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Antibiotic Resistance Is a Major Risk Factor for Epidemic Behavior of Acinetobacter baumannii

Published online by Cambridge University Press:  02 January 2015

Johannes G.M. Koeleman ,
Madelon W. van der Bijl ,
Jeroen Stoof ,
Christina M.J.E. Vandenbroucke-Grauls  and
Paul H.M. Savelkoul
Johannes G.M. Koeleman
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Madelon W. van der Bijl
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Jeroen Stoof
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Christina M.J.E. Vandenbroucke-Grauls
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Paul H.M. Savelkoul*
Affiliation:
Department of Medical Microbiology and Infection Control, Sint Franciscus Gasthuis, Rotterdam, The Netherlands Department of Clinical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
*
Department of Medical Microbiology and Infection Control, Vrije Universiteit Medical Center, Postbox 7057, 1007 MB Amsterdam, The Netherlands
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Abstract

Objective:

To study the presence of bacterial factors in clinical isolates of Acinetobacter species in order to identify markers of epidemic potential.

Design:

Case-control study.

Methods:

Forty-six isolates of Acinetobacter species, including 23 epidemic and 23 sporadic strains from different outbreaks in nine European countries, were compared for the presence of the following factors: hemagglutination, presence of capsules and fimbriae, binding to salivary mucins, resistance to drying, and antibiogram typing. Genotyping of all strains was performed by amplified fragment-length polymorphism (AFLP).

Results:

All outbreak strains except two (91%) were identified as Acinetobacter baumannii. Binding to salivary mucins and resistance to antibiotics were significantly associated with epidemic behavior. Antibiogram typing showed clustering of predominantly A baumannii strains within one group, and these strains were significantly more resistant to antibiotics than sporadic strains. AFLP genotyping revealed a great heterogeneity among the different European Acinetobacter strains. Cluster analysis of AFLP fingerprints showed several small clusters of different A baumannii outbreak strains. AFLP genotyping could not identify a common epidemic marker within the strains studied.

Conclusions:

Antibiogram typing can be used in routine clinical laboratories as a screening method to recognize potentially epidemic A baumannii strains. Several other factors were found, both in different outbreaks as well as in sporadic Acinetobacter isolates. These characteristics were unable to predict epidemic behavior and therefore cannot be used as discriminative epidemic markers. AFLP genotyping demonstrated no common clonal origin of European epidemic A baumannii strains. This indicates that any clinical A baumannii isolate with resistance to multiple antibiotics can be a potential nosocomial outbreak strain.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 5 , May 2001 , pp. 284 - 288
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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