Carbapenem-resistant Acinetobacter baumannii contamination in an intensive care unit
Carbapenem-resistant Acinetobacter baumannii contamination in an intensive care unit
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DOI：
10.1590/0037-8682-0329-2016
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发表时间：
2017-03-01
影响因子：
2
通讯作者：
Oliveira, Sílvia Dias de
中科院分区：
文献类型：
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作者：
Raro, Otávio Hallal Ferreira;Gallo, Stephanie Wagner;Oliveira, Sílvia Dias de
引言：鲍曼不动杆菌是引起重症监护病房（ICU）感染的主要病原体。在这项研究中，我们的目的是评估A。在ICU环境和ICU工作人员的手套中分离鲍曼不动杆菌，并与从同一医院ICU患者中分离的菌株进行比较，以表征分离株的抗菌药物耐药性。方法：收集2010年3月至11月期间的ICU样本。通过靶向16 S rDNA和bla（OXA-51）基因的PCR评价了生化特征为醋酸钙不动杆菌-鲍曼不动杆菌复合菌的分离株。使用纸片扩散法测定抗菌药物的敏感性，并使用肉汤微量稀释法评价碳青霉烯类耐药菌株对亚胺培南的最低抑菌浓度。在对碳青霉烯类抗生素敏感性降低的分离株中评估了bla（OXA-23）基因的存在。结果：A.从ICU环境中采集的886份样本中有9.5%（84）检出鲍曼不动杆菌，包括家具、医疗器械和手套，床栏杆是污染最严重的位置（23.8%; 20/84）。多药耐药（MDR）A.鲍曼不动杆菌的检出率为98.8%（83/84），临床分离株的检出率为97.8%（45/46）。83.3%（70/84）的非临床分离株和80.4%（37/46）的临床分离株对碳青霉烯类抗生素的敏感性降低。所有对碳青霉烯类耐药的分离株均携带bla（OXA-23）。结论：我们发现非临床和临床A。鲍曼不动杆菌分离株。这些数据强调ICU环境是MDR A持续存在的潜在来源。鲍曼不动杆菌，因此ICU可能是由该微生物引起的医院获得性感染的来源。
Introduction: Acinetobacter baumannii is a major pathogen causing infections in intensive care units (ICUs). In this study, we aimed to evaluate the presence of A. baumannii in an ICU environment and gloves from ICU workers and to characterize the antimicrobial resistance of the isolates in comparison with those isolated from ICU patients at the same hospital. Methods: ICU samples were collected from March to November 2010. Isolates biochemically characterized as Acinetobacter calcoaceticus-Acinetobacter baumannii complex were evaluated by PCR targeting the 16S rDNA and bla(OXA-51) genes. Antimicrobial susceptibility was determined using the disk diffusion method, and carbapenem-resistant isolates were also evaluated for the minimum inhibitory concentration of imipenem using broth microdilution. The presence of the bla(OXA-23) gene was evaluated in isolates with reduced susceptibility to carbapenems. Results: A. baumannii was detected in 9.5% (84) of the 886 samples collected from the ICU environment, including from furniture, medical devices, and gloves, with bed rails being the most contaminated location (23.8%; 20/84). Multidrug-resistant (MDR) A. baumannii was found in 98.8% (83/84) of non-clinical and 97.8% (45/46) of clinical isolates. Reduced susceptibility to carbapenems was detected in 83.3% (70/84) of non-clinical and 80.4% (37/46) of clinical isolates. All isolates resistant to carbapenems harbored bla(OXA-23). Conclusions: We found a strong similarity between the antimicrobial susceptibility profiles of non-clinical and clinical A. baumannii isolates. Such data highlight the ICU environment as a potential origin for the persistence of MDR A. baumannii, and hence the ICU may be a source of hospital-acquired infections caused by this microorganism.