title: Investigation of Acinetobacter baumannii resistance to carbapenems in Marseille hospitals, south of France: a transition from an epidemic to an endemic situation.
abstract: Carbapenem-resistant Acinetobacter baumannii infections are a worldwide endemic nosocomial threat. Between December 2010 and April 2011, an increase of carbapenem-resistant A. baumannii infections occurred in several Marseille University Hospitals. The aim of this study was to investigate the increase of carbapenem-resistant A. baumannii infections and to characterize the mechanisms of carbapenem resistance. The increase was detected by a homemade computer surveillance program, known as EPIMIC, that monitors antibiotic resistance profiles on a weekly basis. During this period, positive samples of carbapenem-resistant A. baumannii were retrieved from patients hospitalized in different units. Genotyping of the isolates was performed using pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), and carbapenemase gene analyses were performed to detect the presence of carbapenemases and to determine the relationships of the isolates. Carbapenem-resistant A. baumannii were isolated in a total of 11 patients who were hospitalized in different hospitals units. We identified the presence of the bla(OXA23-like) carbapenemase-encoding gene in all of the isolates and found four major PFGE groups and different MLST groups. These results demonstrate a current evolution in the A. baumannii epidemiology in Marseille with a switch from an epidemic situation to an endemic situation and with several circulating clones.
authors.affiliation: Faculté de Médecine et de Pharmacie, URMITE CNRS-IRD, UMR, Aix-Marseille Univ, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Kempf
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
authors.forename: Saïd
authors.initials: S
authors.lastname: Azza
authors.forename: Seydina
authors.initials: S
authors.lastname: Diene
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Joly-Guillou
authors.forename: Gregory
authors.initials: G
authors.lastname: Dubourg
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
authors.forename: Laurent
authors.initials: L
authors.lastname: Papazian
authors.forename: Hervé
authors.initials: H
authors.lastname: Richet
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Fournier
authors.forename: Amandina
authors.initials: A
authors.lastname: Ribeiro
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D015780:Carbapenems / Q000494:pharmacology*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005602:France / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D016133:Polymerase Chain Reaction
chemical_list: D015780:Carbapenems; D004269:DNA, Bacterial