TY - JOUR
T1 - Sequential outbreaks of multidrug-resistant Acinetobacter baumannii in intensive care units of a tertiary referral hospital in Italy
T2 - Combined molecular approach for epidemiological investigation
AU - Ansaldi, F.
AU - Canepa, P.
AU - Bassetti, M.
AU - Zancolli, M.
AU - Molinari, M. P.
AU - Talamini, A.
AU - Ginocchio, F.
AU - Durando, P.
AU - Mussap, M.
AU - Orengo, G.
AU - Viscoli, C.
AU - Icardi, G.
PY - 2011/10
Y1 - 2011/10
N2 - A laboratory-based surveillance study was conducted from January 2007 to May 2010 in San Martino Tertiary Referral Hospital in Genoa, Italy in which the molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the five intensive care units (ICUs). A total of 53 A. baumannii strains were isolated from patients admitted to ICUs (69.8%) and to other epidemiologically linked hospital wards (30.2%) and were genotyped by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), multilocus sequence typing (MLST) and adeB sequence typing. REP-PCR fingerprinting analysis, MLST and adeB typing results were well correlated and allowed us to classify strains causing epidemic events into three major epidemic clones: A (REP-I/ST4, adeB-STII genotype) isolated for the first time in May 2007, B (REP-IV/ST95, adeB-STI genotype) from November 2007 to May 2009 and C (REP-VII/ST118, adeB-STII genotype) from July 2008 to May 2010. MLST results demonstrated that epidemic clones A and C were related as they were members of the widespread clonal complex CC92. The genetic determinants of carbapenem resistance were investigated and resistance associated with the presence of the bla OxA-58-like gene with ISAba2 and ISAba3 elements flanking it in clone A, and with the bla OxA-23-like gene flanked by ISAba1 in clones B and C. A molecular approach allowed the prompt introduction of infection control measures and the evaluation of data in a global epidemiological context.
AB - A laboratory-based surveillance study was conducted from January 2007 to May 2010 in San Martino Tertiary Referral Hospital in Genoa, Italy in which the molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the five intensive care units (ICUs). A total of 53 A. baumannii strains were isolated from patients admitted to ICUs (69.8%) and to other epidemiologically linked hospital wards (30.2%) and were genotyped by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), multilocus sequence typing (MLST) and adeB sequence typing. REP-PCR fingerprinting analysis, MLST and adeB typing results were well correlated and allowed us to classify strains causing epidemic events into three major epidemic clones: A (REP-I/ST4, adeB-STII genotype) isolated for the first time in May 2007, B (REP-IV/ST95, adeB-STI genotype) from November 2007 to May 2009 and C (REP-VII/ST118, adeB-STII genotype) from July 2008 to May 2010. MLST results demonstrated that epidemic clones A and C were related as they were members of the widespread clonal complex CC92. The genetic determinants of carbapenem resistance were investigated and resistance associated with the presence of the bla OxA-58-like gene with ISAba2 and ISAba3 elements flanking it in clone A, and with the bla OxA-23-like gene flanked by ISAba1 in clones B and C. A molecular approach allowed the prompt introduction of infection control measures and the evaluation of data in a global epidemiological context.
KW - Molecular epidemiology
KW - Multidrug-resistant Acinetobacter baumannii
KW - Multilocus sequence typing
KW - Outbreak
KW - Repetitive extragenic palindromic polymerase chain reaction (REP-PCR)
UR - http://www.scopus.com/inward/record.url?scp=80052259073&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052259073&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2011.05.027
DO - 10.1016/j.jhin.2011.05.027
M3 - Article
C2 - 21820758
AN - SCOPUS:80052259073
VL - 79
SP - 134
EP - 140
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
SN - 0195-6701
IS - 2
ER -