Outbreak of carbapenem-resistant Acinetobacter baumannii carrying the carbapenemase OXA-23 in ICU of the eastern Heilongjiang Province, China

BMC Infectious Diseases

Xuecai Fan¹  Xiaoli Zhang²  Kewang Hu²  Jisheng Zhang²  Yuhang Guo²  Yong Wang²  Yongxin Zhao²  Sedzro Divine Mensal³ 

[1] 0000 0000 8714 7179, grid.411849.1, Second Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China;grid.452866.b, Department of Microbiology, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang Province, China;grid.452866.b, Department of Microbiology, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang Province, China;0000 0000 8714 7179, grid.411849.1, Jiamusi University, Jiamusi, Heilongjiang, China;

关键词: Acinetobacter baumannii;    Carbapenem resistant;    Outbreak;    Infection control;    OXA-23;    CC2;   

DOI  :  10.1186/s12879-019-4073-5

来源: publisher

【 摘 要 】

BackgroundTo investigate the carbapenem resistance mechanisms and clonal relationship of carbapenem-resistant Acinetobacter baumannii (CRAB) strains isolated in the intensive care unit (ICU) of the First Affiliated Hospital of Jiamusi University, management approaches to ICU clonal CRAB outbreaks were described.MethodsThe sensitivity of the antibiotic was determined using the VITEK-2 automated system. Carbapenemase genes (blaTEM, blaSHV, blaKPC, blaNDM, blaIMP-4, blaVIM, blaOXA-23, blaOXA-24, blaOXA-51, and blaOXA-58), AmpC enzyme genes (blaACC, blaDHA, blaADC), and ISAba1 were assessed for all collected isolates using polymerase chain reaction (PCR). The transfer of resistance genes was investigated via conjugation experiments. The clonal relationship of isolates was determined via enterobacterial repetitive intergenic consensus (ERIC)-PCR and multilocus sequence typing (MLST). When the detection rate of CRAB increased from 25% in 2010 to 92% in 2014, a number of actions were initiated, including enhanced infection control, staff education, and the cleaning of the hospital environment.ResultsClinical isolates were positive for the following genes: blaOXA23, blaOXA51, blaOXA24, blaADC, blaTEM, ISAba1, ISA-23, and ISA-ADC; however, blaOXA58, ISA-51, blaNDM, blaIMP, blaKPC, blaTEM, blaSHV, blaVIM, and blaACC were not detected. Four carbapenem-resistant isolates successfully transferred plasmids from A. baumannii isolates to E. coli J53. MLST showed that all strains belonged to ST2 except for one isolate, which belonged to the new genotype ST1199. The ERIC-PCR method found the following three genotypes: type A in 8, type B in 12, type C in 1, and two profiles (A, B) belonged to ST2. After taking control measures, the prevalence of CRAB isolates decreased, and the discovery rate of CRAB dropped to 11.4% in 2017.ConclusionThe obtained result suggests that blaOXA-23-producing CC2 isolates were prevalent in the ICU of the First Affiliated Hospital of Jiamusi University. Targeted surveillance was implemented to identify the current situation of the ICU and the further implementation of infection control effectively prevented the spread of nosocomial infection.

【 授权许可】

CC BY