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Antibiotic Resistance Is a Major Risk Factor for Epidemic Behavior of Acinetobacter baumannii

Published online by Cambridge University Press:  02 January 2015

Johannes G.M. Koeleman ,
Madelon W. van der Bijl ,
Jeroen Stoof ,
Christina M.J.E. Vandenbroucke-Grauls  and
Paul H.M. Savelkoul
Johannes G.M. Koeleman
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Madelon W. van der Bijl
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Jeroen Stoof
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Christina M.J.E. Vandenbroucke-Grauls
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Paul H.M. Savelkoul*
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
*
Department of Medical Microbiology and Infection Control, Vrije Universiteit Medical Center, Postbox 7057, 1007 MB Amsterdam, The Netherlands
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Abstract

Objective:

To study the presence of bacterial factors in clinical isolates of Acinetobacter species in order to identify markers of epidemic potential.

Design:

Case-control study.

Methods:

Forty-six isolates of Acinetobacter species, including 23 epidemic and 23 sporadic strains from different outbreaks in nine European countries, were compared for the presence of the following factors: hemagglutination, presence of capsules and fimbriae, binding to salivary mucins, resistance to drying, and antibiogram typing. Genotyping of all strains was performed by amplified fragment-length polymorphism (AFLP).

Results:

All outbreak strains except two (91%) were identified as Acinetobacter baumannii. Binding to salivary mucins and resistance to antibiotics were significantly associated with epidemic behavior. Antibiogram typing showed clustering of predominantly A baumannii strains within one group, and these strains were significantly more resistant to antibiotics than sporadic strains. AFLP genotyping revealed a great heterogeneity among the different European Acinetobacter strains. Cluster analysis of AFLP fingerprints showed several small clusters of different A baumannii outbreak strains. AFLP genotyping could not identify a common epidemic marker within the strains studied.

Conclusions:

Antibiogram typing can be used in routine clinical laboratories as a screening method to recognize potentially epidemic A baumannii strains. Several other factors were found, both in different outbreaks as well as in sporadic Acinetobacter isolates. These characteristics were unable to predict epidemic behavior and therefore cannot be used as discriminative epidemic markers. AFLP genotyping demonstrated no common clonal origin of European epidemic A baumannii strains. This indicates that any clinical A baumannii isolate with resistance to multiple antibiotics can be a potential nosocomial outbreak strain.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 5 , May 2001 , pp. 284 - 288
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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References

1.Bergogne-Berezin, E, Towner, KJ. Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Microbiol Rev 1996;9:148–165.Google Scholar
2.Koeleman, JG, Parlevliet, GA, Dijkshoorn, L, Savelkoul, PH, Vandenbroucke-Grauls, CM. Nosocomial outbreak of multi-resistant Acinetobacter baumannii on a surgical ward: epidemiology and risk factors for acquisition. J Hosp Infect 1997;37:113–123.CrossRefGoogle ScholarPubMed
3.Struelens, MJ, Carlier, E, Maes, N, Serruys, E, Quint, WG, van Belkum, A. Nosocomial colonization and infection with maltiresistant Acinetobacter baumannii: outbreak delineation using DNA macrorestriction analysis and PCR-fingerprinting. J Hosp Infect 1993;25:15–32.CrossRefGoogle ScholarPubMed
4.Vandenbroucke-Grauls, CM, Kerver, AJ, Rommes, JH, Jansen, R, den Dekker, C, Verhoef, J. Endemic Acinetobacter anitratus in a surgical intensive care unit: mechanical ventilators as reservoir. Eur J Clin Microbiol Infect Dis 1988;7:485–489.Google Scholar
5.Ofek, I, Doyle, RJ. Bacterial Adhesion to Cells and Tissues. New York, NY: Chapman and Hall; 1994.Google Scholar
6.Dijkshoorn, L, Aucken, H, Gerner-Smidt, P, Janssen, P, Kaufmann, ME, Garaizar J, et al. Comparison of outbreak and nonoutbreak Acinetobacter baumannii strains by genotypic and phenotypic methods. J Clin Microbiol 1996;34:1519–1525.Google Scholar
7.Jawad, A, Seifert, H, Snelling, AM, Heritage, J, Hawkey, PM. Survival of Acinetobacter baumannii on dry surfaces: comparison of outbreak and sporadic isolates. J Clin Microbiol 1998;36:1938–1941.CrossRefGoogle ScholarPubMed
8.Wendt, C, Dietze, B, Dietz, E, Ruden, H. Survival of Acinetobacter baumannii on dry surfaces. J Clin Microbiol 1997;35:1394–1397.CrossRefGoogle ScholarPubMed
9.Farrington, M, Brenwald, N, Haines, D, Walpole, E. Resistance to desiccation and skin fatty acids in outbreak strains of methicillin-resistant Staphylococcus aureus. J Med Microbiol 1992;36:56–60.CrossRefGoogle ScholarPubMed
10.Oie, S, Kamiya, A. Survival of methicillin-resistant Staphylococcus aureus (MRSA) on naturally contaminated dry mops. J Hosp Infect 1996;34:145–149.Google Scholar
11.Koeleman, JGM, Stoof, J, Biesmans, DJ, Savelkoul, PHM, Vandenbroucke-Grauls, CMJE. Comparison of amplified ribosomal DNA restriction analysis, random amplified polymorphic DNA analysis, and amplified fragment length polymorphism fingerprinting for identification of Acinetobacter genomic species and typing of Acinetobacter baumannii. J Clin Microbiol 1998;36:2522–2529.Google Scholar
12.Namavar, F, Sparrius, M, Veerman, EI, Appelmelk, BJ, Vandenbroucke-Grauls, CMJE. Neutrophil activating protein mediates adhesion of Helicobacter pylori to sulfated carbohydrates on high-molecular-weight salivary mucin. J Clin Microbiol 1998;66:444–447.Google Scholar
13.Kerr, S, Kerr, GE, Macintosh, CA, Marples, RR. A survey of methicillin-resistant Staphylococcus aureus affecting patients in England and Wales. J Hosp Infect 1990;16:35–48.Google Scholar
14.Dijkshoorn, L, Van Ooyen, A, Hop, WC, Theuns, M, Michel, MF. Comparison of clinical Acinetobacter strains using a carbon source growth assay. Epidemiol Infect 1990;104:443–453.Google Scholar
15.Veerman, ECI, Bank, CMC, Namavar, F, Appelmelk, BJ, Bolscher, FGM, Nieuw Amerongen, AV. Sulfated glycans on oral mucin as receptors for Helicobacter pylori. Glycobiology 1997;7:737–743.CrossRefGoogle ScholarPubMed
16.Webster, C, Towner, KJ, Humphreys, H. Survival of Acinetobacter on three clinically related inanimate surfaces. Infect Control Hosp Epidemiol 2000;21:246.Google Scholar
17.Jawad, A, Heritage, J, Snelling, AM, Gascoyne-Binzi, DM, Hawkey, PM. Influence of relative humidity and suspending menstrua on survival of Acinetobacter spp. on dry surfaces. J Clin Microbiol 1996;34:2881–2887.Google Scholar
18.Gerner-Smidt, P, Tjernberg, I, Ursing, J. Reliability of phenotypic tests for identification of Acinetobacter species. J Clin Microbiol 1991;29:277–282.Google Scholar
19.Kampfer, P, Tjernberg, I, Ursing, J. Numerical classification and identification of Acinetobacter genomic species. J Appl Bacteriol 1993;75:259–268.Google Scholar
20.Bernards, AT, van der Toorn, J, van Boven, CP, Dijkshoorn, L. Evaluation of the ability of a commercial system to identify Acinetobacter genomic species. Eur J Clin Microbiol Infect Dis 1996;15:303–308.Google Scholar