Widespread carbapenem resistant Acinetobacter baumannii clones in Italian hospitals revealed by a multicenter study

E. Carretto, D. Barbarini, L. Dijkshoorn, T. J K van der Reijden, S. Brisse, V. Passet, C. Farina

Research output: Contribution to journalArticlepeer-review

Abstract

Population diversity, susceptibility to antibiotics including carbapenems of 277 Acinetobacter baumannii strains collected in 17 Italian hospitals over a 6-months' period was assessed. Semi-automated rep-PCR was used for screening strains for genotypic relatedness. AFLP analysis and MLST were used as definitive methods for strain, species and/or clone identification.Among the 277 strains, 49 rep-PCR types were distinguished with four types (1-4) predominant, indicating both intra- and interhospital spread. AFLP analysis allowed to distinguish 51 types and largely confirmed rep-typing results. Isolates with predominant rep-types 1 and 2 (in 3 and 9 hospitals) were allocated to EU clones I and II, respectively. Rep-type 3 (8 hospitals) belonged to a new clone (" Italian clone" ). Rep-type 4 was found in 2 neighbouring hospitals. Two isolates from 2 locations belonged to EU clone III. Twenty-five isolates were identified by AFLP-analysis to A. pittii, emphasizing misidentification by phenotypic methods. MLST confirmed clone identification by AFLP; demonstrating also that the " Italian clone" was ST78, recently detected in different Mediterranean countries.Multidrug resistance, defined as resistance to 9 out of the 11 drugs tested, was common in 10 out of 17 hospitals. The high prevalence of carbapenem resistance was associated with OXA-58 found in 9 out of the 10 hospitals. A high percentage of noted very major errors in susceptibility testing, especially for amikacin and meropenem, was probably due to heteroresistant strains. The occurrence of carbapenem and multidrug resistance in A. baumannii was mainly confined to a limited number of clonal lineages of A. baumannii.

Original languageEnglish
Pages (from-to)1319-1326
Number of pages8
JournalInfection, Genetics and Evolution
Volume11
Issue number6
DOIs
Publication statusPublished - Aug 2011

Keywords

  • Acinetobacter baumannii
  • AFLP analysis
  • Carbapenem resistance
  • Epidemiology
  • Italy
  • MLST analysis
  • Semi-automated rep-PCR typing

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Genetics
  • Molecular Biology
  • Microbiology
  • Infectious Diseases
  • Microbiology (medical)

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