scholarly journals Using comparative genomics to understand molecular features of carbapenem-resistant Acinetobacter baumannii from South Korea causing invasive infections and their clinical implications

PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0229416
Author(s):  
Min Hyung Kim ◽  
Haeyoung Jeong ◽  
Young Mi Sim ◽  
Soohyun Lee ◽  
Dongeun Yong ◽  
...  
Keyword(s):  
Comparative Genomics ◽  
South Korea ◽  
Acinetobacter Baumannii ◽  
Clinical Implications ◽  
Molecular Features ◽  
Carbapenem Resistant ◽  
Invasive Infections

scholarly journals Comparison of 30- and 90-Day Mortality Rates in Patients with Cultures Positive for Carbapenem-resistant Enterobacteriaceae and Acinetobacter in Atlanta, 2011–2015

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S44-S44
Author(s):  
Mary Elizabeth Sexton ◽  
Chris Bower ◽  
Stephen Sukumaran ◽  
Jesse T Jacob
Keyword(s):  
Survival Analysis ◽  
Acinetobacter Baumannii ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Rank Test ◽  
Invasive Infection ◽  
Emerging Infections ◽  
Carbapenem Resistant ◽  
Invasive Infections ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (CRAB) pose a threat to public health, but comparisons of disease burden are limited. We compared survival in patients following cultures positive for CRE or CRAB. Methods The Georgia Emerging Infections Program performs active population-based and laboratory-based surveillance for CRE and CRAB in metropolitan Atlanta, GA. Using standard CDC definitions, we included patients who had incident carbapenem-nonsusceptible E. coli, Klebsiella spp., Enterobacter spp., or Acinetobacter baumannii isolated from urine only (noninvasive infection) or a sterile site (invasive infection) between 8/2011 and 12/2015. Death dates, verified by Georgia Vital Statistics records, were used to calculate 30- and 90-day mortality rates. We used the chi-square test for mortality rates and the log-rank test for survival analysis to 90 days to compare patients with invasive CRAB, noninvasive CRAB, invasive CRE, and noninvasive CRE. Results There were 535 patients with CRE (87 invasive, 448 noninvasive) and 279 (78 invasive, 201 noninvasive) with CRAB. Nearly all patients with CRE and CRAB had healthcare exposures (97.2% vs. 100%) and most were immunosuppressed (62.6% vs. 56.3%). Both 30-day (24.4% vs. 18.3%, p = 0.04) and 90-day (37.6% vs. 30.5%, p = 0.04) mortality were higher in patients with CRAB than CRE. Patients with invasive infections were more likely to die at 90 days than those with noninvasive infections (53.3% vs. 38.4%, p < 0.0001). Overall mortality rates for invasive infection were similar between CRAB and CRE at 30 (44.9% vs. 34.5% p = 0.2) and 90 days (59.0% vs. 48.3%, p = 0.2). Using survival analysis at 90 days, invasive CRAB had the worst outcomes, followed by invasive CRE, noninvasive CRAB and noninvasive CRE 
(p < 0.0001, see Figure). Conclusion Ninety -day mortality for invasive infections with CRE and CRAB was ~50%, and patients with CRAB had lower survival than those with CRE, suggesting that prevention efforts may need to prioritize CRAB as highly as CRE in facilities with endemic CRAB. With the high proportion of healthcare exposures and immunosuppression, these infections may signify poor prognosis or directly contribute to mortality. Disclosures All authors: No reported disclosures.

scholarly journals Variations of AbaR4-Type Resistance Islands in Acinetobacter baumannii Isolates from South Korea

2012 ◽  
Vol 56 (8) ◽  
pp. 4544-4547 ◽  
Author(s):  
Dae Hun Kim ◽  
Young Kyoung Park ◽  
Kwan Soo Ko
Keyword(s):  
South Korea ◽  
Acinetobacter Baumannii ◽  
Content Type ◽  
Carbapenem Resistant

ABSTRACTAbaR resistance islands inAcinetobacter baumanniiisolates from South Korea were investigated. AbaR4-type resistance islands, includingblaOXA-23-containing Tn2006, interrupted thecomMgene inA. baumanniiST75 isolates. However, Tn2006was not identified within AbaR resistance islands of ST138 isolates, although theblaOXA-23gene was detected in them. The similar structures of resistance islands suggest that most carbapenem-resistantA. baumanniiisolates in South Korea have originated from the same ancestor with a globally disseminated clone, GC II.

Characteristics of carbapenem-resistant Acinetobacter spp. other than Acinetobacter baumannii in South Korea

2012 ◽  
Vol 39 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Young Kyoung Park ◽  
Sook-In Jung ◽  
Kyong-Hwa Park ◽  
Su Hwan Kim ◽  
Kwan Soo Ko
Keyword(s):  
South Korea ◽  
Acinetobacter Baumannii ◽  
Carbapenem Resistant ◽  
Acinetobacter Spp

scholarly journals 154. comparative Genomics Reveals Extra-hospital Transmission Networks of Carbapenem-resistant acinetobacter Baumannii sustained over Multiple Years in a US Midwest City

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S206-S206
Author(s):  
Juan J Calix ◽  
Maria Claudia Stockler de Almeida ◽  
Robert Potter ◽  
Meghan Wallace ◽  
Carey-Ann Burnham ◽  
...  
Keyword(s):  
Comparative Genomics ◽  
Acinetobacter Baumannii ◽  
Chart Review ◽  
Genetic Relatedness ◽  
Transmission Dynamics ◽  
Transmission Networks ◽  
Hospital Outbreak ◽  
Carbapenem Resistant ◽  
Hospital Environments ◽  
Hospital Transmission

Abstract Background The transmission dynamics of Acinetobacter baumannii (Ab) outside the setting of hospital outbreaks is underinvestigated. The BJC Healthcare System in St. Louis, MO has not experienced an Ab hospital outbreak since 2012. Despite this, nearly 60% of all BJC Ab isolates are carbapenem-resistant Ab (CrAb). Methods We acquired whole genome sequences (WGSs) of 110 Ab isolates identified in five BJC hospitals from July 2017 to May 2019. We performed multilocus sequence typing, core genome alignment and pairwise average nucleotide identity analysis to compare WGSs from BJC isolates and GenBank-available WGSs of Ab isolates from other US hospitals. Further epidemiologic characterization was performed using BJC electronic medical records and detailed chart review. Results Though the majority of CrAb isolates in other US studies belonged to globally-prevalent sequence type 2 (ST2 [Pasteur scheme]), 62% and 26% of BJC CrAb index isolates belonged to the unrelated ST499 and ST406, respectively. BJC ST499 and ST406 isolates were phylogenetically distinct compared to corresponding isolates from other US hospitals. Under the assumption that Ab transmission occurs primarily through nosocomial spread, we expected BJC isolates from the same hospital and timespan to share the highest degree of homogeneity. However, geotemporal proximity between ST499 or ST406 BJC isolates was a poor predictor of their genetic relatedness, according to multiple comparative methods. Review of patient metadata did not identify epidemiological links between BJC isolates within phylogenetic subgroups. Conclusion We combined comparative genomics and detailed clinical chart review to characterize the transmission dynamics of two emerging US CrAb sequence types, ST499 and ST406. Though these highly homogeneous Ab isolates were identified over two years in multiple BJC hospitals, we found no evidence of robust intra-hospital transmission networks. Instead, it appears that these CrAb isolates independently emerged from yet-to-be-identified regional, extra-hospital Ab populations. To neutralize the threat of drug-resistant infections in the US, it is essential to identify, characterize and disrupt emergent CrAb transmission networks that exist outside of hospital environments. Disclosures All Authors: No reported disclosures

Decreased carO gene expression and OXA-type carbapenemases among extensively drug-resistant Acinetobacter baumannii strains isolated from burn patients in Tehran, Iran

2020 ◽  
Author(s):  
Elham Abbasi ◽  
Hossein Goudarzi ◽  
Ali Hashemi ◽  
Alireza Salimi Chirani ◽  
Abdollah Ardebili ◽  
...  
Keyword(s):  
Gene Expression ◽  
Acinetobacter Baumannii ◽  
High Rate ◽  
Burn Patients ◽  
Drug Resistant ◽  
Disc Diffusion ◽  
Carbapenem Resistant ◽  
Extensively Drug Resistant ◽  
Sds Page ◽  
Extensively Drug Resistance

AbstractA major challenge in the treatment of infections has been the rise of extensively drug resistance (XDR) and multidrug resistance (MDR) in Acinetobacter baumannii. The goals of this study were to determine the pattern of antimicrobial susceptibility, blaOXA and carO genes among burn-isolated A. baumannii strains. In this study, 100 A. baumannii strains were isolated from burn patients and their susceptibilities to different antibiotics were determined using disc diffusion testing and broth microdilution. Presence of carO gene and OXA-type carbapenemase genes was tested by PCR and sequencing. SDS-PAGE was done to survey CarO porin and the expression level of carO gene was evaluated by Real-Time PCR. A high rate of resistance to meropenem (98%), imipenem (98%) and doripenem (98%) was detected. All tested A. baumannii strains were susceptible to colistin. The results indicated that 84.9% were XDR and 97.9% of strains were MDR. In addition, all strains bore blaOXA-51 like and blaOXA-23 like and carO genes. Nonetheless, blaOXA-58 like and blaOXA-24 like genes were harbored by 0 percent and 76 percent of strains, respectively. The relative expression levels of the carO gene ranged from 0.06 to 35.01 fold lower than that of carbapenem-susceptible A. baumannii ATCC19606 and SDS – PAGE analysis of the outer membrane protein showed that all 100 isolates produced CarO. The results of current study revealed prevalence of blaOXA genes and changes in carO gene expression in carbapenem resistant A.baumannii.

PREVALENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS (ICUS) OF JPMC, KARACHI

2019 ◽  
Author(s):  
Rabia Arshad
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Carbapenem Resistance ◽  
Chronic Obstructive ◽  
Surgical Intensive Care ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
Increased Risk

Background: Antimicrobial resistance is one of the research priorities of health organizations due to increased risk of morbidity and mortality. Outbreaks of nosocomial infections caused by carbapenem-resistant Acinetobacter Baumannii (CRAB) strains are at rise worldwide. Antimicrobial resistance to carbapenems reduces clinical therapeutic choices and frequently led to treatment failure. The aim of our study was to determine the prevalence of carbapenem resistance in A. baumannii isolated from patients in intensive care units (ICUs). Methods: This cross-sectional study was carried out in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2016 to November 2017. Total 63 non-repetitive A. baumannii were collected from the patients’ specimens, admitted to medical and surgical ICUs and wards of JPMC, Karachi. The bacterial isolates were processed according to standard microbiological procedures to observe for carbapenem resistance. SPSS 21 was used for data analysis. Results: Out of the 63 patients, 40 (63.5%) were male. The age of the patient ranged from 15-85 year, with average of 43 year. 34.9% patients had been hospitalized for 3 days. Chronic obstructive pulmonary disease was present in highest number with average of 58.7% for morbidity. Number of patients on mechanical ventilation was highest (65.1%). All isolates were susceptible to colistin. The resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, amikacin, piperacillin- tazobactam and meropenem was 82.5%, 81%, 100%, 87.3%, 82.5% and 82% respectively. Out of 82% CRAB, 77% were obtained from ICUs. Conclusion: This study has revealed the high rate of carbapenem resistance in A. baumannii isolates in ICUs thus leaving behind limited therapeutic options.

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