Acinetobacter nosocomialis Causes as Severe Disease as Acinetobacter baumannii in Northeast Thailand: Underestimated Role of A. nosocomialis in Infection.
Acinetobacter nosocomialis Causes as Severe Disease as Acinetobacter baumannii in Northeast Thailand: Underestimated Role of A. nosocomialis in Infection.
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DOI：
10.1128/spectrum.02836-22
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发表时间：
2022-12-21
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
不动杆菌属物种的感染由于引起严重的疾病及其高水平的抗生素耐药性而被认为是严重的全球威胁。鲍曼不动杆菌是该属中最常见的病原体，但院内不动杆菌感染已被广泛报道。鲍曼不动杆菌感染患者的诊断经常被误诊为其他不动杆菌属，尤其是院内不动杆菌。本研究调查了泰国东北部感染鲍曼不动杆菌和院内不动杆菌的患者之间的临床结果是否存在显着差异，并表征了对这些病原体感染的血清学反应。结果表明鲍曼不动杆菌具有较高水平的多重耐药性。尽管如此，鲍曼不动杆菌或院内不动杆菌感染的临床结果相似，死亡率分别为 33% 和 36%。两种病原体均引起社区获得性感染（鲍曼不动杆菌占病例的 35%，院内不动杆菌占病例的 29%）。未感染的健康对照者的血浆中含有可识别这两种生物体的 IgG 抗体，而受感染的患者在第一周与两周后相比并没有表现出明显增强的抗体反应。最后，感染鲍曼不动杆菌或院内放线菌感染的患者血浆 IgG 的抗原识别模式相似，而与感染非不动杆菌的患者的模式不同。总之，我们的数据显示，院内放线菌感染与鲍曼不动杆菌感染具有相似的高死亡率，社区获得性感染率高，未感染个体中存在抗体，表明社区对这两种病原体的暴露程度很高。重要性 不动杆菌属细菌感染因其严重性和高水平的抗生素耐药性而成为全球威胁。鲍曼不动杆菌是该属中最常见的病原体；然而，院内放线菌感染也被广泛报道，但被认为不那么严重。在这项研究中，我们前瞻性地调查了泰国东北部 48 例报告的鲍曼不动杆菌感染病例，并描述了感染的血清学反应。我们发现其中 14 例 (29%) 感染实际上是由院内放线菌引起的。此外，医院放线菌菌株的抗生素耐药性发生率、APACHE II评分以及医院放线菌感染患者的死亡率均远高于已发表的数据。鲍曼不动杆菌和院内不动杆菌的死亡率都出乎意料地超过30%，并且这两种病原体都引起了很高的社区获得性感染率。重要的是，未感染个体的背景抗体表明社区大量暴露于环境中的两种病原体。
Infections by Acinetobacter species are recognized as a serious global threat due to causing severe disease and their high levels of antibiotic resistance. Acinetobacter baumannii is the most prevalent pathogen in the genus, but infection by Acinetobacter nosocomialis has been reported widely. Diagnosis of patients with A. baumannii infection is often misdiagnosed with other Acinetobacter species, especially A. nosocomialis. This study investigated whether there were significant differences in clinical outcomes between patients infected with A. baumannii versus A. nosocomialis in Northeast Thailand, and to characterize serological responses to infection with these pathogens. The results show that A. baumannii had higher levels of multidrug resistance. Despite this, clinical outcomes for infection with A. baumannii or A. nosocomialis were similar with mortalities of 33% and 36%, respectively. Both pathogens caused community-acquired infections (A. baumannii 35% and A. nosocomialis 29% of cases). Plasma from uninfected healthy controls contained IgG antibody that recognized both organisms, and infected patients did not show a significantly enhanced antibody response from the first week versus 2 weeks later. Finally, the patterns of antigen recognition for plasma IgG were similar for patients infected with A. baumannii or A. nosocomialis infection, and distinct to the pattern for patients infected with non-Acinetobacter. In conclusion, our data revealed that infection with A. nosocomialis was associated with a similarly high level of mortality as infection with A. baumannii, the high rate of community-acquired infection and antibodies in uninfected individuals suggesting that there is significant community exposure to both pathogens. IMPORTANCE Bacterial infections by Acinetobacter species are global threats due to their severity and high levels of antibiotic resistance. A. baumannii is the most common pathogen in the genus; however, infection by A. nosocomialis has also been widely reported but is thought to be less severe. In this study, we have prospectively investigated 48 reported cases of A. baumannii infection in Northeast Thailand, and characterized the serological responses to infection. We found that 14 (29%) of these infections were actually caused by A. nosocomialis. Furthermore, the incidence of antibiotic resistance among A. nosocomialis strains, APACHE II scores, and mortality for patients infected with A. nosocomialis were much higher than published data. Both A. baumannii and A. nosocomialis had unexpectedly mortality rates of over 30%, and both pathogens caused a high rate of community-acquired infections. Importantly, background antibodies in uninfected individuals suggest significant community exposure to both pathogens in the environment.
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影响因子：
14.9
作者：
Babicki S;Arndt D;Marcu A;Liang Y;Grant JR;Maciejewski A;Wishart DS
通讯作者：
Wishart DS
DOI：
10.1007/s10096-021-04285-4
发表时间：
2021-09
期刊：
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
影响因子：
--
作者：
Huber T;Steininger P;Irrgang P;Korn K;Tenbusch M;Diesch K;Achenbach S;Kremer AE;Werblow M;Vetter M;Bogdan C;Held J
通讯作者：
Held J
影响因子：
7.3
作者：
García-Patiño MG;García-Contreras R;Licona-Limón P
通讯作者：
Licona-Limón P
影响因子：
7.3
作者：
Kamuyu G;Suen Cheng Y;Willcocks S;Kewcharoenwong C;Kiratisin P;Taylor PW;Wren BW;Lertmemongkolchai G;Stabler RA;Brown J
通讯作者：
Brown J
DOI：
10.1007/s13361-018-1911-4
发表时间：
2018-07-01
影响因子：
3.2
作者：
Li, Xiuyuan;Tang, Yanyan;Lu, Xinxin
通讯作者：
Lu, Xinxin