Endemicity of Acinetobacter calcoaceticus-baumannii Complex in an Intensive Care Unit in Malaysia

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2015-12-27 DOI:10.1155/2015/789265

A. Dhanoa, Ganeswrie Rajasekaram, Soo-Sum Lean, Y. Cheong, K. Thong

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引用次数: 8

Abstract

Introduction. Acinetobacter calcoaceticus-baumannii complex (ACB complex) is a leading opportunistic pathogen in intensive care units (ICUs). Effective control of spread requires understanding of its epidemiological relatedness. This study aims to determine the genetic relatedness and antibiotic susceptibilities of ACB complex in an ICU in Malaysia. Methodology. Pulsed field gel electrophoresis (PFGE), E-test, and disk diffusion were used for isolates characterization. Results. During the study period (December 2011 to June 2012), 1023 patients were admitted to the ICU and 44 ACB complex (blood, n = 21, and blind bronchial aspirates, n = 23) were recovered from 38 ICU patients. Six isolates were from non-ICU patients. Of the 44 ICU isolates, 88.6% exhibited multidrug-resistant (MDR) patterns. There was high degree of resistance, with minimum inhibitory concentration90 (MIC90) of >32 μg/mL for carbapenems and ≥256 μg/mL for amikacin, ampicillin/sulbactam, and cefoperazone/sulbactam. Isolates from the main PFGE cluster were highly resistant. There was evidence of dissemination in non-ICU wards. Conclusion. High number of clonally related MDR ACB complex was found. While the ICU is a likely reservoir facilitating transmission, importation from other wards may be important contributor. Early identification of strain relatedness and implementation of infection control measures are necessary to prevent further spread.

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马来西亚重症监护病房内钙酸钙-鲍曼复合不动杆菌的地方性

介绍。钙醋-鲍曼不动杆菌复合体(ACB复合体)是重症监护病房(icu)的主要条件致病菌。有效控制传播需要了解其流行病学相关性。本研究旨在确定遗传关系和抗生素敏感性的ACB复合体在马来西亚ICU。方法。采用脉冲场凝胶电泳(PFGE)、E-test和纸片扩散法对分离物进行鉴定。结果。研究期间(2011年12月至2012年6月)，ICU共收治1023例患者，38例ICU患者中恢复ACB复合物44例(血检21例，支气管盲吸23例)。6株分离株来自非icu患者。在44株ICU分离株中，88.6%呈现多重耐药(MDR)模式。耐药程度高，对碳青霉烯类的最低抑菌浓度(MIC90)为32 μg/mL，对阿米卡星、氨苄西林/舒巴坦、头孢哌酮/舒巴坦的最低抑菌浓度为256 μg/mL。主要PFGE集群的分离株具有高度抗性。有证据表明在非icu病房传播。结论。发现大量克隆相关的MDR ACB复合体。虽然重症监护室可能是促进传播的储存库，但从其他病房输入可能是重要因素。早期识别菌株相关性和实施感染控制措施是防止进一步传播的必要条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.