Details

Autor(en) / Beteiligte

• ALVARGONZALEZ, Jorge Julio Cabrera
• HERNANDO, Ana Vindel
• MARTIN, Maria Dolores Rojo
• CASAS, Consuelo Miranda
• IGLESIAS, Jesús Oteo
• MARIN, Mari Fe Bautista
• ALVAREZ, Maria Luisa Azañedo
• SANCHEZ, Veronica Bautista
• MARI, Jose Maria Navarro

Titel

Sequential outbreaks in a Spanish hospital caused by multiresistant OXA-58-producing Acinetobacter baumannii ST92

Ist Teil von

• Journal of medical microbiology, 2014-08, Vol.63 (8), p.1093-1098

Ort / Verlag

Reading: Society for General Microbiology

Erscheinungsjahr

2014

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• The aim of this study was to assess the epidemiology and molecular basis of the infection and dissemination of multidrug-resistant Acinetobacter baumannii (MDRAB) in three sequential outbreaks at the intensive care units (ICUs) of a tertiary university hospital in Granada, Spain, between 2009 and 2011. Strains from all patients infected and/or colonized by MDRAB during outbreak periods were characterized using PFGE and multilocus sequence typing (MLST). The first outbreak appeared in the summer of 2009 involving 38 ICU patients: 25 from a Traumatology-Rehabilitation hospital (TRH) and 13 from a Medical-Surgery hospital (MSH). Between 2010 and 2011, outbreaks were limited to the MSH-ICU, affecting 9 and 11 patients, respectively. Two PFGE types were detected. In the 2009 outbreak, two clones were identified: profile 1 strains were isolated at the TRH, whilst profile 2 was isolated at the MSH. Only one clone was identified in the 2010 and 2011 outbreaks: the profile 2 clone detected at the MSH in 2009. After MLST analysis, a single sequence type (ST92) was identified. This suggested that an endemic strain could evolve and cause localized outbreaks in vulnerable patients. Multiplex PCR for OXA group enzymes yielded a positive result for blaOXA-58-like and blaOXA-51-like genes, and gene sequencing showed the presence of blaOXA-58. However, the absence of ISAba1 upstream of the blaOXA-51-like gene suggested the absence of OXA-51 expression. The susceptibility pattern was not an appropriate method for MDRAB surveillance, as several susceptibility patterns were identified in a single clone. Consequently, molecular methods of characterization are recommended for epidemiological surveillance of MDRAB.