A prospective multicenter study on the evaluation of antimicrobial resistance and molecular epidemiology of multidrug-resistant Acinetobacter baumannii infections in intensive care units with clinical and environmental features

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dc.contributor.authorBoral, Baris
dc.contributor.authorUnaldi, Ozlem
dc.contributor.authorErgin, Alper
dc.contributor.authorDurmaz, Riza
dc.contributor.authorEser, Ozgen Koseoglu
dc.contributor.authorZarakolu, Pinar
dc.contributor.authorSipahi, Oguz Resat
dc.date.accessioned2020-06-25T18:34:00Z
dc.date.available2020-06-25T18:34:00Z
dc.date.issued2019
dc.departmentKırıkkale Üniversitesi
dc.description.abstractBackgroundMultidrug-resistant (MDR) Acinetobacter baumannii infections are considered as emerging nosocomial infections particularly in patients hospitalized in intensive care units (ICUs). Therefore, reliable detection of MDR strains is crucial for management of treatment but also for epidemiological data collections. The purpose of this study was to compare antimicrobial resistance and the clonal distribution of MDR clinical and environmental A. baumannii isolates obtained from the ICUs of 10 different hospitals from five geographical regions of Turkey in the context of the demographic and clinical characteristics of the patients.MethodsA multicenter-prospective study was conducted in 10 medical centers of Turkey over a 6month period. A total of 164 clinical and 12 environmental MDR A. baumannii isolates were included in the study. Antimicrobial susceptibility testing was performed for amikacin (AN), ampicillin-sulbactam (SAM), ceftazidime (CAZ), ciprofloxacin (CIP), imipenem (IMP) and colistin (COL) by microdilution method and by antibiotic gradient test for tigecycline (TIG). Pulsed-field gel electrophoresis (PFGE) was performed to determine the clonal relationship between the isolates. The detection of the resistance genes, bla(OXA-23),bla(OXA-24),bla(OXA-51,)bla(OXA-58,)bla(IMP,)bla(NDM), bla(KPC), bla(OXA-48) and bla(PER-1) was carried out using the PCR method.ResultsThe mortality rate of the 164 patients was 58.5%. The risk factors for mortality included diabetes mellitus, liv1er failure, the use of chemotherapy and previous use of quinolones. Antimicrobial resistance rates for AN, SAM, CAZ, CIP, IMP, COL and TIG were 91.8%, 99.4%, 99.4%, 100%, 99.4%, 1.2% and 1.7% respectively. Colistin showed the highest susceptibility rate. Four isolates did not grow on the culture and were excluded from the analyses. Of 172 isolates, 166 (96.5%) carried bla(OXA-23), 5 (2.9%) bla(OXA-58) and one isolate (0.6%) was positive for both genes. The frequency of bla(PER-1) was found to be 2.9%. None of the isolates had bla(IMP), bla(KPC), bla(NDM) and bla(OXA-48) genes. PFGE analysis showed 88 pulsotypes. Fifteen isolates were clonally unrelated. One hundred fifty-seven (91.2%) of the isolates were involved in 14 different clusters.ConclusionsColistin is still the most effective antibiotic for A. baumannii infections. The gene bla(OXA-23) has become the most prevalent carbapenemase in Turkey. The distribution of invasive A. baumannii isolates from different regions of Turkey is not diverse so, infection control measures at medical centers should be revised to decrease the MDR A. baumannii infections across the country. The results of this study are expected to provide an important baseline to assess the future prophylactic and therapeutic options.en_US
dc.description.sponsorshipHacettepe University Scientific Research UnitHacettepe University [011 D07 101 007-135]en_US
dc.description.sponsorshipThis study was supported by a Hacettepe University Scientific Research Unit (Project no: 011 D07 101 007-135) grant.en_US
dc.identifier.citationBoral, B., Unaldi, Ö., Ergin, A. et al. A prospective multicenter study on the evaluation of antimicrobial resistance and molecular epidemiology of multidrug-resistant Acinetobacter baumannii infections in intensive care units with clinical and environmental features. Ann Clin Microbiol Antimicrob 18, 19 (2019).en_US
dc.identifier.doi10.1186/s12941-019-0319-8
dc.identifier.issn1476-0711
dc.identifier.pmid31266519
dc.identifier.urihttps://doi.org/10.1186/s12941-019-0319-8
dc.identifier.urihttps://hdl.handle.net/20.500.12587/7739
dc.identifier.volume18en_US
dc.identifier.wosWOS:000474355000001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBmcen_US
dc.relation.ispartofAnnals Of Clinical Microbiology And Antimicrobials
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAcinetobacter baumanniien_US
dc.subjectRisk factorsen_US
dc.subjectAntimicrobial resistance genesen_US
dc.subjectPolymerase chain reactionen_US
dc.subjectPulsed field gel electrophoresisen_US
dc.subjectClonal relatednessen_US
dc.titleA prospective multicenter study on the evaluation of antimicrobial resistance and molecular epidemiology of multidrug-resistant Acinetobacter baumannii infections in intensive care units with clinical and environmental featuresen_US
dc.typeArticle

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