Abstract
BackgroundColistin-resistant/carbapenem-resistant Acinetobacter baumannii is a significant challenge for antibiotic treatment and infection control policies. Since 2012, in Central Greece an increase of colistin/pan- resistant A. baumannii has occurred, indicating the need for further analysis.MethodsA total of 86 colistin-resistant/carbapenem-resistant out of 1228 A. baumannii clinical isolates, consecutively collected between 2012 and 2014 in a tertiary Greek hospital of Central Greece, as well as one environmental isolate from surveillance cultures were studied. Molecular typing and mechanisms of resistance to colistin and to carbapenems were assessed, whereas, epidemiological and clinical data of the patients were reviewed.ResultsDuring the study period, the rate of colistin resistance gradually increased and reached 21.1 % in 2014. All colistin-resistant/carbapenem-resistant A. baumannii belonged to 3LST ST101 clone that corresponds to the international clonal lineage II. Carbapenem resistance was associated with the presence of blaoxa-23-like, while resistance to colistin probably correlated with G54E and R109H amino acid substitutions in PmrA and PmrC, respectively.ConclusionsEpidemiological data of the patients indicated that the first detection of colistin-resistant/carbapenem-resistant ST101 clone in the University Hospital of Larissa (UHL) was associated with a patient who previously had received colistin, while, the movement of the infected patients into the hospital probably resulted to its spread.
Highlights
Colistin-resistant/carbapenem-resistant Acinetobacter baumannii is a significant challenge for antibiotic treatment and infection control policies
Acinetobacter baumannii isolates are recognized as major nosocomial pathogens; their ability to survive in dry conditions and their resistance to disinfectants allow these microorganisms to survive in the hospital environment [1, 2]
Identification and susceptibility testing From January 2012 to December 2014, a total of 1228 consecutive A. baumannii isolates (494 in 2012, 407 in 2013 and 327 in 2014) were recovered from clinical samples taken as part of standard care of an equal number of individual patients admitted to the University Hospital of Larissa, Thessaly (Central Greece)
Summary
Colistin-resistant/carbapenem-resistant Acinetobacter baumannii is a significant challenge for antibiotic treatment and infection control policies. In the University Hospital of Larissa (UHL), that is the main tertiary hospital of Thessaly (Central Greece) serving a region of 1,200,000 habitants, enhanced systemic surveillance resulted to a decrease of carbapenem-resistant A. baumannii between 2012 and 2014 (2.6 cases in 2012 vs 2.1 cases in 2013 and 1.9 cases in 2014 respectively, per 1,000 patient-days). Despite this encouraging record, increased rate of colistin-resistance among A. baumannii was observed. Aim of this study was to determine the molecular characteristics of the isolates (mechanisms of resistance and molecular typing) and to describe the epidemiological traits
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