High endemic levels of multidrug-resistant Acinetobacter baumannii among hospitals in southern Brazil

• Published in: American journal of infection control 2012-03, Vol.40 (2), p.108-112
• Main Authors: Martins, Andreza F., MSc, PhD, Kuchenbecker, Ricardo S., MSc, PhD, MD, Pilger, Kátia O., MSc, Pagano, Mariana, Barth, Afonso L., MSc, PhD
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii - drug effects; Acinetobacter baumannii - genetics; Acinetobacter Infections - drug therapy; Acinetobacter Infections - epidemiology; Acinetobacter Infections - microbiology; Bacterial infections; Bacterial Typing Techniques; beta-Lactamases - genetics; beta-Lactamases - isolation & purification; Biological and medical sciences; Brazil - epidemiology; Clonal dissemination; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Disease control; Disease Outbreaks - prevention & control; Drug resistance; Drug Resistance, Multiple, Bacterial; Electrophoresis, Gel, Pulsed-Field; Epidemics; Epidemiology. Vaccinations; General aspects; Genes, Bacterial; Gram-negative bacteria; Health care–acquired infection; Hospitals; Human infectious diseases. Experimental studies and models; Humans; Infection Control; Infectious Disease; Infectious diseases; Medical sciences; Molecular typing; Nosocomial infections; Phylogeny; Polymerase Chain Reaction
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2011.03.010

Background Most published data on multidrug-resistant Acinetobacter baumanii (MDR Ab) are derived from outbreaks. We report incidence trends on health care–acquired infections due to MDR Ab over a 12-month period in the city of Porto Alegre in southern Brazil. Methods Clinical and epidemiologic data were obtained from the local health care information system of the municipal health department. Polymerase chain reaction was used to detect the presence of the genes blaOXA-23-like , blaOXA-24-like , blaOXA-51 , and blaOXA-58 , and repetitive sequence-based polymerase chain reaction and pulsed-field gel electrophoresis were performed for molecular typing. Results The highest rate of infection (9.0/1,000 inpatient-days) was identified in a trauma hospital. The gene blaOXA-23-like was identified in 99.0% of MDR Ab isolates. Eight main clonal groups were identified by molecular typing, and 3 of these were found in all hospitals. Conclusion The presence of 3 clones in all hospitals demonstrates the ability of MDR Ab to spread among hospitals. Moreover, the occurrence of one particular clone (clone 4) throughout the study period suggests its increased ability to cause outbreaks and to remain in the environment. The monitoring of epidemic strains by molecular methods is of paramount importance to prevent or reduce the spread of MDR Ab.