Recurrent bacteremia caused by the Acinetobacter calcoaceticus- Acinetobacter baumannii complex
Journal
Journal of Clinical Microbiology
Journal Volume
50
Journal Issue
9
Pages
2982-2986
Date Issued
2012
Author(s)
Lai C.-C.
Hsu H.-L.
Tan C.-K.
Tsai H.-Y.
Liu C.-Y.
Liao C.-H.
Abstract
This study investigated the clinical and microbiological characteristics of patients with recurrent bacteremia caused by the Acinetobacter calcoaceticus-Acinetobacter baumannii (ACB) complex at a medical center. All ACB complex isolates associated with recurrent bacteremia were identified to the genomic species level using a 16S-23S rRNA gene intergenic spacer sequence-based method. Genotypes were determined by the random amplified polymorphic DNA patterns generated by arbitrarily primed PCR and by pulsotypes generated by pulsed-field gel electrophoresis. Relapse of infection was defined as when the genotype of the recurrent isolate was identical to that of the original infecting strain. Reinfection was defined as when the genospecies or genotype of the recurrent isolate differed from that of the original isolate. From 2006 to 2008, 446 patients had ACB complex bacteremia and 25 (5.6%) had recurrent bacteremia caused by the ACB complex. Among the 25 patients, 12 (48%) had relapse of bacteremia caused by A. nosocomialis (n = 7) or A. baumannii (n = 5). Among the 13 patients with reinfection, 5 (38.5%) had reinfection caused by different genospecies of the ACB complex. Most of the patients were immunocompromised, and most of the infection foci were catheter-related bloodstream infections. The overall in-hospital mortality rate was 33.3%. A. baumannii isolates had lower antimicrobial susceptibility rates than A. nosocomialis and A. pittii isolates. In conclusion, relapse of ACB complex bacteremia can develop in immunocompromised patients, especially those with central venous catheters. Molecular methods to identify the ACB complex to the genospecies level are essential for differentiating between reinfection and relapse of bacteremia caused by the ACB complex. Copyright ? 2012, American Society for Microbiology. All Rights Reserved.
SDGs
Other Subjects
amikacin; cefepime; ciprofloxacin; colistin; doripenem; gentamicin; imipenem; levofloxacin; meropenem; piperacillin plus tazobactam; RNA 16S; RNA 23S; sultamicillin; tigecycline; timentin; Acinetobacter; Acinetobacter baumannii; Acinetobacter calcoaceticus; Acinetobacter nosocomialis; Acinetobacter pittii; adult; antibiotic sensitivity; article; bacteremia; bacterium identification; bacterium isolate; catheter infection; clinical article; clinical feature; female; gene sequence; genotype; human; immunocompromised patient; male; microbiological examination; mortality; nonhuman; polymerase chain reaction; priority journal; pulsed field gel electrophoresis; random amplified polymorphic DNA; recurrent infection; reinfection; relapse; retrospective study; species differentiation; Academic Medical Centers; Acinetobacter baumannii; Acinetobacter calcoaceticus; Acinetobacter Infections; Adult; Aged; Anti-Bacterial Agents; Bacteremia; Female; Genotype; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Typing; Random Amplified Polymorphic DNA Technique; Recurrence; Sequence Analysis, DNA; Survival Analysis; Taiwan
Type
journal article