Abstract acinetobacter baumannii is an emerging gramnegative nosocomial pathogen that rarely causes infections in or. The risk factors and spread of multidrugresistant acinetobacter baumannii in intubated patients in a medical intensive care unit aim. We investigated 118 patients, on 27 wards, in whom mdr a. Multidrug resistant acinetobacter baumannii isolates from. This retrospective study was conducted to determine the prevalence and antibiotic resistance pattern of a. Acinetobacter baumannii is an opportunistic pathogen that poses an increasing threat in the healthcare community. Current hospital cleaning protocol may be inadequate to rid patient rooms of multidrugresistant mdr acinetobacter baumannii, according to a. The aim of this study was to determine the incidence and mortality of this multiresistant strain of acinetobacter in patients undergoing cardiac surgery, to elucidate the effectiveness of treatment with colistin and to. Antimicrobial susceptibility of acinetobacter baumannii.
Acinetobacter baumannii has emerged over the last decade as a significant opportunistic pathogen and primarily associated with hospitalacquired infections. Acinetobacter baumannii, a gramnegative opportunistic pathogen in humans. Analysis of the extracellular proteome of colistin. The current study investigated the emergence of colistin resistance among carbapenemresistant strains of a. Gramnegative bacilli including multidrugresistant acinetobacter baumannii mdrab are responsible for severe icuacquired infections, mainly pneumonia and bacteraemia. Acinetobacter baumannii complex abc has emerged as an important pathogen causing a variety of infections. In order to better understand transmission and evolutionary dynamics of mdr acinetobacter baumannii ab during longterm infection, we analyzed genomes from a series of isolates from individual. Old antibiotics, such as fosfomycin and polymyxins, are now considered potential treatment alternatives to overcome the lack of new antibiotics 24. Acinetobacter baumannii is an important cause of nosocomial infections worldwide. Acinetobacter baumannii has been reported increasingly as a significant. Prevalence of multidrug resistant acinetobacter baumannii.
Emergence of extensivelyresistant acinetobacter baumannii. Since the 1970s, the spread of multidrugresistant mdr acinetobacter strains among critically ill, hospitalized patients, and subsequent epidemics, have become an. Acinetobacter baumannii is the most common nosocomial pathogen among all acinetobacter spp. The purpose of this study was to evaluate the prevalence, biotyping, and antibiotic resistance status of a. Multidrugresistant acinetobacter baumannii, a major hospitalacquired pathogen, is a serious health threat and poses a great challenge to healthcare providers. It involved identification of clinically recovered a. Multidrugresistant acinetobacter baumannii found growing. The aim of this study was to determine the prevalence and increasing antibiotic resistance of a.
The spread of multidrugresistant acinetobacter baumannii mdra has become a global concern, but detection of mdra is comparatively rare in japan. Treatment of acinetobacter infections oxford academic. Acinetobacter is a gramnegative bacterium commonly found in soil and water. After the outbreak was halted in late october, the number of cases of mdrab remained somewhat elevated in november because of an. Emergence of extensively drugresistant acinetobacter. Investigation of the infection control approach against.
Introduction the extensive use of antibiotics and the gradual increase of different types of drugs have made bacteria resistant to drugs 1,2. Characteristics of multidrugresistant acinetobacter. Epidemiology of mrab survival in the environmental conditions, including seawater especially in the warm period of the year up to 50 days, may also. Acinetobacter baumannii in intensive care units icus are increasing ji ye et al. The global emergence of multidrug resistant acinetobacter baumannii has reduced the number of clinically available antibiotics that retain activity against this pathogen. An outbreak of multidrugresistant acinetobacter baumannii. For this reason, the development of novel treatment strategies for infections. However, the presence of mdra was confirmed in our hospital, after isolation from the sputum of a patient who had received treatment for cerebral infarction at a hospital in a neighboring country, and then was admitted to our hospital after.
The epidemiology of multidrugresistant acinetobacter baumannii. Pdf acinetobacter baumannii, a nonmotile, glucose non. An increasing endemicity of multipledrugresistant acinetobacter baumannii mrab st457 was noted in hong kong. This strain spread rapidly and caused a large outbreak in the hospital. Although other species of acinetobacter are also often associated with hais.
To understand the epidemiology of multidrugresistant mdr acinetobacter baumannii and define individual risk factors for mdr, we used epidemiologic methods, performed organism typing by pulsedfield gel electrophoresis pfge, and conducted a matched casecontrol retrospective study. Among all gramnegative bacteria, acinetobacter baumannii is an emerging pathogen that accounts for about 80% of all reported infections. Between june 1, 2004, and march 14, 2005, 16 patients in the surgicalmedical intensive care unit icu were infected and another 2 were colonized with multidrugresistant mdr acinetobacter baumannii. Antibioticresistant acinetobacter baumannii increasing success. Control of hospital endemicity of multipledrugresistant.
Management of multidrugresistant acinetobacter spp. Pdf acinetobacter baumannii, most often multidrug resistant, is a difficult to treat pathogen particularly in intensive care units icus of a. While there are many species of acinetobacter that can cause human disease, acinetobacter baumannii a. A total of 5,058 patients cultured positive with a. It is difficult to control, and the infections caused by it are difficult to treat, because it is multidrug resistant. Epidemiological characteristics and drug resistance.
Antimicrobial susceptibility of acinetobacter baumannii isolated from hospital patients. Mortality rates associated with multidrugresistant. The acinetobacter species cause infections, which are associated with increased morbidity and mortality rates 4. Acinetobacter baumannii has been reported increasingly as a.
Acinetobacter baumannii can cause severe infections, mainly in critically ill inpatients. Studies have demonstrated that fosfomycin is a promising drug, particularly in combination with other. First report of colistin resistance among carbapenem. Journal of infection and public health 20 6, 179185 prevalence of multidrugresistant acinetobacter baumannii and pseudomonas aeruginosa in an italian hospital m. Research multidrugresistant acinetobacter baumannii. Although there have been many genomic studies on the evolution and antibiotic resistance of this species, there have been very limited transcriptome studies on its responses to antibiotics. Acinetobacter is nonmotile, obligate aerobic gramnegative coccobacillus and are ubiquitous freeliving saprophytes in soil and water. Acinetobacter baumannii has emerged as an important nosocomial pathogen. Appropriate selection of antibiotics for the treatment of the majority of severe microbial infections. Treatment is complicated by multidrugresistance mdr. Pdf prevalence of multidrug resistant acinetobacter baumannii in.
Multidrugresistant acinetobacter baumannii is an important bacterium causing nosocomial infections. Analysis of tigecycline resistance development in clinical. A retrospective analysis of carbapenemresistant acinetobacter. Manca1 institute of microbiology, university of brescia, italy. Most of the isolates were obtained from rectal swabs of. A team of australian and portuguese investigators has discovered yet another resistance mechanism in the pathogen, acinetobacter baumannii, in this. Infections caused by multidrugresistant acinetobacter baumannii have emerged as a serious problem throughout the world. The aim of this study was to determine the risk factors for colonization in the. The outbreak period was in september and october 2003, when a marked increase in the number of cases was noted. The epidemiology, risk factors, and infection control measures to prevent nosocomial transmission of this epidemic clone were analyzed.
Multidrug resistant acinetobacter baumannii in veterinary. Multidrugresistant acinetobacter baumannii medscape. The purpose of this study is to determine the risk factors for mrab in a city hospital patient population. In germany, to date, little is known on the extent of mdr in a. The incidence of multidrugresistant acinetobacter baumannii mdr a. Prevalence and resistance profile of acinetobacter. Methods strains and growth conditions the study included 27 nonduplicate multidrugresistant a. Therefore, it is considered as a new threat in hospitals, which requires a. Multidrug resistant acinetobacter baumannii inside and outside hospital setting.
The administration of penicillin had a protective effect against isolation of mdr a. Ijerph free fulltext infection control programs and. Multidrugresistant acinetobacter baumannii mdrab was found in the environment of 48 percent of the rooms of patients colonized or infected with the pathogen, according to a new study. Oligonucleotide arraybased identification of species in. Among them, acinetobacter baumannii, a ubiquitous, strictly aerobic, nonfermentative coccobacillus, has emerged. Research article control of an outbreak of acinetobacter. Healthcare provider information sheet for acinetobacter. Multidrugresistant acinetobacter baumannii volume 11. Prevalence of multidrugresistant acinetobacter baumannii. Colistin is one of the promising options for treatment of multidrugresistant a. Successful control of an acinetobacter baumannii outbreak in a neonatal intensive care unit. Acinetobacter baumannii has proven to be an increasingly important and demanding species in health careassociated infections. Bacteremia due to acinetobacter baumannii complex abc, which composed of four genomic species gen. Using data from the taiwan surveillance of antimicrobial resistance tsar conducted biennially, we investigated the secular change in resistance of 1640 abc from 2002.
Since the 1970s, the spread of multidrugresistant mdr acinetobacter strains among critically ill, hospitalized patients, and subsequent epidemics, have become an increasing cause of concern. The mechanisms of drug resistance acquisition in a. An array with six oligonucleotide probes based on the 16s23s rrna gene intergenic spacer its region was developed to differentiate species in the a. The drugresistant nature of the pathogen and its unusual and. New resistance mechanism in the often multidrug resistant.
Clinical manifestations, antimicrobial therapy, and prognostic factors. Acinetobacter baumannii, a strictly aerobic, nonfermentative, gramnegative coccobacillary rodshaped bacterium, is an opportunistic pathogen in humans. Multidrugresistant acinetobacter baumannii infection following paraarticular steroid injection in the knee. Multidrug resistant acinetobacter baumannii, mrab is an important cause of hospital acquired infection. Isolation and identification of multidrug resistant. The patterns indicate various strains of multidrugresistant acinetobacter baumannii mdrab as defined by pulsedfield gel electrophoresis. This protective effect was significant after confounding. Melamed r, greenberg d, porat n, karplus m, zmora e, golan a, et al. Longitudinal multicenter surveillance data on abc from different sources in taiwan have not been published. Its ability to survive in a hospital milieu and its ability to persist for extended periods of time on surfaces makes it a frequent cause for healthcareassociated infections and it has led to multiple outbreaks. Complete genome of the multidrugresistant acinetobacter. Limited treatment options are available for patients infected with multidrug mdr or pandrug pdrresistant bacterial pathogens, resulting in infections that can persist for weeks or months.
The challenges of treating multidrugresistant bacteria continue to be at the forefront of the clinicians practice in caring for hospitalized patients. Acinetobacter baumannii, most often multidrug resistant, is a difficult to treat pathogen particularly in intensive care units icus of a hospital. A 5year surveillance study on antimicrobial resistance of. Acinetobacter baumannii is one of the most common causes of ventilatorassociated pneumonia in intensive care units. Multidrugresistant acinetobacter baumannii susceptible.
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