Selection of colistin-resistant Acinetobacter baumannii isolates in postneurosurgical meningitis in an intensive care unit with high presence of heteroresistance to colistin.
Colistin heteroresistance in Acinetobacter baumannii (Ab) has been reported, but the clinical impact and the antimicrobial treatment have not been established yet. We observed the selection intratreatment with colistin of Ab colistin-resistant strains from a colistin-heteroresistant isolate in one patient with postneurosurgical meningitis. The presence and the genetic relationship of heteroresistant Ab isolates from intensive care units (ICUs) obtained in the same period of the case report were analyzed. Twenty-eight isolates from patients admitted to the ICUs of an Argentinian university hospital during June to December 2004 were evaluated. Genomoespecie was determined by amplified ribosomal DNA restriction analysis, and genetic similarity among the strains was determined by pulsed-field electrophoresis. Colistin heteroresistance was observed in 46, 4% of these isolates. The majority belonged to clones previously identified as I and III.
Rodriguez
Carlos Hernan
CH
Laboratorio de Bacteriología, Departamento de Bioquímica Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 1120 Buenos Aires, Argentina. carlos_hernanrodriguez@hotmail.com.ar
Hernan
Rodriguez Carlos
RC
Bombicino
Karina
K
Karina
Bombicino
B
Granados
Gabriela
G
Gabriela
Granados
G
Nastro
Marcela
M
Marcela
Nastro
N
Vay
Carlos
C
Carlos
Vay
V
Famiglietti
Angela
A
Angela
Famiglietti
F
D000151:Acinetobacter Infections / Q000188:drug therapy / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001118:Argentina; D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D003091:Colistin / Q000494:pharmacology / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D021521:Ribotyping; D012641:Selection, Genetic; D055815:Young Adult
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D003091:Colistin