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Clinical and microbiological characteristics of OXA-23- and OXA-143-producing Acinetobacter baumannii in ICU patients at a teaching hospital, Brazil.

Overview of attention for article published in The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, September 2016
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Title
Clinical and microbiological characteristics of OXA-23- and OXA-143-producing Acinetobacter baumannii in ICU patients at a teaching hospital, Brazil.
Published in
The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, September 2016
DOI 10.1016/j.bjid.2016.08.004
Pubmed ID
Authors

Neves, Francelli Cordeiro, Clemente, Wanessa T, Lincopan, Nilton, Paião, Isabela D, Neves, Patrícia R, Romanelli, Roberta M, Lima, Stella S S, Paiva, Luciene F, Mourão, Paulo Henrique O, Nobre-Junior, Vandack A

Abstract

Carbapenem-resistant Acinetobacter baumannii (CRAb) is an important cause of nosocomial infections especially in intensive care units (ICUs). This study aimed to assess clinical aspects and the genetic background of CRAb among ICU patients at a Brazilian teaching hospital. 56 critically ill patients colonized or infected by CRAb, during ICU stay, were prospectively assessed. Based on imipenem MIC≥4μg/mL, 28 CRAB strains were screened for the presence of genes encoding metallo-β-lactamases (MβLs) and OXA-type β-lactamases. The blaOXA-type genes were characterized by PCR using primers targeting ISAba-1 or -3. Genetic diversity of blaOXA-positive strains was determined by ERIC-PCR analysis. Patient's mean age (±SD) was 61 (±15.1), and 58.9% were male. Eighty-percent of the patients presented risk factors for CRAb colonization, mainly invasive devices (87.5%) and previous antibiotic therapy (77.6%). Thirty-three patients died during hospital stay (59.0%). Resistance to carbapenems was associated with a high prevalence of blaOXA-23 (51.2%) and/or blaOXA-143 (18.6%) genes. ERIC-PCR genotyping identified 10 clusters among OXA-producing CRAb. Three CRAb strains exhibited additional resistance to polymyxin B (MIC≥4μg/mL), whereas 10 CRAb strains showed tigecycline MICs>2μg/mL. In this study, clonally unrelated OXA-123- and OXA-143-producing A. baumannii strains in ICU patients were strongly correlated to colonization with infected patients being associated with a poor outcome.

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Geographical breakdown

Country Count As %
Unknown 67 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 15 22%
Student > Bachelor 13 19%
Student > Ph. D. Student 8 12%
Student > Postgraduate 4 6%
Researcher 4 6%
Other 11 16%
Unknown 12 18%
Readers by discipline Count As %
Medicine and Dentistry 13 19%
Biochemistry, Genetics and Molecular Biology 11 16%
Immunology and Microbiology 7 10%
Agricultural and Biological Sciences 6 9%
Pharmacology, Toxicology and Pharmaceutical Science 5 7%
Other 8 12%
Unknown 17 25%