Clonal spread of carbapenem-resistant Acinetobacter baumannii across a community hospital and its affiliated long-term care facilities: A cross sectional study
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
51
Journal Issue
3
Pages
377-384
Date Issued
2018
Author(s)
Abstract
Background: The global spread of carbapenem-resistant Acinetobacter baumannii (CRAB) is now a public health problem. In Taiwan, the relationship of the CRAB circulation between long-term care facilities (LTCFs) and acute care hospitals remains unclear. Here, we use molecular epidemiologic methods to describe the transmission of CRAB isolates between a community hospital and its affiliated LTCFs. Methods: Subjects localized in eight LTCFs who were not admitted acute care hospitals in recent a year were enrolled in this study. CRAB isolates were collected during June 1, 2015 and December 31, 2015. DNA fingerprinting was performed by repetitive extragenic palindromic sequence-based polymerase chain reaction (Rep-PCR) and multilocus sequence typing (MLST). Multiplex-PCR amplification for the detection of blaOXA genes and beta-lactamase genes was performed. Results: Twenty one subjects were enrolled. The major hospital admission diagnoses among the 21 subjects were pneumonia (71.4%). Genotyping of CRAB isolates by Rep-PCR revealed that a major clone, designated as type III, comprised fifteen of 21 (71.4%) isolates taken from 5 LTCFs and one study hospital. The isolates with type III were subtyped by PubMLST into 4 ST types. The most prevalent blaOXA genes in these isolates were blaOXA-23-like (85.70%, 18/21). Twenty isolates carried blaSHV. Conclusion: Clonal spread of blaOxA-23-carrying CRABs was found around LTCFs and the affiliated hospital. In Taiwan, it is important for the government to focus attention on the importance of identifying and tracing CRAB infections in LTCFs. ? 2017
Subjects
A community hospital; Carbapenem-resistant Acinetobacter baumannii; Long-term care facilities
SDGs
Other Subjects
Acinetobacter baumannii; Acinetobacter infection; adult; aged; Article; bacteremia; bacterial colonization; bacterium culture; bacterium isolate; carbapenem resistant Acinetobacter baumannii; chronic obstructive lung disease; community hospital; cross-sectional study; DNA extraction; DNA fingerprinting; emergency care; female; gene amplification; hospital admission; hospital infection; human; infection risk; long term care; major clinical study; male; medical record; multilocus sequence typing; multiplex polymerase chain reaction; non insulin dependent diabetes mellitus; nonhuman; pneumonia; polymerase chain reaction; risk assessment; Taiwan; urinary tract infection; Acinetobacter baumannii; Acinetobacter infection; drug effect; genetics; genotype; genotyping technique; isolation and purification; long term care; microbial sensitivity test; microbiology; middle aged; molecular epidemiology; multidrug resistance; pathogenicity; procedures; prospective study; transmission; very elderly; antiinfective agent; bacterial DNA; bacterial protein; beta lactamase; beta-lactamase OXA-23, Acinetobacter baumannii; carbapenem derivative; Acinetobacter baumannii; Acinetobacter Infections; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Proteins; beta-Lactamases; Carbapenems; Cross-Sectional Studies; DNA Fingerprinting; DNA, Bacterial; Drug Resistance, Multiple, Bacterial; Female; Genotype; Genotyping Techniques; Hospitals, Community; Humans; Long-Term Care; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Epidemiology; Multilocus Sequence Typing; Multiplex Polymerase Chain Reaction; Prospective Studies; Taiwan
Publisher
Elsevier Ltd
Type
journal article