title: Multiresistance and endemic status of acinetobacter baumannii associated with nosocomial infections in a tunisian hospital: a critical situation in the intensive care units.
abstract: Acinetobacter baumannii is often implicated in hospital outbreaks in Tunisia. It's a significant opportunistic pathogen associated with serious underlying diseases such as pneumoniae, meningitis and urinary tract infections. The aim of our study was to evaluate its degree of endemicity and its antibiotic resistance evolution essentially in the unit care where its isolation was predominant (57%). This study used 3 methods: antibiotyping, RAPD using 2 primers VIL 1, VIL5 and PFGE with ApaI restriction enzyme. The presence of integron1 and 2 was also studied. Antibiotyping showed that 92% of patients were resistant of all ß- lactams (except Imipenem) and that the resistance to Imipenem occurred in 47% of cases. RAPD profiles obtained with the 2 arbitrarily primers VIL1 and VIL5 gave respectively 5 and 4groups and PFGE fingerprinting patterns revealed 22 different pulsotypes. Integron 1 was present in 25% of unrelated strains and type 2 integron was not detected in any of the studied strains. Among 204 strains, multiple and heterogeneous groups were detected with the genomic studies. In addition, any correlation was obtained with the antibiotyping results. These findings demonstrate the endemic status of A. baumannii in our hospital and the persistence of a large number of multiresistant strains in the unit's care. When outbreaks of A. baumannii occur, it's essential to develop restricted hygiene procedures and a serious surveillance of critical units such as ICU for very ill patients.
authors.affiliation: Hospital Microbiological laboratory , Rue El Jabberi Tunis, 1007 Tunisia.
authors.forename: A
authors.initials: A
authors.lastname: Ben Othman
authors.forename: M
authors.initials: M
authors.lastname: Zribi
authors.forename: A
authors.initials: A
authors.lastname: Masmoudi
authors.forename: S
authors.initials: S
authors.lastname: Abdellatif
authors.forename: S
authors.initials: S
authors.lastname: Ben Lakhal
authors.forename: C
authors.initials: C
authors.lastname: Fendri
keywords: A. baumannii; PFGE; RAPD; antibiotic resistance; epidemiology
references.citation: Antimicrob Agents Chemother. 2000 Oct;44(10):2684-8
references.pmid: 10991844
references.citation: Braz J Microbiol. 2008 Oct;39(4):623-30
references.pmid: 24031278
references.citation: Med Mal Infect. 2006 Mar;36(3):163-6
references.pmid: 16458466
references.citation: Braz J Microbiol. 2009 Apr;40(2):339-41
references.pmid: 24031369
references.citation: J Hosp Infect. 2002 Feb;50(2):110-4
references.pmid: 11846537
references.citation: Antimicrob Agents Chemother. 2007 Oct;51(10):3471-84
references.pmid: 17646423
references.citation: Infect Control Hosp Epidemiol. 1995 Oct;16(10):590-4
references.pmid: 8568204
references.citation: J Clin Microbiol. 1998 Sep;36(9):2522-9
references.pmid: 9705386
references.citation: J Hosp Infect. 2004 Aug;57(4):300-7
references.pmid: 15262390
references.citation: Braz J Microbiol. 2009 Jan;40(1):155-62
references.pmid: 24031336
references.citation: J Clin Microbiol. 2005 Sep;43(9):4328-35
references.pmid: 16145073
references.citation: J Clin Microbiol. 1996 Dec;34(12):2881-7
references.pmid: 8940416
references.citation: Ann Fr Anesth Reanim. 2006 May;25(5):543-4
references.pmid: 16488103
references.citation: Tunis Med. 2002 May;80(5):245-8
references.pmid: 12534026
references.citation: Burns. 2004 Aug;30(5):419-23
references.pmid: 15225905
references.citation: Int J Antimicrob Agents. 2006 Oct;28(4):366-9
references.pmid: 16971093
references.citation: J Clin Microbiol. 1998 Jul;36(7):1938-41
references.pmid: 9650940
references.citation: Antimicrob Agents Chemother. 2006 Sep;50(9):2946-50
references.pmid: 16940086
references.citation: Eur J Cardiothorac Surg. 2008 Jun;33(6):1086-90
references.pmid: 18339553
references.citation: Res Microbiol. 2004 Mar;155(2):105-12
references.pmid: 14990262
references.citation: Am J Infect Control. 2007 May;35(4):212-5
references.pmid: 17482991
references.citation: Eur J Clin Microbiol Infect Dis. 1999 Aug;18(8):595-8
references.pmid: 10517199
references.citation: Med Trop (Mars). 1995;55(3):255-7
references.pmid: 8559024
references.citation: Clin Microbiol Rev. 1996 Apr;9(2):148-65
references.pmid: 8964033
references.citation: Antimicrob Agents Chemother. 2008 Jan;52(1):351-2
references.pmid: 17954699