Temporal evolution of carbapenem-resistant Acinetobacter baumannii in Curitiba, southern Brazil
Temporal evolution of carbapenem-resistant Acinetobacter baumannii in Curitiba, southern Brazil
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DOI：
10.1016/j.ajic.2009.09.012
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发表时间：
2010-05-01
影响因子：
4.9
通讯作者：
Dalla Costa, Libera Maria
中科院分区：
文献类型：
--
作者：
Schimith, Karina Eugenia;Luiz, Simone Oliveira;Dalla Costa, Libera Maria
Background: In the last few years, carbapenem-resistant Acinetobacter baumannii isolates (CR-AB) have been identified worldwide. The first description of OXA-23-producing A baumannii in Brazil was from the city of Curitiba in 2003. The aim of the present study was to evaluate the persistence and dissemination of the first OXA-23-producing A baumannii clone isolated from patients in Hospital de Clinicas, Curitiba, Brazil.Methods: An antimicrobial susceptibility profile of the isolates was determined by the standard agar dilution method. Molecular detection of beta-lactamase genes was done by polymerase chain reaction. The clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis (PFGE). Epidemiologic and clinical features were evaluated as well.Results: Genotypic analysis of 172 CR-AB isolates by PFGE identified 3 distinct major PFGE clusters (A, B, and C, accounting for 36, 69, and 65 isolates, respectively). All isolates carried the bla(OXA-23)-like gene and were multidrug-resistant, but were susceptible to tigecycline and polymixin B. The mortality rate related to CR-AB infection was 45.4%, and ventilator-associated pneumonia and bloodstream infections were the most frequent clinical manifestations.Conclusions: The presence of 3 clones among the CR-AB isolates suggests that cross-transmission was the main mechanism responsible for dissemination of OXA-23 producers. PFGE pattern A was genotypically similar to that of the first OXA-23-producing A baumannii clone identified in Curitiba in 1999. This clone persisted in the same hospital until April 2004. The presence of the bla(OXA-23)-like gene was the main mechanism associated with carbapenem resistance among the isolates studied.
