Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-28T06:38:55.209Z Has data issue: false hasContentIssue false
  • English
  • Français

Plasmid DNA Fingerprinting of Acinetobacter calcoaceticus Subspecies anitratus From Intubated and Mechanically Ventilated Patients

Published online by Cambridge University Press:  21 June 2016

Alan I. Hartstein ,
Virginia H. Morthland ,
J. William Rourke Jr. ,
Joan Freeman ,
Susan Garber ,
Renee Sykes  and
Abdel L. Rashad
Alan I. Hartstein*
Affiliation:
Department of Hospital Infection Control, University Hospitals, Oregon Health Sciences University, Portland, Oregon Department of Medicine, Oregon Health Sciences University, Portland, Oregon Department of Clinical Pathology, Oregon Health Sciences University, Portland, Oregon
Virginia H. Morthland
Affiliation:
Department of Medicine, Oregon Health Sciences University, Portland, Oregon
J. William Rourke Jr.
Affiliation:
Department of Clinical Pathology, Oregon Health Sciences University, Portland, Oregon
Joan Freeman
Affiliation:
Department of Hospital Infection Control, University Hospitals, Oregon Health Sciences University, Portland, Oregon
Susan Garber
Affiliation:
Department of Hospital Infection Control, University Hospitals, Oregon Health Sciences University, Portland, Oregon
Renee Sykes
Affiliation:
Department of Clinical Pathology, Oregon Health Sciences University, Portland, Oregon
Abdel L. Rashad
Affiliation:
Department of Clinical Pathology, Oregon Health Sciences University, Portland, Oregon
*
Division of Infectious Diseases, L457, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098
Get access Rights & Permissions [Opens in a new window]

Abstract

Forty-three intubated and mechanically ventilated patients in five intensive care units (ICUs) of one hospital developed respiratory colonization or infection with Acinetobacter calcoaceticus subspecies anitratus over a 16-month interval. Neither the frequency nor rate of A anitratus isolation exceeded the hospital endemic norms. Single isolates from 34 of the patients were subtyped by plasmid DNA analysis, two biotyping systems and antimicrobial susceptibility to 24 drugs. Plasmid DNA fingerprints were distinct in 18 isolates (they differed from each other and all others), similar in two and identical or similar in ten. The latter group of isolates were recovered from patients in four ICUs. Reproducibility of biotyping was poor. Neither biotyping nor antimicrobial susceptibility were successful in identifying sameness among the group isolates nor differences among other isolates. We conclude that plasmid DNA fingerprinting should be used to assess the possibility of multiple patient transmissions of the same A anitratus strain in the absence of an obvious outbreak.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 10 , October 1990 , pp. 531 - 538
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Gardner, P, Griffin, WB, Swartz, MN, Kunz, LJ. Nonfermentative gram-negative bacilli of nosocomial interest. Am J Med. 1970;48:735–749.CrossRefGoogle ScholarPubMed
2. Glew, RH, Moellering, RC Jr, Kunz, LJ. Infections with Acinetobacter calcoaceticus (Herellea vaginicola): clinical and laboratory studies. Medicine (Baltimore). 1977;56:79–97.CrossRefGoogle ScholarPubMed
3. Buxton, AE, Anderson, RL, Werdegar, D, Atlas, E. Nosocomial respiratory tract infection and colonization with Acinetobacter calcoaceticus . Am J Med. 1978;65:507–513.CrossRefGoogle ScholarPubMed
4. Retailliau, HF, Hightower, AW, Dixon, RE. Allen, JR. Acinetobacter calcoaceticus: a nosocomial pathogen with an unusual seasonal pattern. J Infect Dis. 1979; 139:371–375.CrossRefGoogle ScholarPubMed
5. Castle, M, Tenney, JH, Weinstein, MP, Eickhoff, TC. Outbreak of a multiply-resistant Acinetobacter in a surgical intensive care unit: epidemiology and control. Heart Lung. 1978;7:641–644.Google Scholar
6. Cunha, BA, Klimek, JJ, Gracewski, J, McLaughlin, JC, Quintiliani, R. A common source outbreak of Acinetobacter pulmonary infections traced to Wright spirometers. Postgrad Med J. 1980;56:169–172.CrossRefGoogle Scholar
7. Carlquist, JF, Conti, M, Burke, JP. Progressive resistance in a single strain of Acinetobacter calcoaceticus recovered during a nosocomial outbreak. Am J Znfect Control. 1982;10:43–48.CrossRefGoogle Scholar
8. Stone, JW, Das, BC. Investigation of an outbreak of infection with Acinetobacter calcoaceticus in a special care baby unit. J Hosp Infect. 1985;6:42–48.CrossRefGoogle Scholar
9. Vandenbroucke, CMJE, Kerver, AJH, Rommes, JH, Jansen, R, den Dekker, C, Verhoef, J. Endemic Acinetobacter anitratus in a surgical intensive care unit. Mechanical ventilators as a reservoir. Eur J Clin Microbiol Infect Dis. 1988;7:485–489.CrossRefGoogle Scholar
10. Gerner-Smidt, P. Endemic occurrence of Acinetobacter calcoaceticus biovar anitratus in an intensive care unit. J Hosp Infect. 1987;10:265–272.CrossRefGoogle Scholar
11. Hartstein, AI, Rashad, AL, Liebler, JM, et al. Multiple intensive care unit outbreak of Acinetobacter calcoaceticus subspecies anitratus respiratory infection and colonization associated with contaminated, reusable ventilator circuits and resuscitation bags. Am J Med. 1988;85:624–631.CrossRefGoogle ScholarPubMed
12. Vivian, A, Hinchliffe, E, Fewson, CA. Acinetobacter calcoaceticus: some approaches to a problem. J Hosp Infect. 1981;2:199–203.CrossRefGoogle ScholarPubMed
13. O'Connell, CJ, Hamilton, R. Gram-negative rod infections, II: Acinetobacter infections in a general hospital. NY State J Med. 1981;81:750–753.Google Scholar
14. Bergogne-Berezin, E, Joly-Guillou, ML. An underestimated nosocomial pathogen, Acinetobacter calcoaceticus . J Antimicrob Chemother. 1985;16:535–538.CrossRefGoogle ScholarPubMed
15. Bergogne-Berezin, E, Joly-Guillou, ML, Vieu, JF. Epidemiology of nosocomial infections due to Acinetobacter calcoaceticus . J Hosp Infect. 1987;10:105–113.CrossRefGoogle ScholarPubMed
16. Peacock, JE, Sorrell, L, Sottile, FD, Price, LE, Rutala, WA. Nosocomial respiratory tract colonization and infection with aminoglycoside-resistant Acinetobmter calcoaceticus var anitratus: epidemiologic characteristics and clinical significance. Infect Control Hosp Epidemiol. 1988;9:302–308.CrossRefGoogle ScholarPubMed
17. Vila, J, Almela, M, Jimenez de Anta, MT. Laboratory investigation of hospital outbreak caused by two different multiresistant Acinetobacter calcoaceticus subsp. anitratus strains. J Clin Microbiol. 1989;27:1086–1089.CrossRefGoogle ScholarPubMed
18. Holton, J. A report of a further hospital outbreak caused by multi-resistant Acinetobacter anitratus . J Hosp Infect. 1982;3:305–309.CrossRefGoogle ScholarPubMed
19. Gerner-Smidt, P, Hansen, L, Knudsen, A. Siboni, K, Sogaard, I. Epidemic spread of Acinetobacter calcoaceticus in a neurosurgical department analyzed by electronic data processing. J Hosp Infect. 1985;6:166–174.CrossRefGoogle Scholar
20. Rosenthal, SL. Sources of Pseudomonas and Acinetobacter species found in human culture materials. Am J Clin Pathol. 1974;62:807–811.CrossRefGoogle ScholarPubMed
21. Rosenthal, S, Tager, IB. Prevalence of gram-negative rods in the normal pharyngeal flora. Ann Intern Med. 1975;83:355–357.CrossRefGoogle ScholarPubMed
22. Aysoon, M, Al-Khoja, MS. Darrell, JH. The skin as the source of Acinetobacter and Moraxella species occurring in blood cultures. J Clin Pathol. 1979;32:497–499.Google Scholar
23. Gaughan, M, White, PM, Noble, WC. Skin as a source of Acinetobacter/Moraxella species. J Clin Pathol. 1979;32:1193.CrossRefGoogle ScholarPubMed
24. Larson, EL. Persistent carriage of gram-negative bacteria on hands. Am J Infect Control. 1981;9:112–119.CrossRefGoogle ScholarPubMed
25. Guenthner, SH, Hendley, JO. Wenzel, RP. Gram-negative bacilli as nontransient flora on the hands of hospital personnel. J Clin Microbiol. 1987;25:488–490.CrossRefGoogle ScholarPubMed
26. Adams, BG, Marrie, TJ. Hand carriage of aerobic gram-negative rods by health care personnel. Journal of Hygiene Cambridge. 1982;89:23–31.CrossRefGoogle ScholarPubMed
27. Moffet, HL, Williams, T. Bacteria recovered from distilled water and inhalation therapy equipment. Am J Dis Child. 1967; 114:7–12.Google ScholarPubMed
28. Baumann, P. Isolation of Acinetobacter from soil and water. J Bacteriol. 1968;96:39–42.CrossRefGoogle ScholarPubMed
29. Getchell-White, SI, Donowitz, LG, Groschel, DH. The inanimate environment of an intensive care unit as a potential source of nosocomial bacteria: evidence for long survival of Acinetobacter calcoaceticus . Infect Control Hosp Epidemiol. 1989;10:402–407.CrossRefGoogle ScholarPubMed
30. Mortensen, JE, LaRocco, MT, Steiner, B, Ribner, B. Protein fingerprinting for the determination of relatedness in Acinetobacter calcoaceticus subspecies anitratus isolated from patients in a surgical intensive care unit. Infect Control. 1987;8:512–515.CrossRefGoogle Scholar
31. Actis, LA, Tolmasky, ME, Rashad, AL. Plasmid pattern analysis of Acinetobacter calcoaceticus subspecies anitratus strains isolated from multiple intensive care unit outbreaks of lower respiratorv tract infection and colonization. Abstracts of the 86th annual meeting of the American Society for Microbiology, Washington, D.C ; September 29-October 1, 1986: Abstract No. L19.Google Scholar
32. Alexander, M, Rahman, M, Taylor, M, Noble, WC. A study of the value of electrophoretic and other techniques for typing Acinetobacter calcoaceticus . J Hosp Infect. 1988;12:273–287.CrossRefGoogle ScholarPubMed
33. Gerner-Smidt, P. Frequency of plasmids in strains of Acinetobacter calcoaceticus . J Hosp Infect. 1989; 14:23–28.CrossRefGoogle ScholarPubMed
34. CDC. Guideline for prevention of nosocomial pneumonia. Infect Control. 1982;3:327–333.CrossRefGoogle Scholar
35. CDC. CDC Guideline for handwashing and hospital environmental control: 1985. Znfect Control. 1986;7:231–243.Google Scholar
36. Rubin, SJ, Granato, PA, Wasilauskas, BL. Glucose-nonfermenting gram-negative bacteria. In: Lennette, EH, Balows, A. Hausler, WJ Jr, Shadomy, JH, eds. Manual of Clinical Microbiology. 4th ed. Washington DC: American Society for Microbiology; 1985:334–335.Google Scholar
37. Bauer, WE, Kirby, WMM, Sherris, JC, Turck, M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966;45:493–496.CrossRefGoogle ScholarPubMed
38. National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests. 4th ed. Villanova, Pa: National Committee for Clinical Laboratory Standards; 1988.Google Scholar
39. Hartstein, AI. Morthland, VH. Eng, S, Archer, GL, Schoenknecht, FD, Rashad, AL. Restriction enzyme analysis of plasmid DNA and bacteriophage typing of paired Staphylococcus aureus blood culture isolates. J Clin Microbiol. 1989;27:1874–1879.CrossRefGoogle ScholarPubMed
40. Macrina, FL, Kopecko, DJ, Jones, KR, Ayers, DJ, McCowen, SM. A multiple plasm&containing Escherichia coli strain. Convenient source of size reference for plasmid molecules. Plasmid. 1978;1:417–420.CrossRefGoogle Scholar
41. Wenzel, RP. Organization for infection control. In: Mandell, GL, Douglas, RG, Bennett, JE, eds. Principles and Practice of Infectious Diseases. 3rd ed. New York. NY: Churchill Livingston; 1971:2176–2180.Google Scholar
42. Pennington, JE. Nosocomial respiratory infection. In: Mandell, GL, Douglas, RG, Bennett, JE, eds. Principles and Practice of Infectious Diseases, 3rd ed. New York, NY: Churchill Livingston; 1990:2199–2205.Google Scholar
43. Cross, AS, Roup, B. Role of respiratory assistance devices in endemic nosocomial pneumonia. Am J Med. 1981;70:681–685.CrossRefGoogle ScholarPubMed
44. Driks, MR, Craven, DE, Celli, BR, et al. Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. N Engl J Med. 1987;317:1376–1382.CrossRefGoogle ScholarPubMed
45. Smith, PW, Massanari, RM. Room humidifiers as the source of Acinetobacter infections . JAMA. 1977;237:795–797.CrossRefGoogle ScholarPubMed
46. Gervich, DH, Grout, CS. An outbreak of nosocomial Acinetobacter infections from humidifiers. Am J Infect Control. 1985;13:210–215.CrossRefGoogle ScholarPubMed
47. Sherertz, RJ, Sullivan, ML. An outbreak of infections with Acinetobacter calcoaceticus in burn patients: contamination of patient mattresses. J Infect Dis. 1985;151:252–258.CrossRefGoogle ScholarPubMed
48. French, GL, Casewell, MW, Roncorani, AJ, Knight, S, Phillips, I. A hospital outbreak of antibiotic resistant Acinetobacter anitratus: epidemiology and control. J Hosp Infect. 1980;1:125–131.CrossRefGoogle ScholarPubMed
49. Rutherford, I, Mood, V, Gavan, TL, Ayers, LW, Talor, DL. Comparative study of three methods of identification of Enterobacterioceae . J Clin Microbiol. 1977;5:458–464.CrossRefGoogle Scholar
50. Parisi, JT, Lampson, BC, Hoover, DL, Khan, JA. Comparison of epidemiologic markers for Staphylococcus epidermidis . J Clin Microbiol. 1986;24:56–60.CrossRefGoogle ScholarPubMed
51. Hartstein, AI, Valvano, MA, Morthland, VH, Fuchs, PL, Potter, SA, Crosa, JH. Antimicrobic susceptibility and plasmid profile analysis as identity tests for multiple blood isolates of coagulase-negative staphylococci. J Clin Microbiol. 1987;25:589–593.CrossRefGoogle ScholarPubMed
52. Podschun, R, Heineken, P, Ullmann, U, Sonntag, HG. Comparative investigations of Klebsiella species of clinical origin. Plasmid patterns, biochemical reactions, antibiotic resistances and serotypes. Zentralblatt fur Bakteriologie Hygiene. 1986;262:335–345.Google ScholarPubMed
53. Levy, J, Laethem, YV, Verhagen, G, Perpete, C, Butzler, JP, Wenzel, RP. Contaminated enteral nutrition solutions as a cause of nosocomial bloodstream infection: a study using plasmid fingerprinting. JPENJ Parenter Enteral Nutr. 1989;13:228–234.CrossRefGoogle ScholarPubMed