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Carbapenem-resistant Acinetobacter baumannii contamination in an intensive care unit
Otávio Hallal Ferreira Raro1, Stephanie Wagner Gallo1, Carlos Alexandre Sanchez Ferreira1
1Laboratório de Imunologia e Microbiologia, Faculdade de Biociências, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Introduction::
Acinetobacter baumannii is a major pathogen causing infections in intensive care units (ICUs). In this study, we aimed to evaluate the presence of A. baumannii in an ICU environment and gloves from ICU workers and to characterize the antimicrobial resistance of the isolates in comparison with those isolated from ICU patients at the same hospital.
Methods::
ICU samples were collected from March to November 2010. Isolates biochemically characterized as Acinetobacter calcoaceticus-Acinetobacter baumannii complex were evaluated by PCR targeting the 16S rDNA and bla OXA-51 genes. Antimicrobial susceptibility was determined using the disk diffusion method, and carbapenem-resistant isolates were also evaluated for the minimum inhibitory concentration of imipenem using broth microdilution. The presence of the bla OXA-23 gene was evaluated in isolates with reduced susceptibility to carbapenems.
Results::
A. baumannii was detected in 9.5% (84) of the 886 samples collected from the ICU environment, including from furniture, medical devices, and gloves, with bed rails being the most contaminated location (23.8%; 20/84). Multidrug-resistant (MDR) A. baumannii was found in 98.8% (83/84) of non-clinical and 97.8% (45/46) of clinical isolates. Reduced susceptibility to carbapenems was detected in 83.3% (70/84) of non-clinical and 80.4% (37/46) of clinical isolates. All isolates resistant to carbapenems harbored bla OXA-23.
Conclusions::
We found a strong similarity between the antimicrobial susceptibility profiles of non-clinical and clinical A. baumannii isolates. Such data highlight the ICU environment as a potential origin for the persistence of MDR A. baumannii, and hence the ICU may be a source of hospital-acquired infections caused by this microorganism.
Insights
The intensive care unit (ICU) environment, including surfaces and staff gloves, is frequently contaminated with multidrug-resistant Acinetobacter baumannii. This highlights the ICU environment as a potential source of hospital-acquired infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Environmental Health
Background:
- Acinetobacter baumannii is a significant pathogen responsible for infections in intensive care units (ICUs).
- Understanding the environmental reservoirs of A. baumannii within ICUs is crucial for infection control.
- The prevalence and antimicrobial resistance patterns of A. baumannii in the ICU environment and from healthcare workers' gloves require investigation.
Purpose of the Study:
- To determine the presence of Acinetobacter baumannii in the ICU environment and on staff gloves.
- To characterize the antimicrobial resistance of A. baumannii isolates from the ICU environment.
- To compare environmental and clinical A. baumannii isolates regarding antimicrobial resistance.
Main Methods:
- Environmental and clinical samples were collected from an ICU over a nine-month period.
- Isolates were identified using biochemical tests and PCR targeting 16S rDNA and bla OXA-51 genes.
- Antimicrobial susceptibility testing (disk diffusion, broth microdilution) and detection of carbapenem resistance genes (bla OXA-23) were performed.
Main Results:
- Acinetobacter baumannii was detected in 9.5% of environmental samples, with bed rails being highly contaminated.
- The majority of environmental and clinical isolates were multidrug-resistant (MDR) and showed reduced susceptibility to carbapenems.
- All carbapenem-resistant isolates harbored the bla OXA-23 gene.
Conclusions:
- The ICU environment is a significant reservoir for multidrug-resistant Acinetobacter baumannii.
- Environmental contamination, including on staff gloves, likely contributes to the persistence and spread of MDR A. baumannii in ICUs.
- The ICU environment may serve as a source for hospital-acquired infections caused by A. baumannii.
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