Yang Q., Xu X. W., Kong S., Xu G. Y., Zhong B. Y. 2004; Typing and characterization of carbapenem-resistant Acinetobacter calcoaceticus-baumannii complex in a Chinese hospital. J Med Microbiol 53:653–656 [CrossRef]
    [Google Scholar]
  30. Yu Y. S., Qu T. T., Zhou J. Y., Wang J. H., Li Y., Walsh R. 2006; Integrons containing the VIM-2 metallo- β -lactamase gene among imipenem-resistant Pseudomonas aeruginosa strains from different Chinese hospitals. J Clin Microbiol 44:4242–4245 [CrossRef]
    [Google Scholar]
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