Universität zu Köln

Nowak, J., Zander, E., Stefanik, D., Higgins, P. G., Roca, I., Vila, J., McConnell, M. J., Cisneros, J. M. and Seifert, H. (2017). High incidence of pandrug-resistant Acinetobacter baumannii isolates collected from patients with ventilator-associated pneumonia in Greece, Italy and Spain as part of the MagicBullet clinical trial. J. Antimicrob. Chemother., 72 (12). S. 3277 - 3283. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Objectives: To investigate the molecular epidemiology, antimicrobial susceptibility and carbapenem resistance determinants of Acinetobacter baumannii isolates from respiratory tract samples of patients diagnosed with ventilator-associated pneumonia (VAP) who were enrolled in the MagicBullet clinical trial. Methods: A. baumannii isolates were prospectively cultured from respiratory tract samples from 65 patients from 15 hospitals in Greece, Italy and Spain. Susceptibility testing was performed by broth microdilution. Carbapenem resistance determinants were identified by PCR and sequencing. Molecular epidemiology was investigated using rep-PCR (DiversiLab) and international clones (IC) were identified using our in-house database. Results: Of 65 isolates, all but two isolates (97%) were resistant to imipenem and these were always associated with an acquired carbapenemase, OXA-23 (80%), OXA-40 (4.6%), OXA-58 (1.5%) or OXA-23/58 (1.5%). Resistance to colistin was 47.7%. Twenty-two isolates were XDR, and 20 isolates were pandrug-resistant (PDR). The majority of isolates clustered with IC2 (n=54) with one major subtype comprising isolates from 12 hospitals in the three countries, which included 19 XDR and 16 PDR isolates. Conclusions: Carbapenem resistance rates were very high in A. baumannii recovered from patients with VAP. Almost half of the isolates were colistin resistant, and 42 (64.6%) isolates were XDR or PDR. Rep-PCR confirmed IC2 is the predominant clonal lineage in Europe and suggests the presence of an epidemic XDR/PDR A. baumannii clone that has spread in Greece, Italy and Spain. These data highlight the difficulty in empirical treatment of patients with A. baumannii VAP in centres with a high prevalence of carbapenem-resistant A. baumannii.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nowak, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zander, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stefanik, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Higgins, P. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Roca, I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vila, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED McConnell, M. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cisneros, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-210188
DOI:	10.1093/jac/dkx322
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	72
Number:	12
Page Range:	S. 3277 - 3283
Date:	2017
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COLISTIN; IMIPENEM; DISSEMINATION; CARBAPENEMASE; MANAGEMENT; INFECTION; EFFICACY; GERMANY; OXA-23; IMPACT Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21018