期刊论文详细信息
BMC Research Notes
Emerging threat of multidrug resistant bugs – Acinetobacter calcoaceticus baumannii complex and Methicillin resistant Staphylococcus aureus
Bharat Mani Pokhrel1  Basista Prasad Rijal1  Shyam Kumar Mishra1 
[1] Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
关键词: ESBL;    MRSA;    MDR;    Acinetobacter spp.;   
Others  :  1143248
DOI  :  10.1186/1756-0500-6-98
 received in 2012-12-23, accepted in 2013-03-08,  发布年份 2013
PDF
【 摘 要 】

Background

Infections caused by bacteria such as multidrug resistant (MDR) Acinetobacter spp. and methicillin-resistant Staphylococcus aureus (MRSA) constitute a worldwide pandemic. Without gathering information about these strains, we cannot reduce the morbidity and mortality due to infections caused by these notorious bugs.

Methods

This study was conducted to identify the status of MDR Acinetobacter spp. and MRSA in a tertiary care centre of Nepal. Sputum, endotracheal aspirate and bronchial washing specimens were collected and processed from patients suspected of lower respiratory tract infection following standard microbiological methods recommended by the American Society for Microbiology (ASM). Double disk synergy test method was employed for the detection of extended-spectrum beta-lactamase (ESBL) in Acinetobacter isolates. Methicillin resistance in S. aureus was confirmed by using cefoxitin and oxacillin disks.

Results

Different genomespecies of Acinetobacter were isolated; these consisted of Acinetobacter calcoaceticus baumannii complex and A. lwoffii. Around 95% of Acinetobacter isolates were MDR, while 12.9% were ESBL-producer. Of the total 33 isolates of S. aureus, 26 (78.8%) were MDR and 14 (42.4%) were methicillin resistant.

Conclusions

A large number of MDR Acinetobacter spp. and MRSA has been noted in this study. The condition is worsened by the emergence of ESBL producing Acinetobacter spp. Hence, judicious use of antimicrobials is mandatory in clinical settings. Moreover, there should be vigilant surveillance of resistant clones in laboratories.

【 授权许可】

   
2013 Mishra et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150329025930297.pdf 171KB PDF download
【 参考文献 】
  • [1]Bergogne-Berezin E, Towner KJ: Acinetobacter species as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Micro Rev 1999, 9:148-165.
  • [2]Cohen J, Powderly WG: Community-acquired pneumonia. In Infectious disease. Volume 1. 2nd edition. Mosby: Elsevier; 2004::369-380.
  • [3]Mammina C, Calà C, Bonura C, Carlo PD, Aleo A, Fasciana T, Giammanco A, EPI-MRSA Working Group: Polyclonal non multiresistant Staphylococcus aureus isolates from clinical cases of infection occurring in Palermo, Italy, during a one-year surveillance period. Ann Clin Microbiol Antimicrob 2012, 11:17. BioMed Central Full Text
  • [4]Lesosky M, McGeer A, Simor A, Green K, Low DE, Raboud J: Effect of patterns of transferring patients among healthcare institutions on rates of nosocomial methicillin-resistant Staphylococcus aureus transmission: a Monte Carlo simulation. Infect Contr Hosp Epidemiol 2011, 32:136-147.
  • [5]HD I: Clinical Microbiology Procedures Handbook. 2nd edition. Washington DC: ASM press; 2004.
  • [6]Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing, 17th informational supplement. Wayne, PA: CLSI; 2007:M100-S17.
  • [7]Beceiro A, Fernández-Cuenca F, Ribera A, Martínez-Martínez L, Pascual A, Vila J, Rodríguez-Baño J, Cisneros JM, Pachón J, Bou G, Spanish Group for Nosocomial Infection (GEIH): False extended-spectrum beta-lactamase detection in Acinetobacter spp. due to intrinsic susceptibility to clavulanic acid. J Antimicrob Chemother 2008, 61:301-308.
  • [8]Adams-Haduch JM, Paterson DL, Sidjabat HE, Pasculle AW, Potoski BA, Muto CA, Harrison LH, Doi Y: Genetic basis of multidrug resistance in Acinetobacter baumannii clinical isolates at a Tertiary Medical Center in Pennsylvania. Antimicrob Agents Chemother 2008, 52:3837-3843.
  • [9]Pokhrel BM, Shrestha B, Sharma AP: A prospective study of adult lower respiratory tract infections at TUTH in Kathmandu. J Inst Med 1997, 19:30-36.
  • [10]Mishra SK, Koirala J, Pokhrel BM: Status of multidrug resistance and extended spectrum beta–lactamase producing strains causing lower respiratory tract and urinary tract infections among patients attending Tribhuvan University Teaching Hospital. J Nepal Assoc Med Lab Sci 2005, 7:30.
  • [11]Tamang MD, Dey S, Makaju RK, Jha BK, Shivananda PG, Bhramadatan KN: Bacterial aetiology of lower respiratory tract infection in patients attending Manipal Teaching Hospital. J Nepal Assoc Med Lab Sci 2005, 7:15-19.
  • [12]Falagas ME, Karveli EA, Siempos II, Vardakas KZ: Acinetobacter infections: a growing threat for critically ill patients. Epidemiol Infect 2008, 136:1009-1019.
  • [13]Joshi SG, Litake GM, Ghole VS, Niphadkar KB: Fluoroquinolone resistance from a transferable plasmid in Acinetobacter calcoaceticus. Ind J Pathol Microbiol 2004, 47:593-594.
  • [14]Mezzatesta ML, Trovato G, Gona F, Nicolosi VM, Nicolosi D, Carattoli A, Fadda G, Nicoletti G, Stefani S: In vitro activity of tigecycline and comparators against carbapenem-susceptible and resistant Acinetobacter baumannii clinical isolates in Italy. Ann Clin Microbiol Antimicrob 2008, 7:4. BioMed Central Full Text
  • [15]Bergogne-Berezin E, Towner KJ: Acinetobacer spp. as nosocomial pathogens: microbiological, clinical and epidemiological features. Clin Microbiol Rev 1996, 9:148-165.
  • [16]Higgins PG, Wisplinghoff H, Stefanki D, Seifert H: In vitro activities of the ß-lactamase inhibitors clavulanic acid, sulbactam, and tazobactam alone or in combination with ß-lactams against epidemiologically characterized multidrug-resistant Acinetobacter baumannii strains. Antimicrob Agents Chemother 2004, 48:1586-1592.
  • [17]Ling TKW, Ying CM, Lee CC, Liu ZK: Comparison of antimicrobial resistance of Acinetobacter baumannii clinical isolates from Shanghai and Hong Kong. Med Princ Pract 2005, 14:338-341.
  • [18]Peleg AY, Potoski BA, Rea R, Adams J, Sethi J, Capitano B, Husain S, Kwak EJ, Bhat SV, Paterson DL: Acinetobacter baumannii bloodstream infection while receiving tigecycline: a cautionary report. J Antimicrob Chemother 2007, 59:128-131.
  • [19]Gupta E, Mohanty S, Sood S, Dhawan B, Das BK, Kapil A: Emerging resistance to carbapenems in a tertiary care hospital in north India. Ind J Med Res 2006, 124:95-98.
  • [20]Sinha M, Srinivasa H: Mechanisms of resistance to carbapenems in meropenem- resistant Acinetobacter isolates from clinical samples. Ind J Med Microbiol 2007, 25:121-125.
  • [21]Gupta V, Datta P, Chander J: Prevalence of metallo -beta lactamase (MBL) producing Pseudomonas spp. and Acinetobacter spp. in a tertiary care hospital in India. J Infect 2006, 52:311-314.
  • [22]Levin AS, Barone AA, Penco J, Santos MV, Marinho IS, Arruda EA, Manrique EI, Costa SF: Intravenous colistin as therapy for nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Clin Infect Dis 1999, 28:1008-1011.
  • [23]Kumari N, Mohapatra TM, Singh YI: Prevalence of Methicillin-resisant Staphylococcus aureus (MRSA) in a tertiary-care hospital in eastern Nepal. J Nepal Med Assoc 2008, 47:53-56.
  • [24]Pokhrel BM, Joshi R: Bacteriological study at TU Teaching Hospital, Kathmandu, Nepal. J Inst Med 1993, 15:217-221.
  • [25]Subedi S, Brahmadathan KN: Antimicrobial susceptibility patterns of clinical isolates of Staphylococcus aureus in Nepal. Clin Microb Infect 2005, 11:235-237.
  • [26]Gonzalez C, Rubio M, Romero-Vivas J, Gonzalez M, Picazo JJ: Bacteremic pneumonia due to Staphylococcus aureus: a comparison of disease caused by methicillin-resistant & methicillin-susceptible organisms. Clin Infect Dis 1999, 29:1171-1177.
  • [27]McClelland RS, Fowler VG Jr, Sanders LL, Gottlieb G, Kong LK, Sexton DJ, Schmader K, Lanclos KD, Corey R: Staphylococcus aureus bacteremia among elderly vs younger adult patients: comparison of clinical features and mortality. Arch Intern Med 1999, 159:1244-1247.
  • [28]Mukae H, Iwamoto M, Takase T, Mori N, Ishino T, Doutsu Y, Kohno S, Yamaguchi K, Hirota M, Hara K: Isolation of methicillin-resistant Staphylococcus aureus (MRSA) from sputum and clinical features of bronchopulmonary infection due to MRSA during 4 years (1985–1988). Nihon Kyobu Shikkan Gakkai Zasshi 1990, 28:320-329.
  • [29]Lo WT, Lin WJ, Tseng MH, Lu JJ, Lee SY, Chu ML, Wang CC: Nasal carriage of single clone of community acquired methicillin-resistant Staphylococcus aureus among Kindergarten attendees in northern Taiwan. BMC Infectious Dis 2007, 7:51. BioMed Central Full Text
  • [30]Dar JA, Thoker MA, Khan JA, Ali A, Khan MA, Rizwan M, Bhat KH, Dar MJ, Ahmed N, Ahmad S: Molecular epidemiology of clinical and carrier strains of methicillin resistant Staphylococcus aureus (MRSA) in the hospital settings of north India. Ann Clin Microbiol Antimicrob 2006, 5:22. BioMed Central Full Text
  文献评价指标  
  下载次数:2次 浏览次数:38次