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Outbreak of Infection With Acinetobacter Strain RUH 1139 in an Intensive Care Unit

Published online by Cambridge University Press:  21 June 2016

Elsa Zuleima Salazar De Vegas ,
Beatriz Nieves ,
Maria Araque ,
Elsa Velasco ,
Joaquim Ruíz  and
Jordi Vila
Elsa Zuleima Salazar De Vegas
Affiliation:
Laboratorio de Bacteriología “Dr. Roberto Gabaldón”, Departamento de Microbiología y Parasitología, Facultad de Farmacia y Bioanálisis, Universidad de Los Andes, Mérida, Venezuela
Beatriz Nieves
Affiliation:
Laboratorio de Bacteriología “Dr. Roberto Gabaldón”, Departamento de Microbiología y Parasitología, Facultad de Farmacia y Bioanálisis, Universidad de Los Andes, Mérida, Venezuela
Maria Araque
Affiliation:
Laboratorio de Bacteriología “Dr. Roberto Gabaldón”, Departamento de Microbiología y Parasitología, Facultad de Farmacia y Bioanálisis, Universidad de Los Andes, Mérida, Venezuela
Elsa Velasco
Affiliation:
Laboratorio de Bacteriología “Dr. Roberto Gabaldón”, Departamento de Microbiología y Parasitología, Facultad de Farmacia y Bioanálisis, Universidad de Los Andes, Mérida, Venezuela
Joaquim Ruíz
Affiliation:
Centro de Salud Internacional, IDIBAPS, Hospital Clínic, Villarroel, Barcelona, Spain
Jordi Vila*
Affiliation:
Servei de Microbiología, IDIBAPS, Hospital Clinic, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
*
Servei de Microbiologia, IDIBAPS, Facultat de Medicina, Hospital Clínic, Villarroel 170, 08036-Barcelona, Spain ([email protected])
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Abstract

Objective.

To investigate a nosocomial outbreak of infection with Acinetobacter strain RUH 1139, in the unit of high neonatal risk at University Hospital of The Andes (Mérida, Venezuela).

Methods.

Twenty-eight Acinetobacter strains were detected by biochemical testing and further identified to the species level by examination of the gene encoding 16S ribosomal DNA, using restriction analysis and gene sequencing. The epidemiological relationship between the strains was established by means of repetitive extragenic palindromic polymerase chain reaction (REP-PCR) and pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibilities were determined by disk diffusion.

Results.

The spread of an epidemic strain of Acinetobacter RUH 1139 among 16 patients over a period of 3 months was demonstrated using antimicrobial susceptibility testing, PFGE, and REP-PCR. The epidemic strain was also isolated in 2 of the sampled parenteral nutrition solutions. All the patients involved in the infection outbreak had received parenteral solution. Moreover, strains of Acinetobacter RUH 1139 with another PFGE pattern and of A. baumannii were sporadically isolated before and during the outbreak.

Conclusion.

This is the first description of an outbreak of infection with this genospecies of Acinetobacter in which parenteral nutrition solution was potentially the infection source.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 4 , April 2006 , pp. 397 - 403
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1.Bergogne-Bérézin, E, Towner, K. Acinetobacter spp as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Microbiol Rev 1996; 9:148–165.CrossRefGoogle ScholarPubMed
2.Carr, E.L, Kämpfer, P, Patel, BKC, Gürtler, V, Seviour, RJ. Seven novel species of Acinetobacter isolated from activated sludge. Int J Syst Evol Microbiol 2003; 53:953–963.CrossRefGoogle ScholarPubMed
3.Di Cello, F, Pepi, M, Baldi, F, Fani, R. Molecular characterization of an nalkane-degrading bacterial community and identification of a new species, Acinetobacter venetianus. Res Microbiol 1997; 148:237–249.CrossRefGoogle ScholarPubMed
4.Nemec, A, De Baere, T, Tjernberg, I, Vaneechoutte, M, van der Reijden, TJ, Dijkshoorn, L. Acinetobacter ursingii sp. nov. and Acinetobacter schindleri sp. nov., isolated from human clinical specimens. Int J Syst Evol Microbiol 2001; 51:1891–1899.CrossRefGoogle ScholarPubMed
5.Nemec, A, Dijkshoorn, L, Cleenwerck, I, De Baere, T, Janssens, D, van der Reijden, TJ, Jezek, P, Vaneechoutte, M. Acinetobacter parvus sp. nov., a small-colony–forming species isolated from human clinical specimens. Int J Syst Evol Microbiol 2003; 53:1563–1567.CrossRefGoogle Scholar
6.Bou, G, Cerveró, G, Domínguez, A, Quereda, C, Martínez-Beltrán, J. Characterization of a nosocomial outbreak caused by a multiresistant Acinetobacter baumannii strain with a carbapenem-hydrolyzing enzyme: high-level carbapenem resistance in A. baumannii is not due solely to the presence of β-lactamases. J Clin Microbiol 2000; 38:3299–3305.CrossRefGoogle Scholar
7.Struelens, MJ, Carlier, E, Maes, N, Serruys, E, Quint, WG, van Belkum, A. Nosocomial colonization and infection with multiresistant Acinetobacter baumannii: outbreak delineation using DNA macrorestriction analysis and PCR fingerprinting. J Hosp Infect 1993; 25:15–32.CrossRefGoogle ScholarPubMed
8.Tankovic, J, Legrand, P, De Gatines, G, Chemineau, V, Brun-Buisson, C, Duval, J. Characterization of a hospital outbreak of imipenem-resistant Acinetobacter baumannii by phenotypic and genotypic typing methods. J Clin Microbiol 1994; 32:2677–2681.CrossRefGoogle ScholarPubMed
9.Stone, JW, Das, BC. Investigation of an outbreak of infection with Acinetobacter calcoaceticus in a special baby care unit. J Hosp Infect 1985; 6:42–48.CrossRefGoogle Scholar
10.Dijkshoorn, L, Nemec, A, Vaneechoutte, M, and ENEMTI. Identification of Acinetobacter genomic species by means of amplified rDNA restriction analysis (ARDRA). Available at: http://allserv.rug.ac.be/~mvaneech/ARDRA/Acinetobacter.html. Accessed June 2003.Google Scholar
11.Horrevorts, A, Bergman, K, Koelée, L, Breuker, I, Tjernberg, I, Dijkshoorn, L. Clinical and epidemiological Investigations of Acinetobacter genomospecies 3 in a neonatal intensive care unit. J Clin Microbiol 1995; 33:1567–1572.CrossRefGoogle Scholar
12.Dijkshoorn, L, Aucken, H, Gerner-Smidt, P, et al. Comparison of outbreak and nonoutbreak Acinetobacter baumannii strains by genotypic and phenotypic methods. J Clin Microbiol 1996; 34:1519–1525.CrossRefGoogle ScholarPubMed
13.Marcos, MA, Jiménez de Anta, MT, Vila, J. Correlation of six methods for typing nosocomial isolates of Acinetobacter baumannii. J Med Microbiol 1995; 42:328–335.CrossRefGoogle ScholarPubMed
14.Quelle, LS, Catalano, M. Efficacy of two DNA fingerprinting methods for typing Acinetobacter baumannii isolates. Diagn Microbiol Infect Dis 2001; 39:215–223.CrossRefGoogle ScholarPubMed
15.Reboli, AC, Houston, ED, Monteforte, JS, Wood, CA, Hamill, RJ. Discrimination of epidemic and sporadic isolates of Acinetobacter baumannii by repetitive element PCR–mediated DNA fingerprinting. J Clin Microbiol 1994; 32:2635–2640.CrossRefGoogle ScholarPubMed
16.Vila, J, Marcos, A, Llovet, T, Coll, P, Jiménez de Anta, T. A comparative study of ribotyping and arbitrarily primed polymerase chain reaction for investigation of hospital outbreaks of Acinetobacter baumannii infection. J Med Microbiol 1994; 41:244–249.CrossRefGoogle ScholarPubMed
17.Bouvet, P, Grimont, P. Taxonomy of the genus Acinetobacter with the recognition of Acinetobacter baumannii sp. nov., Acinetobacter haemolyticus sp. nov., Acinetobacter johnsonii sp. nov. and Acinetobacter junii sp. nov. and emended descriptions of Acinetobacter calcoaceticus and Acinetobacter lwoffii. Int J Syst Bacteriol 1986; 36:228–240.CrossRefGoogle Scholar
18.Nemec, A, Dijkshoorn, L, Jezek, P. Recognition of two novel phenons of the genus Acinetobacter among non–glucose-acidifying isolates from human specimens. J Clin Microbiol 2000; 38:3937–3941.CrossRefGoogle ScholarPubMed
19.Liu, PY, Wu, W. Use of different PCR-based DNA fingerprinting techniques and pulsed-field gel electrophoresis to investigate the epidemiology of Acinetobacter calcoaceticus–Acinetobacter baumannii complex. Diagn Microbiol Infect Dis 1997; 28:19–28.CrossRefGoogle Scholar
20.Gautom, RK. Rapid pulsed-field gel electrophoresis protocol for typing of Escherichia coli O157:H7 and other Gram-negative organisms in one day. J Clin Microbiol 1997; 35:2977–2980.CrossRefGoogle Scholar
21.Tenover, FC, Arbeit, RD, Goering, RV, Mickelsen, PA, Murray, PA, Persing, DH, Swaminathan, B. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995; 33:2233–2239.CrossRefGoogle ScholarPubMed
22.Giamarellos-Bourboulis, EJ, Greka, P, Giamarellou, H. In vitro activity of rifampin (R), of colimicin (C), of meropenem (M), and trovafloxacin (T) on nosocomial Acinetobacter spp. isolates. Rev Esp Quimioterap 2000; 13:88.Google Scholar
23.Marcos, MA. Acinetobacter baumanni. 2003. Available at: http://www.seimc.org/control/revi.Bacte/acinetobacter.htm. Accessed September 2003.Google Scholar
24.Núñez, M, Martínez, M, Bru, M, Simarro, E, Segovia, M, Ruiz, J. Appearance of resistance to meropenem during the treatment of a patient with meningitis by Acinetobacter. Scant J Infect Dis 1998; 30:421–423.Google ScholarPubMed
25.Pandey, A, Kapil, A, Sood, S, Goel, V, Das, B, Seth, P. In vitro activities of ampicilin-sulbactam and amoxicilin-clavulanic acid against Acinetobacter baumannii. J Clin Microbiol 1998; 36:3415–3416.CrossRefGoogle Scholar
26.Chu, YW, Leung, CM, Houang, ETS, et al. Skin carriage of Acinetobacters in Hong Kong. J Clin Microbiol 1999; 37:2962–2967.CrossRefGoogle ScholarPubMed
27.Gerner-Smidt, P. Acinetobacter: epidemiological and taxonomic aspects. APMIS 1994; 47(Suppl):1–41.Google ScholarPubMed
28.Kämpfer, P, Tjernberg, I, Ursing, J. Numerical classification and identification of Acinetobacter genomic species. J Appl Bacteriol 1993; 75:259–268.CrossRefGoogle ScholarPubMed
29.Mcdonald, LC, Walker, M, Carson, L, et al. Outbreak of Acinetobacter spp bloodstream infections in a nursery associated with contaminated aerosols and air conditioners. Pediatr Infect Dis J 1998; 17:716–722.CrossRefGoogle Scholar
30.Martínez-Pellús, A, Ruíz, J, Jaime, J, Simarro, E, Fernández, A. Incidencia de colonización e infección por Acinetobacter baumannii en una UCI con situación de endemia: análisis de factores de riesgo mediante un estudio de vigilancia. Enferm Infecc Microbiol Clin 2002; 20:194–199.CrossRefGoogle Scholar
31.Yaman, A, Aksungur, P. Antibiotic resistance in Acinetobacter species in nosocomial and outpatient infections. Ann Med Sci 1998; 7:31–34.Google Scholar
32.Dijkshoorn, L, Aucken, HM, Gerner-Smidt, P, Kaufmann, ME, Ursing, J, Pitt, TL. Correlation of typing methods for Acinetobacter isolates from hospital outbreaks. J Clin Microbiol 1993; 31:702–705.CrossRefGoogle ScholarPubMed
33.Comegna, M, Guzmán, F, Carmona, O, Molina, M, and Grupo colaborativo del Grupo Venezolano de Resistencia Bacteriana. Resistencia bacteriana a los antimicrobianos en Venezuela-Nuevos hallazgos. Boletn S.V.M. 2000; 20:58–66.Google Scholar
34.Harris, B, Martínez, G, Rincón, G, Castellano, M, Galué, N. Evaluación de la susceptibilidad al imipenem y otros β-lactámicos de genoespecies de Acinetobacter. In: Program and abstracts of the VII Congreso Venezolano de Microbiología “Elsa La Corte Anselmi”, Maracaibo, Venezuela, 2000:56.Google Scholar
35.Harris, B, Martínez, G, Rincón, G, Galué, N.. Resistencia al cefepime y cefalosporinas de tercera generación de genospecies de Acinetobacter aisladas durante los años 1996-2000. In: Program and abstracts of the VII Congreso Venezolano de Microbiología “Elsa La Corte Anselmi”, Maracaibo, Venezuela, 2000:55.Google Scholar
36.Pérez-Sánchez, L, López-Hernández, S, Alarcón, T, de las Cuevas, MC, López-Brea, M. Evaluation of broth microdilution Microscan Walk Away system in Acinetobacter baumannii clinical isolates. Rev Esp Quimioterap 2000; 13:110.Google Scholar
37.Suh, B, Shapiro, T, Jones, R, Satishchandran, V, Truant, A. In vitro activity of β-lactamase inhibitors against clinical isolates of Acinetobacter spp. Diagn Microbiol Infect Dis 1995; 21:111–114.CrossRefGoogle Scholar
38.Vila, J, Marcos, A, Marco, F, et al. In vitro antimicrobial production of β-lactamases, aminoglycoside modifying enzymes, and chloramphenicol acetyltransferase by and susceptibility of clinical isolates of Acinetobacter baumannii. Antimicrob Agents Chemother 1993; 37:138–141.CrossRefGoogle ScholarPubMed
39.Biendo, M, Laurans, G, Lefebvre, FJ, Daoudi, F, Eb, F. Epidemiological study of an Acinetobacter baumannii outbreak by using a combination of antibiotyping and ribotyping. J Clin Microbiol 1999; 37:2170–2175.CrossRefGoogle ScholarPubMed
40.Crombach, WJ, Dijkshoorn, L, van Noort-Klaassen, M, Niessen, J, van Knippenberg-Gordebeke, G. Control of an epidemic spread of multiresistant Acinetobacter calcoaceticus in a hospital. Intensive Care Med 1989; 15:166–170.CrossRefGoogle ScholarPubMed
41.Gräser, Y, Klare, I, Halle, E, Gantenberg, R, Buchholz, P, Jacobi, HD, Presber, W, Schönian, G. Epidemiological study of an Acinetobacter baumannii outbreak by using polymerase chain reaction fingerprinting. J Clin Microbiol 1993; 31:2417–2420.CrossRefGoogle ScholarPubMed
42.López, S, López-Brea, M. ¿Qué debemos saber acerca de las infecciones por Acinetobacter baumannii? Enferm Infecc Microbiol Clin 2000; 18:153–156.Google Scholar
43.Salavert, M. Acinetobacter: ¿Multiresistencia o supervivencia? Rev Esp Quimioter 1999; 12:290–293.Google Scholar