title: Imported and intensive care unit-born Acinetobacter baumannii clonal complexes: one-year prospective cohort study in intensive care patients.
abstract: The main objective of this study was to assess the frequency and possible sources of colonization and infection by Acinetobacter in the intensive care unit (ICU) of a university hospital in Rio de Janeiro, Brazil, and characterize the isolates for relatedness to internationally and locally disseminated lineages. Patients consecutively admitted to the ICU from April 2007 to April 2008 were screened for colonization and infection. Species were identified by rpoB sequencing. The presence of acquired and intrinsic carbapenemase genes was assessed by polymerase chain reaction (PCR). Strains were typed by random amplification of polymorphic DNA (RAPD)-PCR, pulsed-field gel electrophoresis, and multilocus sequence typing (MLST) using the schemes hosted at the University of Oxford (UO) and Institut Pasteur (IP). Of 234 patients, 98 (42%) had at least one specimen positive for the Acinetobacter isolate, and 24 (10%) had infection. A total of 22 (92%) infections were caused by Acinetobacter baumannii and one each (4%) by Acinetobacter nosocomialis and Acinetobacter berezinae. A. baumannii isolates from 60 patients belonged to RAPD types that corresponded to MLST clonal complexes (CCs) 109/1 (UO/IP scheme, known as International Clone I), CC 110/110 (UO/IP), CC 113/79 (UO/IP), and CC 104/15 (UO/IP). Most CCs were carbapenem resistant and carried the bla(OXA-23)-like gene. Strains were introduced by patients transferred from other wards of the same hospital (11 patients, 18%) or acquired from cross-transmission within the ICU (49 patients, 82%). A. nosocomialis lineage sequence type 260 colonized 10% of the whole study population. A. baumannii have become established in this hospital as a part of a global epidemic of successful clones. Once introduced into the hospital, such clones have become entrenched among patients in the ICU.
authors: Institute of Microbiology, Federal University of Rio de Janeiro, Brazil.
authors: Natacha
authors: N
authors: Martins
authors: Ianick Souto
authors: IS
authors: Martins
authors: Wania Vasconcelos
authors: WV
authors: de Freitas
authors: Juliana Arruda
authors: JA
authors: de Matos
authors: Valeria Brígido de Carvalho
authors: VB
authors: Girão
authors: Talita
authors: T
authors: Coelho-Souza
authors: Ana Cristina de Gouveia
authors: AC
authors: Maralhães
authors: Luciana Camila
authors: LC
authors: Cacci
authors: Miriam Perez
authors: MP
authors: de Figueiredo
authors: Rubens Clayton Silva
authors: RC
authors: Dias
authors: Ana Paula Ramalho
authors: AP
authors: Costa-Lourenço
authors: Adriana Lúcia Pires
authors: AL
authors: Ferreira
authors: Libera
authors: L
authors: Dalla-Costa
authors: Simone Aranha
authors: SA
authors: Nouér
authors: Guilherme
authors: G
authors: Santoro-Lopes
authors: Lee W
authors: LW
authors: Riley
authors: Beatriz Meurer
authors: BM
authors: Moreira
mesh_terms: D000150:Acinetobacter / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D001938:Brazil; D015780:Carbapenems / Q000494:pharmacology; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D058885:Multilocus Sequence Typing; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D019105:Random Amplified Polymorphic DNA Technique; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase