National trends in hospital, long-term care and outpatient Acinetobacter baumannii resistance rates

2021 ◽  
Vol 70 (12) ◽  
Author(s):  
Haley J. Appaneal ◽  
Emily O’Neill ◽  
Vrishali V. Lopes ◽  
Kerry L. LaPlante ◽  
Aisling R. Caffrey
Keyword(s):  
Type Species ◽  
Long Term Care ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Term Care ◽  
Content Type ◽  
Link Type ◽  
Carbapenem Resistant ◽  
Resistance Rates

Introduction. Acinetobacter baumannii is a top-priority pathogen of the World Health Organization (WHO) and the Centers for Disease Control (CDC) due to antibiotic resistance. Gap Statement. Trends in A. baumannii resistance rates that include community isolates are unknown. Aim. Identify trends in A. baumannii resistance rates across the Veterans Affairs (VA) Healthcare System, including isolates from patients treated in hospitals, long-term care facilities and outpatient clinics nationally. Methodology. We included A. baumannii clinical cultures collected from VA patients from 2010 to 2018. Cultures were categorized by location: VA medical centers (VAMCs), long-term care (LTC) units [community living centers (CLCs)], or outpatient. We assessed carbapenem resistance, multidrug resistance (MDR) and extensive drug resistance (XDR). Time trends were assessed with Joinpoint regression. Results. We identified 19 376 A . baumannii cultures (53% VAMCs, 4% CLCs, 43% outpatient). Respiratory cultures were the most common source of carbapenem-resistant (43 %), multidrug-resistant (49 %) and extensively drug-resistant (21 %) isolates. Over the study period, the number of A. baumannii cultures decreased significantly in VAMCs (11.9% per year). In 2018, carbapenem resistance was seen in 28% of VAMC isolates and 36% of CLC isolates, but only 6% of outpatient isolates, while MDR was found in 31% of VAMC isolates and 36% of CLC isolates, but only 8 % of outpatient isolates. Carbapenem-resistant, multidrug-resistant and extensively drug-resistant A. baumannii isolates decreased significantly in VAMCs and outpatient clinics over time (VAMCs: by 4.9, 7.2 and 6.9%; outpatient: by 11.3, 10.5 and 10.2% per year). Resistant phenotypes remained stable in CLCs. Conclusion. In the VA nationally, the prevalence of A. baumannii is decreasing, as is resistance. Carbapenem-resistant and multidrug-resistant A. baumannii remain common in VAMCs and CLCs. The focus of infection control and antimicrobial stewardship efforts to prevent transmission of resistant A. baumannii should be in hospital and LTC settings.

scholarly journals Surveillance of Carbapenem-Resistant Klebsiella pneumoniae: Tracking Molecular Epidemiology and Outcomes through a Regional Network

2014 ◽  
Vol 58 (7) ◽  
pp. 4035-4041 ◽  
Author(s):  
David van Duin ◽  
Federico Perez ◽  
Susan D. Rudin ◽  
Eric Cober ◽  
Jennifer Hanrahan ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Long Term Care ◽  
Carbapenem Resistance ◽  
The United States ◽  
Molecular Characteristics ◽  
Regional Network ◽  
Term Care ◽  
Content Type ◽  
Carbapenem Resistant

ABSTRACTCarbapenem resistance in Gram-negative bacteria is on the rise in the United States. A regional network was established to study microbiological and genetic determinants of clinical outcomes in hospitalized patients with carbapenem-resistant (CR)Klebsiella pneumoniaein a prospective, multicenter, observational study. To this end, predefined clinical characteristics and outcomes were recorded andK. pneumoniaeisolates were analyzed for strain typing and resistance mechanism determination. In a 14-month period, 251 patients were included. While most of the patients were admitted from long-term care settings, 28% of them were admitted from home. Hospitalizations were prolonged and complicated. Nonsusceptibility to colistin and tigecycline occurred in isolates from 7 and 45% of the patients, respectively. Most of the CRK. pneumoniaeisolates belonged to repetitive extragenic palindromic PCR (rep-PCR) types A and B (both sequence type 258) and carried eitherblaKPC-2(48%) orblaKPC-3(51%). One isolate tested positive forblaNDM-1, a sentinel discovery in this region. Important differences between strain types were noted; rep-PCR type B strains were associated withblaKPC-3(odds ratio [OR], 294; 95% confidence interval [CI], 58 to 2,552;P< 0.001), gentamicin nonsusceptibility (OR, 24; 95% CI, 8.39 to 79.38;P< 0.001), amikacin susceptibility (OR, 11.0; 95% CI, 3.21 to 42.42;P< 0.001), tigecycline nonsusceptibility (OR, 5.34; 95% CI, 1.30 to 36.41;P= 0.018), a shorter length of stay (OR, 0.98; 95% CI, 0.95 to 1.00;P= 0.043), and admission from a skilled-nursing facility (OR, 3.09; 95% CI, 1.26 to 8.08;P= 0.013). Our analysis shows that (i) CRK. pneumoniaeis seen primarily in the elderly long-term care population and that (ii) regional monitoring of CRK. pneumoniaereveals insights into molecular characteristics. This work highlights the crucial role of ongoing surveillance of carbapenem resistance determinants.

scholarly journals Evaluation of Remel Spectra CRE Agar for Detection of Carbapenem-Resistant Bacteria from Rectal Swabs Obtained from Residents of a Long-Term-Care Facility

2015 ◽  
Vol 53 (9) ◽  
pp. 2823-2826 ◽  
Author(s):  
Vincent J. LaBombardi ◽  
Carl M. Urban ◽  
Barry N. Kreiswirth ◽  
Liang Chen ◽  
Giuliana Osorio ◽  
...  
Keyword(s):  
Long Term Care ◽  
Agar Plate ◽  
Care Facility ◽  
Resistant Bacteria ◽  
Term Care ◽  
Content Type ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Carbapenem Resistant

We compared the Remel Spectra CRE agar plate to CDC standard methodology for the isolation of carbapenem-resistantEnterobacteriaceae(CRE) from 300 rectal swab specimens obtained from patients residing in a long-term-care facility (LTCF). Multiplex PCR experiments were performed on isolates to identify specificKlebsiella pneumoniaecarbapenemases (KPC) and additional β-lactamases. Of the 300 patients, 72 (24%) harbored CRE and were PCR positive for KPC enzymes. The Remel Spectra CRE plates detected KPC-type CRE in isolates from 70 of 72 patients (97.2%), while the CDC method detected CRE in 56 of 72 (77.8%). CRE identification results were available in 18 h compared to 36 h for the CDC method. Remel Spectra CRE agar plates can provide useful means for a fast and reliable method for detecting KPC-type CRE and for accelerated institution of appropriate infection control precautions.

scholarly journals Emerging carbapenem-resistant Klebsiella pneumoniae sequence type 16 causing multiple outbreaks in a tertiary hospital in southern Vietnam

2021 ◽  
Author(s):  
To Nguyen Thi Nguyen ◽  
Phuong Luong Nha Nguyen ◽  
Ngan Thi Quynh Le ◽  
Lan Phu Huong Nguyen ◽  
Thuy Bich Duong ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Type Species ◽  
Carbapenem Resistance ◽  
Sequence Type ◽  
Health Concern ◽  
Environmental Isolates ◽  
Content Type ◽  
Link Type ◽  
Carbapenem Resistant

The emergence of carbapenem resistance in Klebsiella pneumoniae represents a major global public health concern. Nosocomial outbreaks caused by multidrug-resistant K. pneumoniae are commonly reported to result in high morbidity and mortality due to limited treatment options. Between October 2019 and January 2020, two concurrent high-mortality nosocomial outbreaks occurred in a referral hospital in Ho Chi Minh City, Vietnam. We performed genome sequencing and phylogenetic analysis of eight K. pneumoniae isolates from infected patients and two environmental isolates for outbreak investigation. We identified two outbreaks caused by two distinct lineages of the international sequence type (ST) 16 clone, which displayed extensive drug resistance, including resistance to carbapenem and colistin. Carbapenem-resistant ST16 outbreak strains clustered tightly with previously described ST16 K. pneumoniae from other hospitals in Vietnam, suggesting local persistence and transmission of this particular clone in this setting. We found environmental isolates from a hospital bed and blood pressure cuff that were genetically linked to an outbreak case cluster, confirming the potential of high-touch surfaces as sources for nosocomial spread of K. pneumoniae . Further, we found colistin resistance caused by disruption of the mgrB gene by an ISL3-like element, and carbapenem resistance mediated by a transferable IncF/bla OXA-181 plasmid carrying the ISL3-like element. Our study highlights the importance of coordinated efforts between clinical and molecular microbiologists and infection control teams to rapidly identify, investigate and contain nosocomial outbreaks. Routine surveillance with advanced sequencing technology should be implemented to strengthen hospital infection control and prevention measures.

scholarly journals Insights into the complete genomes of carbapenem-resistant Acinetobacter baumannii harbouring bla OXA-23, bla OXA-420 and bla NDM-1 genes using a hybrid-assembly approach

2020 ◽  
Vol 2 (8) ◽  
Author(s):  
Saranya Vijayakumar ◽  
Chand Wattal ◽  
Oberoi J.K. ◽  
Sanjay Bhattacharya ◽  
Karthick Vasudevan ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Type Species ◽  
Carbapenem Resistance ◽  
Complete Characterization ◽  
Hybrid Assembly ◽  
Content Type ◽  
Link Type ◽  
Type Iv ◽  
Carbapenem Resistant ◽  
Complete Genomes

Carbapenem resistance in Acinetobacter baumannii is due to bla OXA-23, which is endemic in India. Recently, the sporadic presence of bla OXA-58 as well as the occurrence of dual carbapenemases were observed. The mobility as well as the dissemination of these resistance genes were mainly mediated by various mobile genetic elements. The present study was aimed at characterizing the genetic arrangement of bla OXA-23, bla NDM-1 and bla OXA-58 identified in two complete genomes of carbapenem-resistant A. baumannii (CRAB). Complete genomes obtained using a hybrid-assembly approach revealed the accurate arrangement of Tn2006 with bla OXA-23, ISAba125 with bla NDM and ISAba3 with bla OXA-58. In addition, the association of IntI1 integrase with the bla CARB-2 gene and several virulence factors required for type-IV pili assembly, motility and biofilm formation have been identified. The current study provided deeper insight into the complete characterization of insertion sequences and transposons associated with the carbapenem-resistant genes using short reads of IonTorrent PGM and long reads of MinIon in A. baumannii .

Antimicrobial resistance and multilocus sequence types of Stenotrophomonas maltophilia isolated from dogs and cats in Japan

2021 ◽  
Vol 70 (4) ◽  
Author(s):  
Takae Shimizu ◽  
Yuzo Tsuyuki ◽  
Kenta Shimoike ◽  
Keita Iyori ◽  
Tadashi Miyamoto ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Type Species ◽  
Companion Animals ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Isolation Rate ◽  
Content Type ◽  
Mlst Analysis ◽  
Link Type ◽  
Sequence Types

As the representative multidrug-resistant pathogen, Stenotrophomonas maltophilia has multiple intrinsic and acquired resistances, including carbapenem resistance. In companion animals, the antimicrobial susceptibility and sequence types (STs) of S. maltophilia are not well understood due to its limited isolation rate. We investigated the antimicrobial susceptibilities and multilocus sequence types (MLSTs) of 38  S . maltophilia strains isolated from dogs and cats in Japan. Prevalence of resistance was detected for imipenem (100 %), aztreonam (94.7 %), piperacillin (65.8 %), trimethoprim–sulfamethoxazole (65.8 %), and ceftazidime (60.5 %). Rates of resistances to chloramphenicol, minocycline, and levofloxacin were low (2.6–5.3 %). MLST analysis revealed that all 38 strains were assigned to 34 STs, including 11 previously reported STs and 23 newly identified STs. Phylogenetic analysis of MLSTs enabled categorization of 13 isolates (34.2 %) into genogroup 6, which is a major genogroup of human isolates. Multinational surveillance would be needed to clarify the significance of antimicrobial-resistant S. maltophilia isolates from companion animals.

Aquabacterium soli sp. nov., a novel bacterium isolated from soil under the long-term application of bifenthrin

2021 ◽  
Vol 71 (9) ◽  
Author(s):  
Lina Sun ◽  
Wei Chen ◽  
Kaihua Huang ◽  
Weiguang Lyu ◽  
Xinhua Gao
Keyword(s):  
Type Species ◽  
Sequence Similarity ◽  
Major Fatty Acid ◽  
Rrna Gene ◽  
Aerobic Bacterium ◽  
Content Type ◽  
Link Type ◽  
Novel Bacterium ◽  
Pr China

Strain SJQ9T, an aerobic bacterium isolated from a soil sample collected in Shanghai, PR China, was characterized using a polyphasic approach. It grew optimally at pH 7.0, 30–35 °C and in the presence of 1 % (w/v) NaCl. A comparative analysis of 16S rRNA gene sequences showed that strain SJQ9T fell within the genus Aquabacterium . The closest phylogenetic relatives of strain SJQ9T were Aquabacterium citratiphilum DSM 11900T (98.6 % sequence similarity) and Aquabacterium commune DSM 11901T (96.4 %). Cells of the strain were Gram-stain-negative, motile, non-spore-forming, rod-shaped and positive for oxidase activity and negative for catalase. The chemotaxonomic properties of strain SJQ9T were consistent with those of the genus Aquabacterium : the major fatty acid was summed feature 3 (C16 : 1  ω6c and/or C16 : 1  ω7c). The isoprenoid quinone was Q-8. The major polar lipids were phosphatidylethanolamine, phosphatidylcholine, phosphatidylglycerol and diphosphatidylglycerol. The DNA G+C content was 65.7 mol%. Strain SH9T exhibited a DNA–DNA relatedness level of 34±2 % with A. citratiphilum DSM 11900T and 28±3 % with A. commune DSM 11901T. Based on the obtained data, strain SJQ9T represents a novel species of the genus Aquabacterium , for which the name Aquabacterium soli sp. nov. is proposed. The type strain is SJQ9T (=JCM 33106T=CCTCC AB 2018284T).

Low prevalence of colonization with multidrug-resistant gram-negative bacteria in long-term care facilities in Graz, Austria

2018 ◽  
Vol 46 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Eva Leitner ◽  
Elisabeth Zechner ◽  
Elisabeth Ullrich ◽  
Gernot Zarfel ◽  
Josefa Luxner ◽  
...  
Keyword(s):  
Long Term Care ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Term Care ◽  
Gram Negative ◽  
Care Facilities ◽  
Low Prevalence
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