title: Molecular epidemiology of carbapenem non-susceptible Acinetobacter baumannii in France.
abstract: Carbapenem-resistant Acinetobacter baumannii have emerged globally. The objective of this study was to investigate the epidemiology, clonal diversity and resistance mechanisms of imipenem non-susceptible A. baumannii isolates in France. Between December 2010 and August 2011, 132 notifications were collected, including 37 outbreaks corresponding to 242 cases (2 to 55 per cluster). Multilocus sequence typing, pulsed-field gel electrophoresis (PFGE) and characterisation of carbapenemase-encoding genes were performed on 110 non-repetitive isolates. Gene blaOXA-23 was the most frequently detected (82%), followed by blaOXA-24 (11%) and blaOXA-58 (7%). Eleven sequence types (ST) were distinguished, among which sequence types ST1, ST2 (64%), ST20, ST25, ST85 and ST107. Isolates from epidemiological clusters had the same ST and resistance genes, indicating probable transmission within centres. In contrast, PFGE types of isolates differed among centres, arguing against transmission among centers. This study provides the first epidemiological snapshot of the population of A. baumannii with reduced susceptibility to carbapenems from France, and further underlines the predominance of international clones.
authors.affiliation: Institut Pasteur, Centre National de Référence de la Résistance aux Antibiotiques, Unité des Agents Antibactériens, Paris, France.
authors.forename: Katy
authors.initials: K
authors.lastname: Jeannot
authors.affiliation: Institut Pasteur, Genotyping of Pathogens and Public Health, Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Diancourt
authors.affiliation: French Institute for Public Health Surveillance (InVS), Saint-Maurice, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Vaux
authors.affiliation: Laboratoire d'Epidémiologie et d'Hygiène Hospitalière, CHRU Jean Minjoz, Besançon, France.
authors.forename: Michelle
authors.initials: M
authors.lastname: Thouverez
authors.affiliation: Institut Pasteur, Centre National de Référence de la Résistance aux Antibiotiques, Unité des Agents Antibactériens, Paris, France.
authors.forename: Amandina
authors.initials: A
authors.lastname: Ribeiro
authors.affiliation: French Institute for Public Health Surveillance (InVS), Saint-Maurice, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Coignard
authors.affiliation: Institut Pasteur, Centre National de Référence de la Résistance aux Antibiotiques, Unité des Agents Antibactériens, Paris, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Courvalin
authors.affiliation: Institut Pasteur, Genotyping of Pathogens and Public Health, Paris, France; Institut Pasteur, Microbial Evolutionary Genomics, Paris, France; CNRS, UMR3525, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Brisse
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000145:classification* / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005602:France / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D016133:Polymerase Chain Reaction
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems