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The Clinical Characteristics, Carbapenem Resistance, and Outcome of Acinetobacter Bacteremia According to Genospecies  [PDF]
Kyung-Hwa Park, Jong-Hee Shin, Seung Yeop Lee, Soo Hyun Kim, Mi Ok Jang, Seung-Ji Kang, Sook-In Jung, Eun-Kyung Chung, Kwan Soo Ko, Hee-Chang Jang
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0065026
Abstract: Background Few clinical data are available on the relationship between genospecies and outcome of Acinetobacter bacteremia, and the results are inconsistent. We performed this study to evaluate the relationship between genospecies and the outcome of Acinetobacter bacteremia. Methods Clinical data from 180 patients who had Acinetobacter bacteremia from 2003 to 2010 were reviewed retrospectively. The genospecies were identified by rpoB gene sequence analysis. The clinical features and outcomes of 90 patients with A. baumannii bacteremia were compared to those of 90 patients with non-baumannii Acinetobacter bacteremia (60 with A. nosocomialis, 17 with Acinetobacter species “close to 13 TU”, 11 with A. pittii, and two with A. calcoaceticus). Results A. baumannii bacteremia was associated with intensive care unit-onset, mechanical ventilation, pneumonia, carbapenem resistance, and higher APACHE II scores, compared to non-baumannii Acinetobacter bacteremia (P<0.05). In univariate analyses, age, pneumonia, multidrug resistance, carbapenem resistance, inappropriate empirical antibiotics, higher APACHE II scores, and A. baumannii genospecies were risk factors for mortality (P<0.05). Multivariate analysis revealed A. baumannii genospecies (OR, 3.60; 95% CI, 1.56–8.33), age, pneumonia, and higher APACHE II scores to be independent risk factors for mortality (P<0.05). Conclusion A. baumannii genospecies was an independent risk factor for mortality in patients with Acinetobacter bacteremia. Our results emphasize the importance of correct species identification of Acinetobacter blood isolates.
Estudio de la sensibilidad antimicrobiana de la especie Acinetobacter baumanii en el Hospital "Hermanos Ameijeiras", a o 2006 Study of the antimicrobial sensitivity of Acinetobacter baumanii in "Hermanos Ameijeiras" Hospital, year 2006
Marcia Hart Casares,Neima Llanes Rodríguez,Fidel Espinosa Rivera,María del Carmen Halley Posada
Revista Cubana de Medicina , 2008,
Abstract: Acinetobacter baumanii, microorganismo que está adquiriendo mucha relevancia como patógeno nosocomial, ha desarrollado gran aumento de la resistencia antimicrobiana, lo que dificulta hallar un fármaco eficaz que cubra las infecciones graves que produce, dando lugar en muchos casos al fracaso terapéutico. Por esto nos motivamos a identificar cepas de Acinetobacter baumanii aisladas de pacientes hospitalizados y determinar su sensibilidad frente a un amplio grupo de antibióticos. Las pruebas diagnóstico se realizaron empleando el sistema API, con galerías ID 32 GN y ATB GN 5. Se identificaron 72 cepas, las cuales mostraron elevados niveles de resistencia frente a los antibióticos ensayados. Se obtuvo más de 65 % de resistencia frente a los b-lactámicos, los antibióticos menos activos dentro de este grupo fueron: amoxicilina, ticarcilina, piperacilina, cefotaxima y cefuroxima, con 100% de resistencia en todos los casos. La ciplrofloxacina, única quinolona probada, mostró también 100 % de resistencia. Dentro de los aminoglucósidos, la amikacina fue el antimicrobiano más efectivo, incluso el de menor porcentaje de resistencia. Los carbapenémicos, imipenem y meropenem se comportaron también con altos valores de resistencia, 52,8 y 55,2 %, respectivamente. Acinetobacter baumanii is a microorganism that is acquiring a great relevance as a nosocomial pathogen. It has developed a great increase of antimicrobial resitance that makes difficult to find an effective drug capable of covering all the severe infections it produces, leading to therapeutical failure in many cases. That is why we carried out a characterization study of Acinetobacter baumanii strains, isolated from patients admitted to determine their sensitivity level to a wide range of antibiotics. The diagnostic tests were performed using API system, with ID 32 GTN and ATB GN 5 galleries. There were identified 72 strains, which showed high levels of resistance against the assayed antibiotics. More than 65% percent of resistance to b-lactamics was obtained. The less active antibiotics within this group were Amoxicillin, Ticarcillin, Piperacillin, Cefotaxime, and Cefuroxime, with 100% de resistance in all the cases. Cyprofloxacine, the only quinolone tested, showed 100% of resistance. Among the aminoglycosides, Amikacin was the most effective antimicrobial agent, and that with the lowest resistance. The carbapenemics, imipenem and meropenem had also high values of resistance (52.8% and 55.2%, respectively).
OCCURRENCE AND DETECTION OF EXTENDED SPECTRUM β-LACTAMASE AND AmpC β-LACTAMASE IN CLINICAL ISOLATES OF Pseudomonas aeruginosa AND Acinetobacter baumanii BY INHIBITOR BASED METHOD  [cached]
Trivedi G.R.,Soni S.T., Vegad M.M.,Yadav K.S.
International Journal of Microbiology Research , 2012,
Abstract: Background & Objective: Pseudomonsa aeruginosa and Acinetobacter baumanii are common non-fermenters which have emerged as the most common opportunistic pathogens in recent years. Persistent exposure of Pseudomonas aeruginosa and Acinetobacter baumanii to β-lactam antibiotics leads to acquired resistance through mutation and over production of various enzymes which also include AmpC or class C β-lactamases and extended spectrum β-lactamase (ESBL). For clinical microbiologists, detection of ESBL and AmpC-mediated resistance together poses a problem because the phenotypic tests may be misleading; resulting in misreporting and treatment failures.Methods: A total number of 94 consecutive, non-repetitive, imipenem sensitve clinical isolates of Pseudomonas aeruginosa (n=64) and Acinetobacter baumanii (n=30) obtained over a period of 6 months, were screened for β-lactamase production by nitrocefin disc and production of ESBL and AmpC β-lactamase is detected by Inhibitor based test.Results: A total of 50 out of 94 isolates were positive for β-lactamase production; of which 17 (15.98%) and 22(20.68%) were ESBL and AmpC β-lactamase producers respectively.Conclusion: The inhibitor based method is useful for detection of ESBL and AmpC β-lactamase and helpful to differentiate ESBL from AmpC producers. As high incidence of ESBL and AmpC β-lactamase production in gram negative isolates is alarming and urgent actions needs to be taken for therapeutic and infection control measure. This is only possible if correct detection of ESBL and AmpC β-lactamase is done in clinical laboratory.
Physician’s dilemma in treating Acinetobacter baumanii: A combination of art and science  [PDF]
Sagar Khadanga, Karuna Tadepalli, Pravat Kumar Thatoi, Rina Mohanty, Namita Mohapatra
Asian Journal of Medical Sciences , 2015, DOI: 10.3126/ajms.v6i2.10405
Abstract: Acinetobacter are gram negative coccobacilli and ubiquitous in nature 1 . Quiet frequently they are recovered from inpatients who are hospitalized for prolonged illness and often multiple times. ?Although originally considered to be a low grade opportunistic pathogen Acinetobacter species has emerged to be one of the common nosocomial pathogen. These isolates are often MDR 1 . It still remains a physician’s dilemma whether to treat or not such isolates, considering them pathological or commmensals.? In one of our case it was isolated as a commensal and the patient did not require any antibiotic. On the hand the second case succumbed just after we started the susceptible antibiotic.? DOI: http://dx.doi.org/10.3126/ajms.v6i2.10405 Asian Journal of Medical Sciences Vol.6(2) 2015 105-107
Successful treatment of multidrug resistant Acinetobacter baumannii meningitis
Acinetobacter baumannii, Post-surgical meningitis, High dose meropenem
Journal of Infection in Developing Countries , 2007,
Abstract: Background: Acinetobacter baumannii is a major cause of nosocomial infections in many hospitals and appears to have a propensity for developing multiple antimicrobial resistance rapidly.Cases: We report two cases with post-surgical meningitis due to multidrug resistant A. baumannii which were successfully treated with high-dose intravenous meropenem therapy.Conclusions: Multidrug resistant Acinetobacter spp. in intensive care units are a growing concern. High-dose meropenem is used in the treatment of these infections.
Antimicrobial Susceptibility of Multidrug-Resistant Acinetobacter baumanii in a Teaching Hospital: A Two-Year Observation  [PDF]
Cucunawangsih  , Veronica Wiwing, Nata Pratama Hardjo Lugito
Open Journal of Medical Microbiology (OJMM) , 2015, DOI: 10.4236/ojmm.2015.52010
Abstract: Multidrug-resistant (MDR) Acinetobacter baumanii (A. baumanii) caused hospital acquired infection, typically in critical-ill patients with medical devices. This is a retrospective descriptive study on epidemiology and microbiology data to determine the antimicrobial susceptibility pattern of MDR-Acinetobacter baumanii isolates from a teaching hospital in Tangerang, Indonesia from Januari 2013 to December 2014. A total of 84 A. baumanii were collected. Patients suffering from respiratory tract infection had the highest number (41.7%) of A. baumanii isolate. There were 39 (46.6%) patients admitted in critical care. A. baumanii isolates in this study mostly were multidrug-resistant organisms with low susceptibility level to 11 antibiotic tested, 44% - 69% in 2013 and 26% - 67% in 2014. A high susceptibility level was observed to amikacin (80% and 79% in 2013, 2014 consecutively) and trimethoprim-sulfamethoxazole (73% and 72% in 2013, 2014 consecutively). A. baumanii is a hospital acquired pathogen in critically-ill patients. The susceptibility pattern of this study result showed MDR organism. There was a sharp decrease of susceptibility in all antibiotics studied from 2013 to 2014 except amikacin and trimethoprim-sulfamethoxazole.
In-Vitro Activity of Polymyxin B, Rifampicin, Tigecycline Alone and in Combination against Carbapenem-Resistant Acinetobacter baumannii in Singapore  [PDF]
Tze-Peng Lim,Thean-Yen Tan,Winnie Lee,S. Sasikala,Thuan-Tong Tan,Li-Yang Hsu,Andrea L. Kwa
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0018485
Abstract: Carbapenem-resistant Acinetobacter baumannii (CR-AB) is an emerging cause of nosocomial infections worldwide. Combination therapy may be the only viable option until new antibiotics become available. The objective of this study is to identify potential antimicrobial combinations against CR-AB isolated from our local hospitals.
Estudio de la sensibilidad antimicrobiana de la especie Acinetobacter baumanii en el Hospital "Hermanos Ameijeiras", a?o 2006
Hart Casares,Marcia; Llanes Rodríguez,Neima; Espinosa Rivera,Fidel; Halley Posada,María del Carmen; Martínez Batista,María Luisa; López Suárez,Ada Lidia;
Revista Cubana de Medicina , 2008,
Abstract: acinetobacter baumanii is a microorganism that is acquiring a great relevance as a nosocomial pathogen. it has developed a great increase of antimicrobial resitance that makes difficult to find an effective drug capable of covering all the severe infections it produces, leading to therapeutical failure in many cases. that is why we carried out a characterization study of acinetobacter baumanii strains, isolated from patients admitted to determine their sensitivity level to a wide range of antibiotics. the diagnostic tests were performed using api system, with id 32 gtn and atb gn 5 galleries. there were identified 72 strains, which showed high levels of resistance against the assayed antibiotics. more than 65% percent of resistance to b-lactamics was obtained. the less active antibiotics within this group were amoxicillin, ticarcillin, piperacillin, cefotaxime, and cefuroxime, with 100% de resistance in all the cases. cyprofloxacine, the only quinolone tested, showed 100% of resistance. among the aminoglycosides, amikacin was the most effective antimicrobial agent, and that with the lowest resistance. the carbapenemics, imipenem and meropenem had also high values of resistance (52.8% and 55.2%, respectively).
Outbreak of resistant Acinetobacter baumannii: measures and proposal for prevention and control
Romanelli, Roberta Maia de Castro;Jesus, Lenize Adriana de;Clemente, Wanessa Trindade;Lima, Stella Sala Soares;Rezende, Edna Maria;Coutinho, Rosane Luiza;Moreira, Ricardo Luiz Fontes;Neves, Francelli Aparecida Cordeiro;Brás, Nelma de Jesus;
Brazilian Journal of Infectious Diseases , 2009, DOI: 10.1590/S1413-86702009000500005
Abstract: acinetobacter baumannii colonization and infection, frequent in intensive care unit (icu) patients, is commonly associated with high morbimortality. several outbreaks due to multidrug-resistant (mdr) a. baumanii have been reported but few of them in brazil. this study aimed to identify risk factors associated with colonization and infection by mdr and carbapenem-resistant a. baumannii strains isolated from patients admitted to the adult icu at hc/ufmg. a case-control study was performed from january 2007 to june 2008. cases were defined as patients colonized or infected by mdr/carbapenem-resistant a. baumannii, and controls were patients without mdr/carbapenem-resistant a. baumannii isolation, in a 1:2 proportion. for statistical analysis, due to changes in infection control guidelines, infection criteria and the notification process, this study was divided into two periods. during the first period analyzed, from january to december 2007, colonization or infection by mdr/carbapenem-resistant a. baumannii was associated with prior infection, invasive device utilization, prior carbapenem use and clinical severity. in the multivariate analysis, prior infection and mechanical ventilation proved to be statistically significant risk factors. carbapenem use showed a tendency towards a statistical association. during the second study period, from january to june 2008, variables with a significant association with mdr/carbapenem-resistant a. baumannii colonization/infection were catheter utilization, carbapenem and third-generation cephalosporin use, hepatic transplantation, and clinical severity. in the multivariate analysis, only cvc use showed a statistical difference. carbapenem and third-generation cephalosporin use displayed a tendency to be risk factors. risk factors must be focused on infection control and prevention measures considering a. baumanni dissemination.
The Benefit of Education and Appropriate Antibiotics Use to Reduce Multidrug-Resistant Acinetobacter baumanii in a University-Affiliated Intensive Care Unit in Indonesia  [PDF]
  Cucunawangsih, Leni Lukman, R. Sariwijaya, P. Wibowo, V. Sungono
Open Journal of Medical Microbiology (OJMM) , 2015, DOI: 10.4236/ojmm.2015.54020
Abstract: Acinetobacter baumanii is an opportunistic pathogen known to cause hospital acquired infection presenting with varying clinical feature from simply to much more severe manifestation. More importantly, widely improper and overuse of antibiotics consumption have caused an endemic of multidrug-resistant-Acinetobacter baumanii leading to prolonged hospital stay and poorer prognosis for intensive care patients. A descriptive study of pre- and post-education was conducted at an intensive care setting in Indonesia. The microbiology data were collected to evaluate the benefit of education on hand hygiene and management of antibiotic use to reduce the number of MDR-Acinetobacter baumanii infection. Based on the result of previous local susceptibility patterns, Cefoperazone/Sulbactam and Amikacin are favored as the empirical therapy. Chi-square analysis shows the significant reduction of Acinetobacter baumanii cases from 70.8% (17/24) to 38% (3/8) with P-value 0.006. Similarly, the susceptibility rate significantly increased, from 21% to 100% to Amikacin; from 5% to 89% to Piperacillin/Tazobactam, and from 42% to 89% to Meropenem. Education improving around hand hygiene, appropriate antibiotic prescribing following local hospital guidelines and the result of antibiotic susceptibility has been shown to reduce the transmission of MDR-Acinetobacter baumanii in the intensive care in our unit within this Indonesian hospital.
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