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Epidemic diffusion of OXA-23-producing Acinetobacter baumannii isolates in Italy: results of the first cross-sectional countrywide survey.
Principe, Luigi; Piazza, Aurora; Giani, Tommaso; Bracco, Silvia; Caltagirone, Maria Sofia; Arena, Fabio; Nucleo, Elisabetta; Tammaro, Federica; Rossolini, Gian Maria; Pagani, Laura; Luzzaro, Francesco.
Afiliação
  • Principe L; Microbiology and Virology Unit, Department of Laboratory Medicine, A. Manzoni Hospital, Lecco, Italy.
  • Piazza A; Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy.
  • Giani T; Department of Medical Biotechnologies, University of Siena, Siena, Italy.
  • Bracco S; Microbiology and Virology Unit, Department of Laboratory Medicine, A. Manzoni Hospital, Lecco, Italy.
  • Caltagirone MS; Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy.
  • Arena F; Department of Medical Biotechnologies, University of Siena, Siena, Italy.
  • Nucleo E; Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy.
  • Tammaro F; Department of Medical Biotechnologies, University of Siena, Siena, Italy.
  • Rossolini GM; Department of Medical Biotechnologies, University of Siena, Siena, Italy Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy Clinical Microbiology and Virology Unit, Department of Laboratory Medicine, Careggi University Hospital, Florence, Italy.
  • Pagani L; Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy.
  • Luzzaro F; Microbiology and Virology Unit, Department of Laboratory Medicine, A. Manzoni Hospital, Lecco, Italy f.luzzaro@ospedale.lecco.it.
J Clin Microbiol ; 52(8): 3004-10, 2014 Aug.
Article em En | MEDLINE | ID: mdl-24920776
Carbapenem-resistant Acinetobacter baumannii (CRAb) is emerging worldwide as a public health problem in various settings. The aim of this study was to investigate the prevalence of CRAb isolates in Italy and to characterize their resistance mechanisms and genetic relatedness. A countrywide cross-sectional survey was carried out at 25 centers in mid-2011. CRAb isolates were reported from all participating centers, with overall proportions of 45.7% and 22.2% among consecutive nonreplicate clinical isolates of A. baumannii from inpatients (n = 508) and outpatients (n = 63), respectively. Most of them were resistant to multiple antibiotics, whereas all remained susceptible to colistin, with MIC50 and MIC90 values of ≤ 0.5 mg/liter. The genes coding for carbapenemase production were identified by PCR and sequencing. OXA-23 enzymes (found in all centers) were by far the most common carbapenemases (81.7%), followed by OXA-58 oxacillinases (4.5%), which were found in 7 of the 25 centers. In 6 cases, CRAb isolates carried both bla(OXA-23-like) and bla(OXA-58-like) genes. A repetitive extragenic palindromic (REP)-PCR technique, multiplex PCRs for group identification, and multilocus sequence typing (MLST) were used to determine the genetic relationships among representative isolates (n = 55). Two different clonal lineages were identified, including a dominant clone of sequence type 2 (ST2) related to the international clone II (sequence group 1 [SG1], SG4, and SG5) and a clone of ST78 (SG6) previously described in Italy. Overall, our results demonstrate that OXA-23 enzymes have become the most prevalent carbapenemases and are now endemic in Italy. In addition, molecular typing profiles showed the presence of international and national clonal lineages in Italy.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Beta-Lactamases / Infecções por Acinetobacter / Acinetobacter baumannii / Epidemias Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Beta-Lactamases / Infecções por Acinetobacter / Acinetobacter baumannii / Epidemias Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2014 Tipo de documento: Article