Abstract
The global spread of carbapenem-resistant Acinetobacter baumannii (A. baumannii) strains has restricted the therapeutic options available to treat infections due to this pathogen. Understanding the prevalence of such infections and the underlying genetic mechanisms of resistance may help in the implementation of adequate measures to control and prevent acquisition of nosocomial infections, especially in an intensive care unit setting. This study describes the molecular characteristics and risk factors associated with OXA-23-producing A. baumannii infections. A case-control study was undertaken from September/2013 to April/2015. Acquisition of OXA-23-producing A. baumannii was found to be associated with the use of nasogastric tubes, haemodialysis, and the use of cephalosporins. These isolates were only susceptible to amikacin, gentamicin, tigecycline, and colistin, and contained the ISAba1 insertion sequence upstream ofblaOXA-23 and blaOXA-51 genes. Twenty-six OXA-23-producing A. baumannii strains belonged to the ST79 (CC79) clonal group,and patients infected or colonised by these isolates had a higher mortality rate (34.6%). In conclusion, this study showed a dissemination of OXA-23-producing A. baumannii strains that was associated with several healthcare-related risk factors and high mortality rates among intensive care unit patients.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Acinetobacter Infections / drug therapy
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Acinetobacter Infections / microbiology
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Acinetobacter Infections / mortality*
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Acinetobacter baumannii / drug effects
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Acinetobacter baumannii / isolation & purification*
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Acinetobacter baumannii / physiology
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Adult
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Aged
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Aged, 80 and over
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Anti-Bacterial Agents / pharmacology*
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Anti-Bacterial Agents / therapeutic use
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Bacterial Proteins / genetics
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Brazil / epidemiology
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Case-Control Studies
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Cross Infection / drug therapy
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Cross Infection / microbiology
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Cross Infection / mortality*
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Drug Resistance, Multiple, Bacterial / genetics
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Female
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Hospital Mortality*
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Humans
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Intensive Care Units / statistics & numerical data
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Male
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Microbial Sensitivity Tests
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Middle Aged
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beta-Lactamases / genetics
Substances
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Anti-Bacterial Agents
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Bacterial Proteins
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beta-Lactamases
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beta-lactamase OXA-23, Acinetobacter baumannii
Grants and funding
This work was partially supported by the National Council for Science and Technological Development (CNPq grants 480949/2013-1),the Support Foundation for the Development of Education, Science and Technology of Mato Grosso do Sul state of (FUNDECT grants 0212/12, 0077/12, 0068/13, 44/2014, and 092/2015) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, 88887.103413/2015-01). W. G. M., K. E. S., A. C. R., and R.C. (PNPD 20131991) received scholarship grants from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). A. C. G. is a researcher from the CNPq (Process number: 307816/2009-5). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.