Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Nosocomial Infection by Sequence Type 357 Multidrug-Resistant Acinetobacter baumannii Isolates in a Neonatal Intensive Care Unit in Daejeon, Korea

  • Sung, Ji Youn (Department of Biomedical Laboratory Science, Far East University) ;
  • Koo, Sun Hoe (Department of Laboratory Medicine, College of Medicine, Chungnam National University) ;
  • Cho, Hye Hyun (Department of Biomedical Laboratory Science, Jeonju Kijeon College) ;
  • Kwon, Kye Chul (Department of Laboratory Medicine, College of Medicine, Chungnam National University)
  • Published : 2013.07.01
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Abstract

Acinetobacter baumannii is an important microorganism responsible for a number of nosocomial outbreaks, in particular, in intensive care units (ICUs). We investigated a nosocomial infection caused by multidrug-resistant (MDR) A. baumannii in a neonatal intensive care unit (NICU) in Korea. A. baumannii isolates were characterized using Etest (AB Biodisk, Sweden), two multiplex PCR assays, and multilocus sequence typing (MLST) scheme. PCR and PCR mapping experiments were performed for detecting and characterizing the determinants of antimicrobial resistance. Eight strains isolated from an NICU belonged to European (EU) clone II and revealed only one sequence type (ST), namely, ST357. All the isolates were susceptible to imipenem but were resistant to amikacin, gentamicin, ceftazidime, cefepime, and ciprofloxacin. To the best of our knowledge, this is the first report of a nosocomial infection in an NICU in Korea caused by ST357 MDR/carbapenem-susceptible A. baumannii strains. This result demonstrates that nosocomial outbreaks of MDR/carbapenem-susceptible strains as well as MDR/carbapenem-resistant isolates may occur in NICUs.

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References

  1. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008;21:538-82. https://doi.org/10.1128/CMR.00058-07
  2. Wisplinghoff H, Edmond MB, Pfaller MA, Jones RN, Wenzel RP, Seifert H. Nosocomial bloodstream infections caused by Acinetobacter species in United States hospitals: clinical features, molecular epidemiology, and antimicrobial susceptibility. Clin Infect Dis 2000;31:690-7. https://doi.org/10.1086/314040
  3. Villegas MV and Hartstein AI. Acinetobacter outbreaks, 1977-2000. Infect Control Hosp Epidemiol 2003;24:284-95. https://doi.org/10.1086/502205
  4. Garnacho-Montero J, Ortiz-Leyba C, Fernandez-Hinojosa E. Aldabo- Pallas T, Cayuela A, Marguez-Vacaro JA, et al. Acinetobacter baumannii ventilator-associated pneumonia: epidemiological and clinical findings. Intensive Care Med 2005;31:649-55. https://doi.org/10.1007/s00134-005-2598-0
  5. Touati A, Achour W, Cherif A, Hmida HB, Afif FB, Jabnoun S, et al. Outbreak of Acinetobacter baumannii in a neonatal intensive care unit: antimicrobial susceptibility and genotyping analysis. Ann Epidemiol 2009;19:372-8. https://doi.org/10.1016/j.annepidem.2009.03.010
  6. Gundi VA, Dijkshoom L, Burignat S, Raoult D, La Scola B. Validation of partial rpoB gene sequence analysis for the identification of clinically important and emerging Acinetobacter species. Microbiology 2009;155:2333-41. https://doi.org/10.1099/mic.0.026054-0
  7. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Fifteenth Informational supplement, M100-S20. Wayne, PA: Clinical and Laboratory Standards Institute, 2010.
  8. Turton JF, Gabriel SN, Valderrey C, Kaufmann ME, Pitt TL. Use of sequence-based typing and multiplex PCR to identify clonal lineages of outbreak strains of Acinetobacter baumannii. Clin Microbiol Infect 2007;13:807-15. https://doi.org/10.1111/j.1469-0691.2007.01759.x
  9. Bartual SG, Seifert H, Hippler C, Luzon MA, Wisplinghoff H, Rodriguez-Valera F. Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii. J Clin Microbiol 2005;43:4382-90. https://doi.org/10.1128/JCM.43.9.4382-4390.2005
  10. Bou G, Cervero G, Dominguez MA, Quereda C, Martinez-Beltran J. PCR-based DNA fingerprinting (REP-PCR, AP-PCR) and pulsed-field gel electrophoresis characterization of a nosocomial outbreak caused by imipenem- and meropenem-resistant Acinetobacter baumannii. Clin Microbiol Infect 2000;6:635-43. https://doi.org/10.1046/j.1469-0691.2000.00181.x
  11. Koo SH, Kwon KC, Cho HH, Sung JY. Genetic basis of multidrug-resistant Acinetobacter baumannii clinical isolates from three university hospitals in Chungcheong Province, Korea. Korean J Lab Med 2010;30:498-506. https://doi.org/10.3343/kjlm.2010.30.5.498
  12. Cho YJ, Moon DC, Jin JS, Choi CH, Lee YC, Lee JC. Genetic basis of resistance to aminoglycosides in Acinetobacter spp. and spread of armA in Acinetobacter baumannii sequence group 1 in Korean hospitals. Diagn Microbiol Infect Dis 2009;64:185-90. https://doi.org/10.1016/j.diagmicrobio.2009.02.010
  13. Zhou Y, Yu H, Guo Q, Xu X, Ye X, Wu S, et al. Distribution of 16S rRNA methylases among different species of Gram-negative bacilli with highlevel resistance to aminoglycosides. Eur J Clin Microbiol Infect Dis 2010;29:1349-53. https://doi.org/10.1007/s10096-010-1004-1
  14. Akasaka T, Tanaka M, Yamaguchi A, Sato K. Type II topoisomerase mutations in fluoroquinolone-resistant clinical strains of Pseudomonas aeruginosa isolated in 1998 and 1999: role of target enzyme in mechanism of fluoroquinolone resistance. Antimicrob Agents Chemother 2001;45:2263-8. https://doi.org/10.1128/AAC.45.8.2263-2268.2001
  15. Valentine SC, Contreras D, Tan S, Real LJ, Chu S, Xu HH. Phenotypic and molecular characterization of Acinetobacter baumannii clinical isolates from nosocomial outbreaks in Los Angeles County, California. J Clin Microbiol 2008;46:2499-507. https://doi.org/10.1128/JCM.00367-08
  16. McGrath EJ, Chopra T, Abdel-Haq N, Preney K, Koo W, Asmar BI, et al. An outbreak of carbapenem-resistant Acinetobacter baumannii infection in a neonatal intensive care unit: investigation and control. Infect Control Hosp Epidemiol 2011;32:34-41. https://doi.org/10.1086/657669

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