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Co-existence of blaOXA-23 and blaVIM in carbapenem-resistant Acinetobacter baumannii isolates belonging to global complex 2 in a Chinese teaching hospital

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Chinese Medical Journal 2019年第10期132卷 1166-1172页

作者： Zi-Yan Huang Jun Li Jian Shui Hai-Chen Wang Yong-Mei Hu Ming-Xiang Zou Department of Clinical Laboratory Xiangya Hospital Central South University Changsha Hunan 410008 China

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) have been a challenging concern of health-care associated infections. The aim of the current study was to investigate the molecular epidemiology and clonal dissemination of CRAB isolates in a Chinese teaching hospital. Methods: Non-duplicate clinical A. baumannii isolates were collected from inpatients, and we measured the minimal inhibitory concentrations to determine antimicrobial susceptibility. Polymerase chain reaction (PCR) and sequencing were performed to detect carbapenem-resistance genes and occurrence of transposons among CRAB isolates. Moreover, the genetic diversity among isolates and clonal dissemination were determined by repetitive element PCR-mediated DNA fingerprinting (rep-PCR) and multilocus sequence typing (MLST). Results: A total of 67 CRAB isolates displayed resistance to most of the antibiotics tested in this study, except tigecycline. We detected bldOXA-23,bldOXA-51, bldOXAA-58, and bldVIM genes in 94.0%, 100.0%, 1.5%, and 80.6% of the CRAB isolates, respectively. Nevertheless, 74.6% of the CRAB isolates co-harbored the bldOXA-23 and bldVIM. Only one type of transposons was detected: Tn2008 (79.1%, 53/67). Although 12 distinctive types (A-L) were determined (primarily A type) STI95 was the most prevalent sequence type (ST). ST368, ST210, ST90, ST829, and ST136 were also detected, and all belonged to clonal complex 208 (CC208) and global complex 2 (GC2). Conclusion: The bldOXA-23 and bldVIM genes contributed to the resistance among CRAB isolates collected in our study. Notably, most of the CRAB strains co-harbored bldOXA-23 and vim genes, as well as Tn2008, which could contribute to clonal dissemination. The prevalence of such organisms may underlie hospital acquired infections.

关键词： Acinetobacter baumannii bldOXA-23 and bldVIM genes rep-PCR Transposons

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Specific and Selective Bacteriophages in the Fight against Multidrug-resistant Acinetobacter baumannii

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Virologica Sinica 2019年第4期34卷 347-357页

作者： Natalia Baginska Anna Pichlak Andrzej Gorski Ewa Jonczyk-Matysiak Bacteriophage Laboratory Hirszfeld Institute of Immunology and Experimental TherapyPolish Academy of Sciences53-114 WroclawPoland Phage Therapy Unit Hirszfeld Institute of Immunology and Experimental TherapyPolish Academy of Sciences53-114 WroclawPoland Department of Clinical Immunology Transplantation InstituteMedical University of Warsaw53-114 WarsawPoland

Acinetobacter baumannii causes serious infections especially in immunocompromised and/or hospitalized patients.Several A.baumannii strains are multidrug resistant and infect wounds,bones,and the respiratory tract.Current studies are focused on finding new effective agents against A.baumannii.Phage therapy is a promising means to fight this bacterium and many studies on procuring and applying new phages against A.baumannii are currently being conducted.As shown in animal models,phages against multidrug-resistant A.baumannii may control bacterial infections caused by this pathogen and may be a real hope to solve this dangerous health problem.

关键词： Acinetobacter baumannii Bacteriophages Phage therapy Multidrug resistance(MDR)

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Synergistic effects of ethnomedicinal plants of Apocynaceae family and antibiotics against clinical isolates of Acinetobacter baumannii

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Asian Pacific Journal of Tropical Medicine 2014年第6期7卷 456-461页

作者： Sasitorn Chusri Thanyaluck Siriyong Pinanong Na-Phatthalung Supayang Piyawan Voravuthikunchai Faculty of Traditional Thai Medicine Prince of Songkla University Natural Product Research Center of Excellence Prince of Songkla University Department of Microbiology Faculty of SciencePrince of Songkla University

Objective:To investigate the efficacy of 17 ethnomedicinal plants belonging to Apocynaceae family used in combination with 16 conventional antibiotics against non-multidrug resistant-,multidrug resistant(MDR)-.and extensive drug resistant(XDR) Acinetobacter baumannii(A.haumannii).Methods:Antibacterial activity and resistance modifying ability of 272combinations were determined by growth inhibition assays and further confirmed by time-kill assay.Results:Among the combinations of the antibiotics with Apocynaceae ethanol extracts on this pathogen,15(5%) had synergistic effects,23(8%) had partial synergistic effects and 234(86%) had no effects.Synergistic activity was observed mostly when the Apocynaceae extracts were combined with rifampicin or cefazolin.Interestingly.10 out of 17 combinations between the extracts and rifampicin displayed synergistic or partial synergistic behaviors.Holarrhena antidysenterica extract was additionally tested to restore rifampicin activity against clinical isolates of MDR and XDR A.haumannii.With respect to total or partial synergy,70%was XDR A.haumannii isolates and 66%was MDR A.haumannii isolates.Conclusions:Holarrhena antidysenterica extract clearly demonstrated the ability to restore rifampicin activity against both A.haumannii ATCC19606 and clinically isolated A.haumannii.Additional studies examining its active principles as well as nieclianisms of actions such as the effects on efflux pumps and outer membrane permeability alterations are recommended.

关键词： Acinetobacter baumannii Antibacterial activity Resistance modifying agents Apocynaceae Combination Synergistic effect

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Morbidity and mortality risk factors in emergency department patients with Acinetobacter baumannii bacteremia

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World Journal of Emergency Medicine 2020年第3期11卷 164-168页

作者： Rui-xue Sun Priscilla Song Joseph Walline He Wang Ying-chun Xu Hua-dong Zhu Xue-zhong Yu Jun Xu Emergency Department Peking Union Medical College HospitalBeijing 100010China Department of Anthropology Washington University in Saint LouisSaint Louis 63101USA Division of Emergency Medicine Saint Louis UniversitySaint Louis 63101USA Laboratory Department Peking Union Medical College HospitalBeijingChina

BACKGROUND:Acinetobacter baumannii(AB)bacteremia is an increasingly common and often fatal nosocomial infection.Identification of morbidity and mortality risk factors for AB bacteremia in emergency department(ED)patients may provide ways to improve the clinical outcomes of these patients.METHODS:The records for 51 patients with AB bacteremia and 51 patients without AB infection were collected and matched in a retrospective case-control study between 2013 and 2015 in a singlecenter ED.Risk factors were analyzed by Chi-square and multivariate logistic regression statistical models.RESULTS:A significant risk factor for morbidity was the presence of a central venous catheter(CVC)(P<0.001).The mortality rate for the 51 patients with AB bacteremia was 68.6%.Risk factors for mortality were the presence of a CVC(P=0.021)and an ED stay longer than two weeks(P=0.015).CONCLUSION:AB infections lead to high morbidity and mortality.The presence of a CVC was associated with higher morbidity and mortality in patients with AB bacteremia.Avoiding CVC insertions may improve outcomes in ED patients with AB bacteremia.

关键词： Acinetobacter baumannii Bacteremia Morbidity Mortality

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Risk factors and clinical responses of pneumonia patients with colistin-resistant Acinetobacter baumannii-calcoaceticus

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World Journal of Clinical Cases 2019年第10期7卷 1111-1121页

作者： Hande Aydemir Hande Idil Tuz Nihal Piskin Guven Celebi Canan Kulah Furuzan Kokturk Department of Infectious Diseases and Clinical Microbiology Zonguldak Bulent Ecevit UniversityFaculty of MedicineZonguldak 67100Turkey Department of Microbiology Zonguldak Bulent Ecevit UniversityFaculty of MedicineZonguldak 67100Turkey Department of Biostatistics Zonguldak Bulent Ecevit UniversityFaculty of MedicineZonguldak 67100Turkey

BACKGROUND Nosocomial infections with carbapenem-resistant Acinetobacter baumanniicalcoaceticus complex(ABC)strains are great problem for intensive care units.ABC strains can develop resistance to all the antibiotics available.Carbapenem resistance is common and colistin resistance is rare in our country.Knowing the risk factors for colistin resistance is important since colistin seems to be the only remaining therapeutic option for the patients with pneumonia due to extensively drug resistant ABC for our country.AIM To investigate the comparison of clinical responses and outcomes between pneumonia patients with colistin-susceptible and-resistant Acinetobacter sp.Strains.METHODS During the study period,108 patients with pneumonia due to colistin-susceptible strains and 16 patients with colistin-resistant strains were included retrospectively.Continuous variables were compared with the Mann-Whitney U test,and categorical variables were compared using Pearson’s chi-square test or Fisher’s Exact chi-square test for two groups.A binary logistic regression model was developed to identify the potential independent factors associated with colistin resistance in patients with colistin-resistant strains.RESULTS High Acute Physiology and Chronic Health Evaluation II scores(OR=1.9,95%CI:1.4-2.7;P<0.001)and prior receipt of teicoplanin(OR=8.1,95%CI:1.0-63.3;P=0.045)were found to be independent risk factors for infection with colistin-resistant Acinetobacter sp.Different combinations of antibiotics including colistin,meropenem,ampicillin/sulbactam,amikacin and trimethoprim/sulfamethoxazole were used for the treatment of patients with colistin-resistant strains.Although the median duration of microbiological cure(P<0.001)was longer in the colistin-resistant group,clinical(P=0.703),laboratory(P=0.277),radiological(P=0.551),microbiological response(P=1.000)and infection related mortality rates(P=0.603)did not differ between the two groups.Among the patients with infections due to colistin-resistant strains,seven were treated wit

关键词： Acinetobacter baumannii Colistin Ventilator-associated pneumonia

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High prevalence of multidrug-resistance in Acinetobacter baumannii and dissemination of carbapenemase-encoding genes bla_(OXA-23-like),bla_(OXA-24-like)and bla_(NDM-1) in Algiers hospitals

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Asian Pacific Journal of Tropical Medicine 2015年第6期8卷 439-447页

作者： Khadidja Khorsi Yamina Messai Moufida Hamidi Houria Ammari Rabah Bakour Laboratory of Cellular and Molecular Biology Faculty of Biological SciencesUniversity of Sciences and Technology Houari BoumedieneP.B.32 El-AliaBab-Ezzouar16111 AlgiersAlgeria Hospital Salim Zemirli Route de Baraki.BP N'71El Harrach 16000AlgiersAlgeria University Hospital Isaad Hassani.Rue Ibrahim Hadjeras Beni Messous 16206AlgiersAlgeria

Objective:To assess and characterize antibiotic resistance in Acinetobacter baumannii strains recovered from 5 health-care facilities in Algiers.Methods:Antibiotic susceptibility testing was performed by agar diffusion and agar dilution methods,resistance genes were identified by PCR and sequencing,and molecular typing of isolates was carried out by enterobacterial repetitive intergenic consensus-PCR(ERIC-PCR).Results:Among 125 tested isolates,117(93.6% ) were multidrug-resistant.of which 94(75.2% ) were imipenem resistant.The bla_(ADC)and bla_(OXA-51-like) genes were detected in all isolates,in association with ISAba I sequence in 84% and 8% (imipenem resistant) of isolates,respectively.The bla_(OXA-23-like) and bla_(OXA-24-like)carbapenemase genes were delected in 67.02% and 20.21% of imipenem-resistant isolates,respectively.The bla_(OXA-23-like) gene is linked to ISAba1 or ISAba4 elements.The metallo-β-lactamase NDM-1 gene was found in 10(10.6% ) imipenem-resisianl strains from three hospitals,it is linked to ISAba125 clement in nine strains.Extended spectrum β-lactamases production was not detected.Imipenem and cefotaxime resistance phenolypes could not be transferred to Escherichia coli by conjugation.Outer membrane protein CarO gene was not delected in four imipenem-resisianl isolates.The aac(6')-1b.sul1,sul2,tetA and tetB genes were present in 5.31% .36.17% .77.65% .1.06% and 65.92% of strains,respectively.Class 1 integrons were detected in 23.4% strains.KRIC-PCR typing showed a genetic diversity among bla_(OXA-23-like) and bla_(OXA-24-like) positive strains,while clonality was observed among bla_(NDM-1)positives.Conclusions:This study highlighted the high prevalence of imipenem resistance in Acinetobacter baumannii in Algiers hospitals mediated mainly by bla_(OXA-23-like),bla_(OXA-24-like),and bla_(NDM-1) genes.

关键词： Acinetobacter baumannii Multidrug-resistance Carbapenemase carO Hospital Algiers

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Anti-Acinetobacter baumannii activity of Rumex crispus L. and Rumex sanguineus L. extracts

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Asian Pacific Journal of Tropical Biomedicine 2020年第4期10卷 172-182页

作者： Verica Aleksic Sabo Emilija Svircev Neda Mimica-Dukic Dejan Orcic Jelena Narancic Petar Knezevic Department of Biology and Ecology Faculty of SciencesUniversity of Novi SadTrg Dositeja Obradovica 321000 Novi SadVojvodinaSerbia Department of Chemistry Biochemistry and environmental protectionFaculty of SciencesUniversity of Novi SadTrg Dositeja Obradovica 321000 Novi SadVojvodinaSerbia

Objective:To examine the effect of Rumex crispus(R.crispus)and Rumex sanguineus(R.sanguineus)plant extracts against isolates of Acinetobacter baumannii(A.baumannii)from wounds,including multidrug-resistant strains.Methods:Six prepared Rumex extracts were subjected to liquid chromatography-tandem mass spectrometry.Antimicrobial activity of extracts and pure compounds(catechin,quercetin,isoquercitrin,emodin,and gallic acid)was examined by a microtiter plate method,while for determination of compound binary combinations activity a checkerboard method was applied.Active fractions of extracts were detected by agar-overlay high-performance thinlayer chromatography-bioautography assay followed by liquid chromatography-diode array detection-mass spectrometry analysis.Results:A total of 28 compounds were detected in two extracts of R.crispus and 26 compounds in four different R.sanguineus extracts,with catechin as a dominant component.Anti-A.baumannii activity was confirmed for all six R.sanguineus and R.crispus extracts at the concentration range from 1 to 4 mg/mL.Neither examined single compounds nor their binary combinations exhibited an anti-A.baumannii activity(MIC>256μg/mL).The bioautography showed that fractions with the most prominent anti-A.baumannii activity tended to contain more polar compounds,predominantly flavonol(quercetin and kaempherol)glycosides;but also fractions containing flavanone(eriodictyol)glycosides and anthraquinone(emodin)glycosides;and less polar eriodictyol aglycone.Conclusions:The results justify and elucidate the traditional application of R.sanguineus and R.crispus extracts for wound healing,indicating the necessity for their further examination in combat against multidrug-resistant A.baumannii isolates from wounds.

关键词： Acinetobacter baumannii Isolates Wound Multidrug resistance Rumex extracts High-performance thin-layer chromatography-bioautography

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Antimicrobial resistance in Acinetobacter baumannii : From bench to bedside

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World Journal of Clinical Cases 2014年第12期2卷 787-814页

作者： Ming-Feng Lin Chung-Yu Lan Institute of Molecular and Cellular Biology National Tsing Hua UniversityHsin-Chu 31064Taiwan Department of Medicine National Taiwan University Hospital Chu-Tung Branch Hsin-Chu 31064 Taiwan

Acinetobacter baumannii(A. baumannii) is undoubtedly one of the most successful pathogens in the modern healthcare system. With invasive procedures, antibiotic use and immunocompromised hosts increasing in recent years, A. baumannii has become endemic in hospitals due to its versatile genetic machinery, which allows it to quickly evolve resistance factors, and to its remarkable ability to tolerate harsh environments. Infections and outbreaks caused by multidrugresistant A. baumannii(MDRAB) are prevalent and have been reported worldwide over the past twenty or more years. To address this problem effectively, knowledge of species identification, typing methods, clinical manifestations, risk factors, and virulence factors is essential. The global epidemiology of MDRAB is monitored by persistent surveillance programs. Because few effective antibiotics are available, clinicians often face serious challenges when treating patients with MDRAB. Therefore, a deep understanding of the resistance mechanisms used by MDRAB can shed light on two possible strategies to combat the dissemination of antimicrobial resistance: stringent infection control and antibiotic treatments, of which colistin-based combination therapy is the mainstream strategy. However, due to the current unsatisfying therapeutic outcomes, there is a great need to develop and evaluate the efficacy of new antibiotics and to understand the role of other potential alternatives, such as antimicrobial peptides, in the treatment of MDRAB infections.

关键词： Acinetobacter baumannii Antibiotic resistance Epidemiology Genomics Infection control

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Anti-N-methyl-D-aspartate receptor encephalitis that aggravates after acinetobacter baumannii pneumonia:A case report

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World Journal of Clinical Cases 2017年第9期5卷 368-372页

作者： Cheng C Wang Da J Li Yi Q Xia Kai Liu Center of Infectious Diseases West China Hospital of Sichuan University Emergency Department West China Hospital of Sichuan University

We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis(ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed severe status epilepticus and decreased level of conscience with new hyperpyrexia and dyspnea, and was admitted to the emergency intensive care unit. Acinetobacter baumanii were found in the sputum culture; and anti-NMDAR antibodies were positive(titer: 1/80) in the cerebrospinal fluid. Repeated immunotherapy was administered with antibacterial agents, and the patient recovered except for mild psychiatric sequelae. This is the first report of ANMDARE that aggravates after acinetobacter baumannii pneumonia. Awareness and knowledge of this disorder should be extended, especially in the emergency medicine community.

关键词： Anti-N-methyl-D-aspartate receptor encephalitis Acinetobacter baumannii pneumonia Emergency

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Biofilm formation in clinical isolates of nosocomial Acinetobacter baumannii and its relationship with multidrug resistance

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Asian Pacific Journal of Tropical Biomedicine 2016年第6期6卷 528-533页

作者： Ebrahim Babapour Azam Haddadi Reza Mirnejad Seyed-Abdolhamid Angaji Nour Amirmozafari Department of Microbiology Karaj BranchIslamic Azad University Medical Bacteriology Molecular Biology Research CenterBaqiyatallah University of Medical Sciences Department of Cell and Molecular Biology Faculty of Biological SciencesKharazmi University Iran University of Medical Sciences School of MedicineMicrobiology Department

Objective: To check biofilm formation by Acinetobacter baumannii(A. baumannii)clinical isolates and show their susceptibility to different antibiotics and investigate a possible link between establishment of biofilm and multidrug resistance.Methods: This study was performed on clinical samples collected from patients with nosocomial infections in three hospitals of Tehran. Samples were initially screened by culture and biochemical tests for the presence of different species of Acinetobacter. Identifications were further confirmed by PCR assays. Their susceptibilities to 11 antibiotics of different classes were determined by disc diffusion method according to Clinical and Laboratory Standards Institute guidelines. The ability to produce biofilm was investigated using methods: culture on Congo red agar, microtiter plate, and test tube method.Results: From the overall clinical samples, 156 specimens were confirmed to contain A. baumannii. The bacteria were highly resistant to most antibiotics except polymyxin B.Of these isolates, 10.26% were able to produce biofilms as shown on Congo red agar.However, the percentage of bacteria with positive biofilm in test tube, standard microtiter plate, and modified microtiter plate assays were 48.72%, 66.66%, and 73.72%, respectively. At least 92% of the biofilm forming isolates were multidrug resistant.Conclusions: Since most of the multidrug resistant strains produce biofilm, it seems necessary to provide continuous monitoring and determination of antibiotic susceptibility of clinical A. baumannii. This would help to select the most appropriate antibiotic for treatment.

关键词： Acinetobacter baumannii Biofilm Multidrug resistance Nosocomial infections

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