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Cross-transmission of Acinetobacter junii carrying blaOXA-58 in a neonatal ICU
I Boudjella-Senhadji1, M Bour2, A Potron2
1Service d'Hygiène, Prévention et Contrôle des Infections, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France.
Insights
Acinetobacter junii carrying the blaOXA-58 carbapenem resistance gene colonized two preterm infants. Case 1 was the index case, with cross-transmission to case 2 confirmed by SNP analysis.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Genomics
Background:
- Nasal colonization by Acinetobacter junii harboring the blaOXA-58 carbapenem resistance gene was identified in two preterm infants within a neonatal intensive care unit.
- This highlights a potential threat in healthcare settings, particularly for vulnerable populations.
Purpose of the Study:
- To determine if the Acinetobacter junii isolates from the two preterm infants were genetically identical.
- To investigate the possibility of cross-transmission between the infants.
Main Methods:
- Antibiotic susceptibility testing and carbapenem minimum inhibitory concentration (MIC) determination.
- Polymerase chain reaction (PCR) to detect the blaOXA-58 gene.
- Whole Genome Sequencing (WGS) followed by Single Nucleotide Polymorphism (SNP) analysis for isolate comparison.
Main Results:
- The two Acinetobacter junii isolates were confirmed to be the same strain.
- Case 1 was identified as the index case, indicating successful cross-transmission to case 2.
Conclusions:
- The acquisition of this carbapenem-resistant strain was likely linked to prior carbapenem treatment in case 1.
- Cross-transmission is probable due to the intensive care environment and close proximity of the infants.
- This study represents the first documented instance of cross-transmission of Acinetobacter junii carrying the blaOXA-58 gene.
Background:
Nasal colonization of two preterm infants in our neonatal ICU by Acinetobacter junii carrying the blaOXA-58 carbapenem resistance gene was demonstrated.
Objectives:
To study whether the two isolates were identical and to investigate the hypotheses of cross-transmission.
Methods:
Antibiotic susceptibility tests of the two isolates were performed by standard diffusion and the MICs of carbapenems determined by the MIC-gradient strip method. The blaOXA-58 gene was detected by PCR. Isolates were compared using SNP analysis performed after WGS. The timelines of the two cases were determined based on the investigations and the study of the patients' records.
Results:
The two isolates corresponded to the same strain, with case 1 being the index case, demonstrating cross-transmission to case 2.
Conclusions:
Acquisition of the strain was likely due to the recent carbapenem treatment of case 1 and cross-transmission due to the high amount of care administered to the two preterm infants. This is the first description of cross-transmission of A. junii carrying the blaOXA-58 gene.
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