Environmental contamination by carbapenem-resistant Acinetobacter baumannii: The effects of room type and cleaning methods

2019 ◽  
pp. 1-6 ◽  
Author(s):  
Anat Or Lerner ◽  
Jalal Abu-Hanna ◽  
Yehuda Carmeli ◽  
Vered Schechner
Keyword(s):  
Hydrogen Peroxide ◽  
Acinetobacter Baumannii ◽  
Environmental Contamination ◽  
Tertiary Care ◽  
Care Hospital ◽  
Single Patient ◽  
Carbapenem Resistant ◽  
Cleaning Methods ◽  
Almost All

Abstract Objective: We evaluated environmental contamination by carbapenem-resistant Acinetobacter baumannii (CRAB), the effectiveness of cleaning practices, the performance of aerosolized hydrogen-peroxide (aHP) technology, and the correlation between measures of cleaning and environmental contamination. Design: Serial testing of environmental contamination during a 7-month period. Setting: Single-patient rooms in intensive care units (ICUs) and multipatient step-up and regular rooms in internal medicine wards in a tertiary-care hospital with endemic CRAB. Methods: CRAB environmental contamination was determined semiquantitatively using sponge sampling. Results: In step-up rooms, 91% of patient units (56% of objects) were contaminated, and half of them were heavily contaminated. In regular rooms, only 21% of patient units (3% of objects) were contaminated. In ICUs, 76% of single-patient rooms (24% of objects) were contaminated. Cleaning did not reduce the number of contaminated objects or patient units in step-up rooms. After refresher training, cleaning reduced the proportion of contaminated objects by 2-fold (P = .001), but almost all patient units remained contaminated. Using aerosolized hydrogen peroxide (aHP) disinfection after discharge of a known CRAB-carrier decreased room contamination by 78%, similar to the reduction achieved by manual hypochloride cleaning. Measuring cleaning efficacy using fluorescent gel did not correlate with recovery of CRAB by sponge cultures. Conclusions: In step-up rooms, the high number of objects contaminated combined with poor efficacy of cleaning resulted in failure to eliminate CRAB in patient units. Fluorescent gel is a poor detector of CRAB contamination. The role of aHP is still unclear. However, its use in multipatient rooms is limited because it can only be used in unoccupied rooms.

Molecular detection of blaOXA-23gene and blaOXA-51 gene in carbapenem resistant strains of Acinetobacterbaumannii in patients with ventilator associated pneumonia at tertiary care hospital

2021 ◽  
Vol 71 (11) ◽  
pp. 2576-2581
Author(s):  
Saima Ishtiaq ◽  
Sidrah Saleem ◽  
Abdul Waheed ◽  
Arslan Ahmed Alvi
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Conventional Polymerase Chain Reaction ◽  
Diffusion Method ◽  
Military Hospital ◽  
Care Hospital ◽  
Acinetobacter Baumanii ◽  
Cross Sectional ◽  
Carbapenem Resistant

Objective: To evaluate carbapenem resistance and to detect blaOXA-23 and blaOXA-51 genes in carbapenem-resistant acinetobacter baumanii isolates recovered from patients having pneumonia secondry to ventilation. Methods: The cross-sectional study was conducted from July 2017 to June 2018 at the Department of Microbiology, University of Health Sciences, Lahore, Pakistan, and comprised endotracheal aspirates / tracheobroncheal lavage samples from patients irrespective of age and gender who developed pneumonia after being on the ventilator for 48 hrs at the Combined Military Hospital, and Jinnah Hospital, Lahore.  The samples were inoculated on MacConkey and blood agar and aerobically incubated at a temperature of 370C for 18-24 hours. The isolated organisms were further assessed by standard morphological, cultural and biochemical profile. Antibiotic susceptibility was done by Kirby-Bauer disc diffusion method. Carbapenem-resistant acinetobacter baumannii were checked for carbapenemase production using Modified Hodge Test. Conventional polymerase chain reaction and agarose gel electrophoreses were performed to detect blaOXA-23 and blaOXA-51 genes. Data was analysed using SPSS 17. Results: Out of 157 samples, 92(58.6%) yielded growth of bacteria, and, among them, 39(42.4%) were identified as acinetobacter baumannii. All (100%) acinetobacter baumannii cases showed resistance to carbapenem, were producing carbapenemase enzyme, and were positive for blaOXA-51 gene. The blaOXA-23 gene was amplified in 38(97.4%) isolates. Conclusion: BlaOXA-23 gene appeared to be the major cause of carbapenem resistance. Continuous...

scholarly journals Molecular Characterization of Invasive Carbapenem-Resistant Acinetobacter baumannii from a Tertiary Care Hospital in South India

2016 ◽  
Vol 5 (3) ◽  
pp. 379-387 ◽  
Author(s):  
Saranya Vijayakumar ◽  
Radha Gopi ◽  
Priya Gunasekaran ◽  
Manjurekar Bharathy ◽  
Kamini Walia ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Molecular Characterization ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Carbapenem Resistant

scholarly journals Emergence and spread of carbapenem-resistant Acinetobacter baumannii in a tertiary care hospital in Turkey

2008 ◽  
Vol 282 (2) ◽  
pp. 214-218 ◽  
Author(s):  
Meliha Meric ◽  
Murat Kasap ◽  
Gulcin Gacar ◽  
Fatma Budak ◽  
Devrim Dundar ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Carbapenem Resistant

scholarly journals Identification, Speciation and Antibiogram along with Detection of Metallo Beta-lactamase Production in Acinetobacter Isolated from Clinical Samples in a Tertiary Care Hospital

2021 ◽  
Author(s):  
N Ashwin Chitrabanu ◽  
Shrikara Mallya
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Clinical Samples ◽  
Care Hospital ◽  
Acinetobacter Species ◽  
Carbapenem Resistant ◽  
Appropriate Treatment ◽  
Sensitivity Pattern ◽  
Synergy Test

Acinetobacter species are gram negative non fermenters, which are important nosocomial pathogens involved in various outbreaks in hospitals due to widespread resistance to majority antibiotics. The aim of this study is to speciate Acinetobacter isolated from clinical samples, to assess the antibiotic sensitivity pattern and to detect the production of metallo-β-lactamase by double disc synergy test. The study was conducted in the department of microbiology, A. J Institute of Medical Sciences. All clinical samples were subjected to gram stain & cultured; the Acinetobacter isolates obtained were subjected to antibiogram. Those isolates that showed Imipenem resistant were further tested for production of metallo-β-lactamase by double disc synergy test. Out of 6625 culture positive isolates, 414 (36.1%) were identified biochemically to belong to Acinetobacter species. Of the 414 cases, 393 (94.9%) were further identified to be Acinetobacter baumannii and the remaining 21 (5.1%) to be Acinetobacter lwoffi. Acinetobacter lwoffii showed 100% sensitivity to all the drugs. Of the 393 Acinetobacter baumannii isolates 109 (27.7%) showed resistant to Imipenem. Out of these 109 isolates, 65 (59.63%) were positive for metallo-β-lactamase production by double disk synergy test. The speciation is highly demanding and laborious but it’s important to be demonstrated due to difference in the antibiotic susceptibility pattern. Carbapenem resistant Acinetobacter nosocomial strains in ICUs are detected to be more resistant to antibiotics. As shown in this study the metallo-β-lactamase producing A.baumannii isolates were 59.63% and therapeutic options were limited. Therefore early identification of metallo-β-lactamase producers is of great importance to start appropriate treatment and to control the spread.

scholarly journals Temporal Variation in Antibiotic Resistance of Acinetobacter baumannii in a Teaching Hospital in Tunisia: Correlation with Antimicrobial Consumption

2019 ◽  
Vol 13 (1) ◽  
pp. 106-111
Author(s):  
Jaidane Nadia ◽  
Mansour Wejdene ◽  
Bonnin Remy A. ◽  
Ghardallou Meriam ◽  
Chaouch Cherifa ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Antibiotic Consumption ◽  
Resistance Rate ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Local Setting ◽  
Hygiene Measures ◽  
Drastic Increase ◽  
Long Time

Background: To investigate the potential correlation between the rates of antimicrobial drug consumption and the prevalence of antimicrobial resistance among clinical Acinetobacter baumannii recovered in a tertiary care hospital in Tunisia. Methods: The microbiological and epidemiological profiles of A. baumannii infections at the Hospital Sahloul, Sousse, were investigated between 2001 to 2004 and 2012 to 2015 along with the consumption record of broad-spectrum antibiotics. Results: Our data showed that extensively drug-resistant A. baumannii (XDRAb) isolates increased from 11.2% to 30.5% between 2012 and 2015 and disseminated endemically for a long time. Furthermore, we evidenced a drastic increase of carbapenem-resistant A. baumannii isolates from 29.5% in 2001 up to 88.6% in 2015 (612/691). This rise could be paralleled with a significant increase in antibiotic consumption over the last 15 years, especially with the sharp increase in the annual consumption of imipenem (r = 0.816 and p <103). A noteworthy correlation between carbapenem use and resistance rate (r = 0.778, p<0.001) was evidenced. Conclusion: Feedback of these data to clinicians and decision-makers in the local setting was crucial to promote the rational use of antimicrobials and to raise awareness to strictly implement hygiene measures to limit the spread of these XDRAb isolates, to prevent colonization and subsequent infection.

Community-acquired in name only: A cluster of carbapenem-resistant Acinetobacter baumannii in a burn intensive care unit and beyond

2020 ◽  
Vol 41 (5) ◽  
pp. 531-538 ◽  
Author(s):  
Erica S. Shenoy ◽  
Virginia M. Pierce ◽  
Mohamad R. A. Sater ◽  
Febriana K. Pangestu ◽  
Ian C. Herriott ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Index Patient ◽  
Environmental Sampling ◽  
Snp Analysis ◽  
Environmental Isolates ◽  
Carbapenem Resistant ◽  
Single Cluster ◽  
Clinical Cases

AbstractObjective:To describe an investigation into 5 clinical cases of carbapenem-resistant Acinetobacter baumannii (CRAB).Design:Epidemiological investigation supplemented by whole-genome sequencing (WGS) of clinical and environmental isolates.Setting:A tertiary-care academic health center in Boston, Massachusetts.Patients or participants:Individuals identified with CRAB clinical infections.Methods:A detailed review of patient demographic and clinical data was conducted. Clinical isolates underwent phenotypic antimicrobial susceptibility testing and WGS. Infection control practices were evaluated, and CRAB isolates obtained through environmental sampling were assessed by WGS. Genomic relatedness was measured by single-nucleotide polymorphism (SNP) analysis.Results:Four clinical cases spanning 4 months were linked to a single index case; isolates differed by 1–7 SNPs and belonged to a single cluster. The index patient and 3 case patients were admitted to the same room prior to their development of CRAB infection, and 2 case patients were admitted to the same room within 48 hours of admission. A fourth case patient was admitted to a different unit. Environmental sampling identified highly contaminated areas, and WGS of 5 environmental isolates revealed that they were highly related to the clinical cluster.Conclusions:We report a cluster of highly resistant Acinetobacter baumannii that occurred in a burn ICU over 5 months and then spread to a separate ICU. Two case patients developed infections classified as community acquired under standard epidemiological definitions, but WGS revealed clonality, highlighting the risk of burn patients for early-onset nosocomial infections. An extensive investigation identified the role of environmental reservoirs.

scholarly journals The Role of Uniform Meropenem Usage in Acinetobacter baumannii Clone Replacement

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 127
Author(s):  
Bence Balázs ◽  
Zoltán Tóth ◽  
Fruzsina Nagy ◽  
Renátó Kovács ◽  
Hajnalka Tóth ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Care Center ◽  
Tertiary Care ◽  
Antibiotic Consumption ◽  
Resistance Level ◽  
Carbapenem Resistant ◽  
Significant Difference ◽  
Time Kill ◽  
Sequence Types

The dominant carbapenem resistant Acinetobacter baumannii harboring blaOXA-23-like carbapenemase was replaced by blaOXA-40-like carriers in a Hungarian tertiary-care center with high meropenem but relatively low imipenem use. We hypothesized that alterations in antibiotic consumption may have contributed to this switch. Our workgroup previous study examined the relation between resistance spiral and the antibiotic consumption, and the results suggest that the antibiotic usage provoked the increasing resistance in case of A. baumannii. We aimed at measuring the activity of imipenem and meropenem to compare the selection pressure exerted by the different carbapenems in time-kill assays. Strain replacement was confirmed by whole genome sequencing, core-genome multilocus sequence typing (cgMLST), and resistome analysis. Based on results of the time-kill assays, we found a significant difference between two different sequence-types (STs) in case of meropenem, but not in case of imipenem susceptibility. The newly emerged ST636 and ST492 had increased resistance level against meropenem compared to the previously dominant ST2 and ST49. On the other hand, the imipenem and colistin resistance profiles were similar. These results suggest, that the uniform meropenem usage may have contributed to A. baumannii strain replacement in our setting.

Sign in / Sign up

Export Citation Format

Share Document