Investigation of Carbapenem-Resistant AcinetobacterBaumannii Resistance Rate in Clinical Specimens of Newborns at Imam Khomeini Hospital in Tehran
Archives of Medical Laboratory Sciences,
Vol. 3 No. 3 (2017),
13 May 2018
https://doi.org/10.22037/amls.v3i3.19794
Abstract
Background: Carbapenem-resistant Acinetobacter Baumannii (CRAB) hospital infection poses a serious threat to the health of the newborns in neonatal intensive care units (NICU). The present study was conducted to evaluate the prevalence and resistance of hospital infections in the NICU ward at Imam Khomeini hospital in Tehran.
Materials and Methods: The blaOXA-51 like gene was investigated with polymerase chain reaction (PCR). Then, sensitivity of isolates to different antibiotics was assessed using disc diffusion method and broth micro dilutions to determine the minimum inhibitory concentrations (MICs). Pulsed field gel electrophoresis (PFGE) was used for typing of randomly collected CRAB infection at different wards of this hospital.
Results: A total of 10 CRAB infections were isolatedduringthe6-month study period, and it was found that 100% of them were positive forblaOXA-51-like gene in PCR assay. All isolates were resistant to all tested antibiotics, except colistin, polymyxin B, and tigecycline. CRAB isolates had a high MIC values for imipenem, cefotaxim, and amikacin, showing multidrug resistant (MDR) phenotype. According to PFGE analysis,3palsotypes including clone A (7%), clone B (2%), and clone D (1%) were seen in the 10 CRAB isolates. Clone A was a dominant clone and spread in different wards of the hospital, especially in other ICUs and the emergency ward. Moreover, the similarity between the palsotypes showed the ability of transferring CRAB infection from different wards of the hospital to the NICU.
Conclusions: Based on the results of this study, CRAB infection, with a high resistance rate, has the ability to enter into important wards such as NICU, and thus it is highly important to control the presence of these isolates in different parts of the hospital.
- CRAB
- NICU
- bla OXA-51 like
- MIC
- Clonal Relationship
How to Cite
References
Al Jarousha AM, El Jadba AH, Al Afifi AS, El Qouqa IA. Nosocomial multidrug-resistant Acinetobacterbaumannii in the neonatal intensive care unit in Gaza City, Palestine. International Journal of Infectious Diseases. 2009 Sep 30;13(5):623-8.
Ardebili A, Lari AR, Talebi M. Correlation of ciprofloxacin resistance with the AdeABC efflux system in Acinetobacterbaumannii clinical isolates. Annals of laboratory medicine. 2014; 34(6):433-8.
Camp C, Tatum OL. A review of Acinetobacter baumannii as a highly successful pathogen in times of war. Laboratory Medicine. 2010; 41(11):649-57.
Shete VB, Ghadage DP, Muley VA, Bhore AV. Acinetobacter septicemia in neonates admitted to intensive care units. Journal of laboratory physicians. 2009 Jul;1(2):73.
Brito DV, Oliveira EJ, Abdallah VO, Darini AL, GontijoFilho PP. An outbreak of Acinetobacterbaumannii septicemia in a neonatal intensive care unit of a university hospital in Brazil. Brazilian Journal of Infectious Diseases. 2005 Aug;9(4):301-9.
Wei HM, Hsu YL, Lin HC, Hsieh TH, Yen TY, Lin HC, Su BH, Hwang KP. Multidrug-resistant Acinetobacterbaumannii infection among neonates in a neonatal intensive care unit at a medical center in central Taiwan. Journal of Microbiology, Immunology and Infection. 2015 Oct 31;48(5):531-9.
Espinal P, Marti S, Vila J. Effect of biofilm formation on the survival of Acinetobacterbaumannii on dry surfaces. Journal of Hospital Infection. 2012; 80(1):56-60.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson Liljequist B, Paterson DL. Multidrug resistant, extensively drug resistant and pandrug resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection. 2012;18(3):268-81.
Qureshi, Z.A., Hittle, L.E., O'Hara, J.A., Rivera, J.I., Syed, A., Shields, R.K., Pasculle, A.W., Ernst, R.K., Doi Y.: Colistin-resistant Acinetobacterbaumannii: beyond carbapenem resistance. Clinical Infectious Diseases.2015; 60, 1295-303.
Tsakris A, Ikonomidis A, Pournaras S, Tzouvelekis LS, Sofianou D, Legakis NJ, Maniatis AN. VIM-1 metallo-β-lactamase in Acinetobacterbaumannii. Emerging infectious diseases. 2006; 12(6):1-3.
Bifulco JM, Shirey JJ, Bissonnette GK. Detection of Acinetobacter spp. in rural drinking water supplies. Applied and environmental microbiology. 1989;55(9):2214-9.
Touati A, Achour W, Cherif A, Hmida HB, Afif FB, Jabnoun S, Khrouf N, Hassen AB. Outbreak of Acinetobacterbaumannii in a neonatal intensive care unit:antimicrobial susceptibility and genotyping analysis. Ann Epidemiol. 2009 ;19(6):372-8.
Turton, J.F., Woodford, N., Glover, J., Yarde, S., Kaufmann, M.E., Pitt, T.L.: Identification of Acinetobacterbaumannii by detection of the bla OXA-51-like carbapenemase gene intrinsic to this species. Journal of clinical microbiology. 2006; 44, 2974-6.
Bifulco JM, Shirey JJ, Bissonnette GK. Detection of Acinetobacter spp. in rural drinking water supplies. Applied and environmental microbiology. 1989;55(9):2214-9.
Turton, J.F., Woodford, N., Glover, J., Yarde, S., Kaufmann, M.E., Pitt, T.L.: Identification of Acinetobacterbaumannii by detection of the blaOXA-51-likecarbapenemase gene intrinsic to this species. Journal of clinical microbiology 44, 2974-6 (2006).
Woodford, N., Ellington, M.J., Coelho, J.M., Turton, J.F., Ward, M.E., Brown, S., Amyes, S.G., Livermore, D.M.: Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. International journal of antimicrobial agents 27, 351-3 (2006).
Wayne, P.A.: Clinical and Laboratory Standards Institute (CLSI) performance standards for antimicrobial disk diffusion susceptibility tests. 20th Edition. Clinical and Laboratory Standards Institute, United States , 2010; pp.29.
Durmaz R, Otlu B, Koksal F, et al. The optimization of a rapid pulsed-field gel electrophoresis protocol for the typing of Acinetobacterbaumannii, Escherichia coli and Klebsiella spp. Jpn J Infect Dis. 2009; 62(5): 372-7.
Morovat T, Bahram F, Mohammad E, Setareh S, Mohamad Mehdi F. Distribution of different carbapenem resistant clones of Acinetobacterbaumannii in Tehran hospitals. The new microbiologica. 2009 Jul 1;32(3):265.
Zarrilli R, Di Popolo A, Bagattini M, Giannouli M, Martino D, Barchitta M, Quattrocchi A, Iula VD, de Luca C, Scarcella A, Triassi M. Clonal spread and patient risk factors for acquisition of extensively drug-resistant Acinetobacterbaumannii in a neonatal intensive care unit in Italy. Journal of Hospital Infection. 2012 Dec 31;82(4):260-5.
McGrath EJ, Chopra T, Abdel-Haq N, Preney K, Koo W, Asmar BI, Kaye KS. An outbreak of carbapenem-resistant Acinetobacterbaumannii infection in a neonatal intensive care unit: investigation and control. Infection Control & Hospital Epidemiology. 2011 Jan;32(1):34-41.
Melamed R, Greenberg D, Porat N, Karplus M, Zmora E, Golan A, Yagupsky P,
Dagan R. Successful control of an Acinetobacterbaumannii outbreak in a neonatal
intensive care unit. J Hosp Infect. 2003 Jan;53(1):31-8.
von Delinger de Brito D, Oliveira EJ, Steffen Abdallah VO, da Costa Darini AL, GontijoFilho PP. An outbreak of Acinetobacterbaumannii septicemia in a neonatal intensive care unit of a university hospital in Brazil. Braz J Infect Dis. 2005;9:301–309.
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