De Freitas LC , 2013. Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery, and Development of New Antibiotics. Vol. 43. Geneva, Switzerland: World Health Organization, 348–365.
Piperaki ET , Tzouvelekis LS , Miriagou V , Daikos GL , 2019. Carbapenem-resistant Acinetobacter baumannii: in pursuit of an effective treatment. Clin Microbiol Infect 25: 951–957.
Schmid A , Wolfensberger A , Nemeth J , Schreiber PW , Sax H , Kuster SP , 2019. Monotherapy versus combination therapy for multidrug-resistant Gram-negative infections: systematic review and meta-analysis. Sci Rep 9: 1–11.
Llaca-Díaz JM , Mendoza-Olazarán S , Camacho-Ortiz A , Flores S , Garza-González E , 2013. One-year surveillance of eskape pathogens in an intensive care unit of Monterrey, Mexico. Chemotherapy 58: 475–481.
Marchaim D , Levit D , Zigron R , Gordon M , Lazarovitch T , Carrico JA , Chalifa-Caspi V , Moran-Gilad J , 2017. Clinical and molecular epidemiology of Acinetobacter baumannii bloodstream infections in an endemic setting. Future Microbiol 12: 271–283.
Morfin-Otero R et al., 2013. Acinetobacter baumannii infections in a tertiary care Hospital in Mexico over the past 13 years. Chemotherapy 59: 57–65.
Bocanegra-Ibarias P , Peña-López C , Camacho-Ortiz A , Llaca-Díaz J , Silva-Sánchez J , Barrios H , Garza-Ramos U , Rodríguez-Flores AM , Garza-González E , 2015. Genetic characterisation of drug resistance and clonal dynamics of Acinetobacter baumannii in a hospital setting in Mexico. Int J Antimicrob Agents 45: 309–313.
Mancilla-Rojano J et al., 2020. Molecular epidemiology of Acinetobacter calcoaceticus-Acinetobacter baumannii complex isolated from children at the Hospital Infantil de México Federico Gómez. Front Microbiol 11: 1–15.
Higgins PG , Wisplinghoff H , Krut O , Seifert H , 2007. A PCR-based method to differentiate between Acinetobacter baumannii and Acinetobacter genomic species 13TU. Clin Microbiol Infect 13: 1199–1201.
Clinical and Laboratory Institute , 2020. Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. Wayne, PA: CLSI.
Magiorakos A et al., 2011. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 18: 268–281.
Chen Y , Ai L , Guo P , Huang H , Wu Z , Liang X , Liao K , 2018. Molecular characterization of multidrug resistant strains of Acinetobacter baumannii isolated from pediatric intensive care unit in a Chinese tertiary hospital. BMC Infect Dis 18: 1–7.
Lukić-Grlić A , Kos M , Žižek M , Luxner J , Grisold A , Zarfel G , Bendenić B , 2020. Emergence of carbapenem-hydrolyzing oxacillinases in Acinetobacter baumannii in children from Croatia. Chemotherapy 64: 167–172.
Bello-López E et al., 2020. Antibiotic resistance mechanisms in Acinetobacter spp. isolated from patients in a pediatric hospital in Mexico. J Glob Antimicrob Resist 23: 120–129.
McGrath EJ , Chopra T , Abdel-Haq N , Preney K , Koo W , Asmar BI , Kaye KS , 2011. An outbreak of carbapenem-resistant Acinetobacter baumanii infection in a neonatal intensive care unit: investigation and control. Infect Control Hosp Epidemiol 32: 34–41.
Gajic I , Jovicevic M , Milic M , Kekic D , Opavski N , Zrnic Z , Dacic S , Pavlovic L , Mijac V , 2021. Clinical and molecular characteristics of OXA-72-producing Acinetobacter baumanii ST636 outbreak at a neonatal intensive care unit in Serbia. J Hosp Infect 112: 54–60.
Thatrimotriachai A , Apisarnthanarak A , Chanvitan P , Janjindamai W , Dissaneevate S , Maneenil G , 2013. Risk factors and outcomes of carbapenem-resistant Acinetobacter baumanii bacteremia in neonatal intensive care unit: a case-case-control study. Pediatr Infect Dis J 32: 140–145.
Karaaslan A , Soysal A , Gelmez A , Kepenekli E , Söyletir G , Bakir M , 2015. Molecular characterization and risk factors for carbapenem-resistant Gram-negative bacilli colonization in children: emergence of NDM-producing Acinetobacter baumannii in a newborn intensive care unit in Turkey. J Hosp Infect 92: 67–72.
Routsi C , Pratikaki M , Platsouka E , Sotiropoulou C , Nanas S , Markaki V , Vrettou C , Paniara O , Giamarellou H , Roussos C , 2010. Carbapenem-resistant versus carbapenem-susceptible Acinetobacter baumannii bacteremia in a Greek intensive care unit: risk factors, clinical features and outcomes. Infection 38: 173–180.
Al Jarousha AM , El Jabda AH , Al Afifi AS , El Quaqa LA , 2009. Nosocomial multidrug-resistant Acinetobacter baumanii in the neonatal intensive care unit in Gaza City, Palestine. Int J Infect Dis 13: 623–628.
Hsu JF , Chu SM , Lien R , Chiu CH , Chiang MC , Fu RH , Lee CW , Huang HR , Tsai MH , 2014. Case–control analysis of endemic Acinetobacter baumannii bacteremia in the neonatal intensive care unit. Am J Infect Control 42: 23–27.
European Centre for Disease Prevention and Control , 2022. Antimicrobial Resistance in the EU/EEA (EARS-Net)—Annual Epidemiological Report 2021. Stockholm, Sweden: ECDC.
Konca C , Tekin M , Geyik M , 2021. Susceptibility patterns of multidrug-resistant Acinetobacter baumanii. Indian J Pediatr 88: 120–126.
Logan L , Gandra S , Trett A , Weinstein R , Laxminarayan R , 2019. Acinetobacter baumannii resistance trends in children in the United States, 1999–2012. J Pediatric Infect Dis Soc 8: 136–142.
Cerezales M , Ocampo-Sosa AA , Álvarez Montes L , Díaz Ríos C , Bustamante Z , Santos J , Martínez-Martínez L , Higgins PG , Gallego L , 2018. High prevalence of extensively drug-resistant Acinetobacter baumanii at a children’s hospital in Bolivia. Pediatr Infect Dis J 37: 1118–1123.
Garza-González E et al., 2020. The evolution of antimicrobial resistance in Mexico during the last decade: results from the INVIFAR Group. Microb Drug Resist 26: 1372–1382.
Goic-Barisic I et al., 2021. Endemicity of OXA-23 and OXA-72 in clinical isolates of Acinetobacter baumannii from three neighbouring countries in southeast Europe. J Appl Genet 62: 353–359.
Neves FC , Clemente WT , Lincopan N , Paião ID , Neves PR , Romanelli RM , Lima SS , Paiva LF , Mourão PH , Nobre-Junior VA , 2016. Clinical and microbiological characteristics of OXA-23- and OXA-143-producing Acinetobacter baumannii in ICU patients at a teaching hospital, Brazil. Braz J Infect Dis 20: 556–563.
Henrique Camargo C et al.Clonal spread of ArmA- and OXA-23-coproducing Acinetobacter baumannii International Clone 2 in Brazil during the first wave of the COVID-19 pandemic. J Med Microbiol 71: 556–563.
Romanin P et al., 2019. Multidrug- and extensively drug-resistant Acinetobacter baumannii in a tertiary hospital from Brazil: the importance of carbapenemase encoding genes and epidemic clonal complexes in a 10-year study. Microb Drug Resist 25: 1365–1373.
Merkier AK et al., 2008. Polyclonal spread of blaOXA-23 and blaOXA-58 in Acinetobacter baumannii isolates from Argentina. J Infect Dev Ctries 2: 235–240.
Alcántar-Curiel MD et al., 2014. Molecular mechanisms associated with nosocomial carbapenem-resistant Acinetobacter baumannii in Mexico. Arch Med Res 45: 553–560.
Hu Z , Wang Z , Liu D , Chen P , Wang H , Chen Y , Zhao X , Shi Y , 2011. Clinical and molecular microbiological characteristics of carbapenem-resistant Acinetobacter baumannii strains in a NICU. Pediatr Int 53: 867–872.
Bello-López E , Castro-Jaimes S , Cevallos MÁ , Rocha-Gracia RDC , Castañeda-Lucio M , Sáenz Y , Torres C , Gutiérrez-Cazares Z , Martínez-Laguna Y , Lozano-Zarain P , 2019. Resistome and a novel blaNDM-1-harboring plasmid of an Acinetobacter haemolyticus strain from a children’s hospital in Puebla, Mexico. Microb Drug Resist 25: 1023–1031.
Mancilla-Rojano J et al., 2020. Molecular epidemiology of Acinetobacter calcoaceticus–Acinetobacter baumannii complex isolated from children at the Hospital Infantil de México Federico Gómez. Front Microbiol 11: 576673.
Lukovic B , Gajic I , Dimkic I , Kekic D , Zornic S , Pozder T , Radisavljevic S , Opavski N , Kojic M , Ranin L , 2020. The first nationwide multicenter study of Acinetobacter baumannii recovered in Serbia: emergence of OXA-72, OXA-23 and NDM-1-producing isolates. Antimicrob Resist Infect Control 9: 101.
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Abstract Views | 3355 | 829 | 37 |
Full Text Views | 103 | 48 | 4 |
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Acinetobacter baumannii poses a significant threat to public health due to the high rate of multidrug-resistant strains. However, information on the molecular characterization of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections in children is scarce. This study aimed to describe the molecular characterization of carbapenem-resistant A. baumannii infections in children from a hospital in Mexico. A retrospective study was conducted during the period 2017–2022. Clinical and demographic data were collected from the clinical records. Mass spectrometry was used for the identification of the strains. To confirm A. baumannii strains, a polymerase chain reaction (PCR) method was applied using a gyrB sequence. The carbapenemase-encoding resistance genes were detected by PCR. Six cases of CRAB were documented, including five in neonates. The median intensive care unit stay was 20 days, and all cases had an invasive medical device. Half of the patients had at least one medical condition. A high prevalence of coresistance was observed in most of the antibiotic groups. Three of the six strains coharbored carbapenemase genes: blaOXA-51, blaOXA-24, and blaIMP. Mortality was reported in two neonate patients. The present study shows a high rate of coharboring blaOXA-51, blaOXA-24, and blaIMP-1, which has a direct impact on therapeutic decisions. Implementation of antimicrobial stewardship programs is urgent to stop the spread of this microorganism.
Disclosure: Verbal informed consent was obtained from the patients’ parents to collect data from the clinical record.
Authors’ addresses: José Iván Castillo Bejarano, Abiel Homero Mascareñas de los Santos, Fernando Espinosa Villaseñor, and Rebeca Aguayo Samaniego, Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Monterrey, Mexico, E-mails: jicastillobejarano@gmail.com, a_mascarenas@hotmail.com, fernandoe2405@gmail.com, and rebesam97@gmail.com. Jorge Llaca Díaz, Hugo Sánchez Alanís, and Nestor Casillas Vega, Department of Clinical Pathology, Hospital Universitario “Dr. José Eleuterio González,” Francisco I. Madero Avenue, Universidad Autónoma de Nuevo León, Monterrey, Mexico, E-mails: jorgellaca@hotmail.com, has_inte@hotmail.com, and nestor.casillas.vega@hotmail.com. Manuel Enrique de la O Cavazos, Department of Pediatrics, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León, Monterrey, Mexico, E-mail: manuel.delaocvz@uanl.edu.mx. Daniel Siller Rodríguez, Hospital Epidemiology and Surveillance Unit, Christus Muguerza Hospital Alta Especialidad, Monterrey, México, E-mail: daniel.siller@christus.mx.
De Freitas LC , 2013. Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery, and Development of New Antibiotics. Vol. 43. Geneva, Switzerland: World Health Organization, 348–365.
Piperaki ET , Tzouvelekis LS , Miriagou V , Daikos GL , 2019. Carbapenem-resistant Acinetobacter baumannii: in pursuit of an effective treatment. Clin Microbiol Infect 25: 951–957.
Schmid A , Wolfensberger A , Nemeth J , Schreiber PW , Sax H , Kuster SP , 2019. Monotherapy versus combination therapy for multidrug-resistant Gram-negative infections: systematic review and meta-analysis. Sci Rep 9: 1–11.
Llaca-Díaz JM , Mendoza-Olazarán S , Camacho-Ortiz A , Flores S , Garza-González E , 2013. One-year surveillance of eskape pathogens in an intensive care unit of Monterrey, Mexico. Chemotherapy 58: 475–481.
Marchaim D , Levit D , Zigron R , Gordon M , Lazarovitch T , Carrico JA , Chalifa-Caspi V , Moran-Gilad J , 2017. Clinical and molecular epidemiology of Acinetobacter baumannii bloodstream infections in an endemic setting. Future Microbiol 12: 271–283.
Morfin-Otero R et al., 2013. Acinetobacter baumannii infections in a tertiary care Hospital in Mexico over the past 13 years. Chemotherapy 59: 57–65.
Bocanegra-Ibarias P , Peña-López C , Camacho-Ortiz A , Llaca-Díaz J , Silva-Sánchez J , Barrios H , Garza-Ramos U , Rodríguez-Flores AM , Garza-González E , 2015. Genetic characterisation of drug resistance and clonal dynamics of Acinetobacter baumannii in a hospital setting in Mexico. Int J Antimicrob Agents 45: 309–313.
Mancilla-Rojano J et al., 2020. Molecular epidemiology of Acinetobacter calcoaceticus-Acinetobacter baumannii complex isolated from children at the Hospital Infantil de México Federico Gómez. Front Microbiol 11: 1–15.
Higgins PG , Wisplinghoff H , Krut O , Seifert H , 2007. A PCR-based method to differentiate between Acinetobacter baumannii and Acinetobacter genomic species 13TU. Clin Microbiol Infect 13: 1199–1201.
Clinical and Laboratory Institute , 2020. Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. Wayne, PA: CLSI.
Magiorakos A et al., 2011. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 18: 268–281.
Chen Y , Ai L , Guo P , Huang H , Wu Z , Liang X , Liao K , 2018. Molecular characterization of multidrug resistant strains of Acinetobacter baumannii isolated from pediatric intensive care unit in a Chinese tertiary hospital. BMC Infect Dis 18: 1–7.
Lukić-Grlić A , Kos M , Žižek M , Luxner J , Grisold A , Zarfel G , Bendenić B , 2020. Emergence of carbapenem-hydrolyzing oxacillinases in Acinetobacter baumannii in children from Croatia. Chemotherapy 64: 167–172.
Bello-López E et al., 2020. Antibiotic resistance mechanisms in Acinetobacter spp. isolated from patients in a pediatric hospital in Mexico. J Glob Antimicrob Resist 23: 120–129.
McGrath EJ , Chopra T , Abdel-Haq N , Preney K , Koo W , Asmar BI , Kaye KS , 2011. An outbreak of carbapenem-resistant Acinetobacter baumanii infection in a neonatal intensive care unit: investigation and control. Infect Control Hosp Epidemiol 32: 34–41.
Gajic I , Jovicevic M , Milic M , Kekic D , Opavski N , Zrnic Z , Dacic S , Pavlovic L , Mijac V , 2021. Clinical and molecular characteristics of OXA-72-producing Acinetobacter baumanii ST636 outbreak at a neonatal intensive care unit in Serbia. J Hosp Infect 112: 54–60.
Thatrimotriachai A , Apisarnthanarak A , Chanvitan P , Janjindamai W , Dissaneevate S , Maneenil G , 2013. Risk factors and outcomes of carbapenem-resistant Acinetobacter baumanii bacteremia in neonatal intensive care unit: a case-case-control study. Pediatr Infect Dis J 32: 140–145.
Karaaslan A , Soysal A , Gelmez A , Kepenekli E , Söyletir G , Bakir M , 2015. Molecular characterization and risk factors for carbapenem-resistant Gram-negative bacilli colonization in children: emergence of NDM-producing Acinetobacter baumannii in a newborn intensive care unit in Turkey. J Hosp Infect 92: 67–72.
Routsi C , Pratikaki M , Platsouka E , Sotiropoulou C , Nanas S , Markaki V , Vrettou C , Paniara O , Giamarellou H , Roussos C , 2010. Carbapenem-resistant versus carbapenem-susceptible Acinetobacter baumannii bacteremia in a Greek intensive care unit: risk factors, clinical features and outcomes. Infection 38: 173–180.
Al Jarousha AM , El Jabda AH , Al Afifi AS , El Quaqa LA , 2009. Nosocomial multidrug-resistant Acinetobacter baumanii in the neonatal intensive care unit in Gaza City, Palestine. Int J Infect Dis 13: 623–628.
Hsu JF , Chu SM , Lien R , Chiu CH , Chiang MC , Fu RH , Lee CW , Huang HR , Tsai MH , 2014. Case–control analysis of endemic Acinetobacter baumannii bacteremia in the neonatal intensive care unit. Am J Infect Control 42: 23–27.
European Centre for Disease Prevention and Control , 2022. Antimicrobial Resistance in the EU/EEA (EARS-Net)—Annual Epidemiological Report 2021. Stockholm, Sweden: ECDC.
Konca C , Tekin M , Geyik M , 2021. Susceptibility patterns of multidrug-resistant Acinetobacter baumanii. Indian J Pediatr 88: 120–126.
Logan L , Gandra S , Trett A , Weinstein R , Laxminarayan R , 2019. Acinetobacter baumannii resistance trends in children in the United States, 1999–2012. J Pediatric Infect Dis Soc 8: 136–142.
Cerezales M , Ocampo-Sosa AA , Álvarez Montes L , Díaz Ríos C , Bustamante Z , Santos J , Martínez-Martínez L , Higgins PG , Gallego L , 2018. High prevalence of extensively drug-resistant Acinetobacter baumanii at a children’s hospital in Bolivia. Pediatr Infect Dis J 37: 1118–1123.
Garza-González E et al., 2020. The evolution of antimicrobial resistance in Mexico during the last decade: results from the INVIFAR Group. Microb Drug Resist 26: 1372–1382.
Goic-Barisic I et al., 2021. Endemicity of OXA-23 and OXA-72 in clinical isolates of Acinetobacter baumannii from three neighbouring countries in southeast Europe. J Appl Genet 62: 353–359.
Neves FC , Clemente WT , Lincopan N , Paião ID , Neves PR , Romanelli RM , Lima SS , Paiva LF , Mourão PH , Nobre-Junior VA , 2016. Clinical and microbiological characteristics of OXA-23- and OXA-143-producing Acinetobacter baumannii in ICU patients at a teaching hospital, Brazil. Braz J Infect Dis 20: 556–563.
Henrique Camargo C et al.Clonal spread of ArmA- and OXA-23-coproducing Acinetobacter baumannii International Clone 2 in Brazil during the first wave of the COVID-19 pandemic. J Med Microbiol 71: 556–563.
Romanin P et al., 2019. Multidrug- and extensively drug-resistant Acinetobacter baumannii in a tertiary hospital from Brazil: the importance of carbapenemase encoding genes and epidemic clonal complexes in a 10-year study. Microb Drug Resist 25: 1365–1373.
Merkier AK et al., 2008. Polyclonal spread of blaOXA-23 and blaOXA-58 in Acinetobacter baumannii isolates from Argentina. J Infect Dev Ctries 2: 235–240.
Alcántar-Curiel MD et al., 2014. Molecular mechanisms associated with nosocomial carbapenem-resistant Acinetobacter baumannii in Mexico. Arch Med Res 45: 553–560.
Hu Z , Wang Z , Liu D , Chen P , Wang H , Chen Y , Zhao X , Shi Y , 2011. Clinical and molecular microbiological characteristics of carbapenem-resistant Acinetobacter baumannii strains in a NICU. Pediatr Int 53: 867–872.
Bello-López E , Castro-Jaimes S , Cevallos MÁ , Rocha-Gracia RDC , Castañeda-Lucio M , Sáenz Y , Torres C , Gutiérrez-Cazares Z , Martínez-Laguna Y , Lozano-Zarain P , 2019. Resistome and a novel blaNDM-1-harboring plasmid of an Acinetobacter haemolyticus strain from a children’s hospital in Puebla, Mexico. Microb Drug Resist 25: 1023–1031.
Mancilla-Rojano J et al., 2020. Molecular epidemiology of Acinetobacter calcoaceticus–Acinetobacter baumannii complex isolated from children at the Hospital Infantil de México Federico Gómez. Front Microbiol 11: 576673.
Lukovic B , Gajic I , Dimkic I , Kekic D , Zornic S , Pozder T , Radisavljevic S , Opavski N , Kojic M , Ranin L , 2020. The first nationwide multicenter study of Acinetobacter baumannii recovered in Serbia: emergence of OXA-72, OXA-23 and NDM-1-producing isolates. Antimicrob Resist Infect Control 9: 101.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 3355 | 829 | 37 |
Full Text Views | 103 | 48 | 4 |
PDF Downloads | 95 | 53 | 4 |