Skip to main content Accessibility help
×
Home
Hostname: page-component-cf9d5c678-m9wwp Total loading time: 0.284 Render date: 2021-07-27T09:26:29.073Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

The Epidemiology of Multidrug-Resistant Acinetobacter Baumannii Does the Community Represent a Reservoir?

Published online by Cambridge University Press:  02 January 2015

Cosmina Zeana
Affiliation:
Columbia University College of Physicians & Surgeons, New York, New York
Elaine Larson
Affiliation:
Columbia University College of Physicians & Surgeons, New York, New York
Jyoti Sahni
Affiliation:
Southern Illinois University, Carbondale, Illinois
S. J. Bayuga
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York, New York
Fann Wu
Affiliation:
Columbia University College of Physicians & Surgeons, New York, New York
Phyllis Della-Latta
Affiliation:
Columbia University College of Physicians & Surgeons, New York, New York

Abstract

Objective:

To explore the role of the community as a potential reservoir for Acinetobacter baumannii.

Design:

Antimicrobial resistance patterns and genotypes of A. baumannii isolates from patients in two Manhattan hospitals were compared with those of A. baumannii isolates from the hands of community members.

Results:

A total of 103 isolates from two hospitals (hospital A, 81; hospital B, 22) and 23 isolates from community residents were studied. Of the hospital isolates, 36.6% were multidrug resistant (hospital A, 68.2%; hospital B, 27.8%). In contrast, there were no multidrug-resistant isolates from the community (P < .005 between hospital and community). The prevalence of A. baumannii on the hands of community residents was 10.4% (23 of 222). By molecular typing, 42 strains of A. baumannii were identified. Of the isolates from hospital A and hospital B, 55.6% (45 of 81) and 68.2% (15 of 22), respectively, were indistinguishable or closely related. In contrast, most community (83.3%) isolates were unrelated (P = .001 between hospital and community).

Conclusion:

Acinetobacter isolates from the community, characterized by a large variety of unrelated strains (83.3%), were distinct from the hospital isolates, of which 58.3% were closely related. The absence of multidrug-resistant strains in the community compared with 36.6% prevalence among hospital isolates suggests that the reservoir for epidemic strains resides in the hospital environment itself. To our knowledge, this is the first study to examine the community as a potential reservoir for hospital strains of A. baumannii.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Garcia-Garmendia, JL, Ortiz-Leyba, C, Garnacho-Montero, J, et al. Risk factors for Acinetobacter baumannii nosocomial bacteremia in critically ill patients: a cohort study. Clin Infect Dis 2001;33:939946.CrossRefGoogle ScholarPubMed
2.Wisplinghoff, H, Edmond, MB, Pfaller, MA, Jones, RN, Wenzel, RP, Seifert, H. Nosocomial bloodstream infections caused by Acinetobacter species in United States hospitals: clinical features, molecular epidemiology, and antimicrobial susceptibility. Clin Infect Dis 2000;31:690697.CrossRefGoogle Scholar
3.Bergogne-Berezin, E, Towner, KJ. Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Microbiol Rev 1996;9:148165.Google ScholarPubMed
4.Villari, P, Iacuzio, L, Vozzella, EA, Bosco, U. Unusual genetic heterogeneity of Acinetobacter baumannii isolates in a university hospital in Italy. Am J Infect Control 1999;27:247253.CrossRefGoogle Scholar
5.Husni, RN, Goldstein, LS, Arroliga, AC, et al. Risk factors for an outbreak of multi-drug-resistant Acinetobacter nosocomial pneumonia among intubated patients. Chest 1999;115:13781382.CrossRefGoogle ScholarPubMed
6.Pillay, T, Pillay, DG, Adhikari, M, Pillay, ASturm, AW. An outbreak of neonatal infection with Acinetobacter linked to contaminated suction catheters. J Hosp Infect 1999;43:299304.CrossRefGoogle ScholarPubMed
7.Cox, TR, Roland, WE, Dolan, ME. Ventilator-related Acinetobacter outbreak in an intensive care unit. Mil Med 1998;163:389391.Google Scholar
8.Patterson, JE, Vecchio, J, Pantelick, EL, et al. Association of contaminated gloves with transmission of Acinetobacter calcoaceticus var. anitratus in an intensive care unit. Am J Med 1991;91:479483.CrossRefGoogle Scholar
9.Weernink, A, Severin, WP, Tjernberg, I, Dijkshoorn, L. Pillows, an unexpected source of Acinetobacter. J Hosp Infect 1995;29:189199.CrossRefGoogle Scholar
10.Nagels, B, Ritter, E, Thomas, P, Schulte-Wissermann, H, Wirsing von Konig, CH. Acinetobacter baumannii colonization in ventilated preterm infants. Eur J Clin Microbiol Infect Dis 1998;17:3740.CrossRefGoogle Scholar
11.McDonald, IX, Walker, M, Carson, L, et al. Outbreak of Acinetobacter spp. bloodstream infections in a nursery associated with contaminated aerosols and air conditioners. Pediatr Infect Dis J 1998;17:716722.CrossRefGoogle Scholar
12.Go, ES, Urban, C, Burns, J, et al. Clinical and molecular epidemiology of Acinetobacter infections sensitive only to polymyxin B and sulbactam. Lancet 1994;344:13291332.CrossRefGoogle ScholarPubMed
13.D'Agata, EM, Thayer, V, Schaffner, W. An outbreak of Acinetobacter baumannii: the importance of cross-transmission. Infect Control Hosp Epidemiol 2000;21:588591.CrossRefGoogle Scholar
14.Fierobe, L, Lucet, JC, Deere, D, et al. An outbreak of imipenem-resistant Acinetobacter baumannii in critically ill surgical patients. Infect Control Hosp Epidemiol 2001;22:3540.CrossRefGoogle Scholar
15.Manikal, VM, Landman, D, Saurina, G, Oydna, E, Lai, H, Quale, J. Endemie carbapenem-resistant Acinetobacter species in Brooklyn, New York: citywide prevalence, interinstitutional spread, and relation to antibiotic usage. Clin Infect Dis 2000;31:101106.CrossRefGoogle Scholar
16.Rahal, JJ, Urban, C, Segal-Maurer, S. Nosocomial antibiotic resistance in multiple gram-negative species: experience at one hospital with squeezing the resistance balloon at multiple sites. Clin Infect Dis 2002;34:499503.CrossRefGoogle Scholar
17.Dijkshoorn, L, Aucken, H, Gerner-Smidt, P, et al. Comparison of outbreak and nonoutbreak Acinetobacter baumannii strains by genotypic and phenorypic methods. J Clin Microbiol 1996;34:15191525.Google Scholar
18.Baron, E, Peterson, L, Finegold, S. Bailey and Scott's Diagnostic Microbiology, 9th ed. St. Louis, MO: Mosby; 1994.Google Scholar
19.Isenberg, H. Clinical Microbiology Procedures Handbook, vol. 1. Washington, DC: American Society for Microbiology; 1992.Google Scholar
20.Bean, P, Olive, M. Molecular principles underlying hepatitis C virus diagnosis. Am Clin Lab 2001;20:1921.Google ScholarPubMed
21.Tenover, FC, Arbeit, RD, Goering, RV. How to select and interpret molecular strain typing methods for epidemiological studies of bacterial infections: a review for healthcare epidemiologists. Molecular Typing Working Group of the Society for Healthcare Epidemiology of America. Infect Control Hosp Epidemiol 1997;18:426439.CrossRefGoogle Scholar
22.Tenover, FC, Arbeit, RD, Goering, RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:22332239.Google ScholarPubMed
23.Seifert, H, Dijkshoorn, L, Gerner-Smidt, P, Pelzer, N, Tjernberg, I, Vaneechoutte, M. Distribution of Acinetobacter species on human skin: comparison of phenotypic and genotypic identification methods. J Clin Microbiol 1997;35:28192825.Google ScholarPubMed
24.Chu, YW, Leung, CM, Houang, ET, et al. Skin carriage of Acinetobacter in Hong Kong. J Clin Microbiol 1999;37:29622967.Google ScholarPubMed
25.Dy, ME, Nord, JA, LaBombardi, VJ, Kislak, JW. The emergence of resistant strains of Acinetobacter baumannii: clinical and infection control implications. Infect Control Hosp Epidemiol 1999;20:565567.CrossRefGoogle ScholarPubMed
26.Bernards, AT, Frenay, HM, Lim, BT, Hendriks, WD, Dijkshoorn, L, van Boven, CP. Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii: an unexpected difference in epidemiologic behavior. Am J Infect Control 1998;26:544551.CrossRefGoogle ScholarPubMed
27.Thurm, V, Ritter, E. Genetic diversity and clonal relationships of Acinetobacter baumannii strains isolated in a neonatal ward: epidemiological investigations by allozyme, whole-cell protein and antibiotic resistance analysis. Epidemiol Infect 1993;111:491498.CrossRefGoogle Scholar
28.Spiliopoulou, I, Droukopoulou, A, Athanassiadou, A, Dimitracopoulos, G. Plasmid profiles of Acinetobacter and Enterobacter species of hospital origin: restriction endonuclease analysis of plasmid DNA and transformation of Escherichia coli by R plasmids. J Chemother 1992;4:7277.CrossRefGoogle ScholarPubMed
29.McDonald, A, Amyes, SG, Paton, R. The persistence and clonal spread of a single strain of Acinetobacter 13TU in a large Scottish teaching hospital. J Chemother 1999;11:338344.CrossRefGoogle Scholar
30.Webster, CA, Towner, KJ, Saunders, GL, Crewe-Brown, HH, Humphreys, H. Molecular and antibiogram relationships of Acinetobacter isolates from two contrasting hospitals in the United Kingdom and South Africa. Eur J Clin Microbiol Infect Dis 1999;18:595598.CrossRefGoogle ScholarPubMed
31.Musa, EK, Desai, N, Casewell, MW. The survival of Acinetobacter calcoaceticus inoculated on fingertips and on formica. J Hosp Infect 1990;15:219227.CrossRefGoogle ScholarPubMed
32.Webster, C, Towner, KJ, Humphreys, H. Survival of Acinetobacter on three clinically related inanimate surfaces. Infect Control Hosp Epidemiol 2000;21:246.CrossRefGoogle ScholarPubMed
33.Debast, SB, Meis, JF, Melchers, WJ, Hoogkamp-Korstanje, JA, Voss, A. Use of interrepeat PCR fingerprinting to investigate an Acinetobacter baumannii outbreak in an intensive care unit. Scand J Infect Dis 1996;28:577581.CrossRefGoogle Scholar
34.Pina, P, Guezenec, P, Grosbuis, S, Guyot, L, Ghnassia, JC, Allouch, PY. An Acinetobacter baumannii outbreak at the Versailles Hospital Center [in French]. Pathol Biol (Paris) 1998;46:385394.Google Scholar
35.Webster, CA, Crowe, M, Humphreys, H, Towner, KJ. Surveillance of an adult intensive care unit for long-term persistence of a multi-resistant strain of Acinetobacter baumannii. Eur J Clin Microbiol Infect Dis 1998;17:171176.Google ScholarPubMed
36.Ling, ML, Ang, A, Wee, M, Wang, GC. A nosocomial outbreak of multiresistant Acinetobacter baumannii originating from an intensive care unit. Infect Control Hosp Epidemiol 2001;22:4849.CrossRefGoogle ScholarPubMed
37.Levin, AS, Gobara, S, Mendes, CM, Cursino, MR, Sinto, S. Environmental contamination by multidrug-resistant Acinetobacter baumannii in an intensive care unit. Infect Control Hosp Epidemiol 2001;22:717720.CrossRefGoogle Scholar
38.Allen, KD, Green, HT. Hospital outbreak of multi-resistant Acinetobacter anitratus: an airborne mode of spread? J Hosp Infect 1987;9:110119.CrossRefGoogle Scholar
39.Buxton, AE, Anderson, RL, Werdegar, D, Atlas, E. Nosocomial respiratory tract infection and colonization with Acinetobacter calcoaceticus: epidemiologic characteristics. Am J Med 1978;65:507513.CrossRefGoogle ScholarPubMed
40.Riley, TV, Webb, SA, Cadwallader, H, Briggs, BD, Christiansen, L, Bowman, RA. Outbreak of gentamicin-resistant Acinetobacter baumannii in an intensive care unit: clinical, epidemiological, and microbiological features. Pathology 1996;28:359363.CrossRefGoogle Scholar
41.Roberts, SA, Findlay, R, Lang, SD. Investigation of an outbreak of multidrug resistant Acinetobacter baumannii in an intensive care burns unit. J Hosp Infect 2001;48:228232.CrossRefGoogle Scholar
42.Cardoso, CL, Pereira, HH, Zequim, JC, Guilhermetti, M. Effectiveness of hand-cleansing agents for removing Acinetobacter baumannii strain from contaminated hands. Am J Infect Control 1999;27:327331.CrossRefGoogle ScholarPubMed
51
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The Epidemiology of Multidrug-Resistant Acinetobacter Baumannii Does the Community Represent a Reservoir?
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

The Epidemiology of Multidrug-Resistant Acinetobacter Baumannii Does the Community Represent a Reservoir?
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

The Epidemiology of Multidrug-Resistant Acinetobacter Baumannii Does the Community Represent a Reservoir?
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *