Objective:To investigate the pattern of antibiotic resistance and biofilm production capabilities of clinical Acinetobacter baumannii(A.baumannii)isolates in this study.Methods:A.baumannii isolates were collected from...Objective:To investigate the pattern of antibiotic resistance and biofilm production capabilities of clinical Acinetobacter baumannii(A.baumannii)isolates in this study.Methods:A.baumannii isolates were collected from Tehran Imam Khomeini Hospital in this cross-sectional study,and the minimum inhibitory concentrations for 16 antibiotics were determined using Vitek2®systems.All isolates were analyzed for biofilm production,then presence of biofilm-associated genes,and class Ⅰ and Ⅱ integron genes.Results:60 non-replicate A.baumannii isolates were included in this study.The resistance rates reached 100%for aztreonam,cefepime,ceftazidime,ciprofloxacin,piperacillin-tazobactam,piperacillin,ticarcillin,and trimethoprim-sulfamethoxazole.A.baumannii isolates were most sensitive to colistin and rifampicin being the most effective treatments.Multi-drug resistant and extensively drug-resistant isolates accounted for 83.3%and 16.7%,respectively.Of the isolates,91.6%formed biofilms,categorized as 10%strong,31.6%moderate,and 50%weak.No correlation was found between antibiotic resistance and biofilm formation.The genes csuE,abaI,and ompA were prevalent,but their distribution was similar across biofilm categories.A relationship between Int1 and biofilm production was noted.Conclusions:The high rates of antibiotic resistance and biofilm formation,alongside the presence of integrons including class Ⅰ and Ⅱ,underscore the necessity for ongoing monitoring of A.baumannii.Notably,classⅠintegron presence was significantly linked to biofilm formation.Further research is needed to explore the connection between antibiotic resistance and biofilm production in A.baumannii.展开更多
Objective:To study the clinical efficacy and safety of tigecycline in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)combined with multidrug-resistant Acinetobacter baumannii infecti...Objective:To study the clinical efficacy and safety of tigecycline in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)combined with multidrug-resistant Acinetobacter baumannii infection.Methods:113 patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection were recruited between January 2021 and January 2023,and given tigecycline treatment.The total effective rate,lung function indexes,related biochemical index levels,and the incidence rate of adverse reactions were observed after the treatment.Results:After the treatment,100 patients were cured,1 case with apparent effect,2 cases were effective,10 cases were ineffective,and the total effective rate was 91.15%.The post-treatment CRP(21.22±3.35 mg/L),PCT(3.18±1.11 ng/L),CRE(76.36±9.24μmol/L),and ALT(37.76±6.99 U/L)were significantly improved as compared to the pre-treatment(P<0.05).After treatment,10 cases of vomiting(8.85%),13 cases of nausea(11.50%),4 cases of diarrhea(3.53%),1 case of abdominal pain(0.88%),and 2 cases of allergy(1.77%)were observed in 113 patients.Conclusion:Tigecycline therapy for patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection not only has significant therapeutic efficacy but also has a high degree of safety.展开更多
The development of resistance against most of the available antibiotics has made Acinetobacter baumannii(A.baumannii)a pathogen of high risk.In this study,thirty novel berberine derivatives are rationally designed,syn...The development of resistance against most of the available antibiotics has made Acinetobacter baumannii(A.baumannii)a pathogen of high risk.In this study,thirty novel berberine derivatives are rationally designed,synthesized,and evaluated for their synergistic antibacterial activities against A.baumannii.Among them,compound 2d shows the most potent synergetic effect to aztreonam against A.baumannii,including carbapenem-resistant and extended-spectrumβ-lactamases-producing strains.Moreover,synergistic effects were observed for the combinations of 2d and different antibacterial used in clinical practices,indicating its potent broad-spectrum antibiotic-sensitizing effects against A.baumannii.The combination of 2d and aztreonam significantly improves the survival rates of G.mellonella larvae compared with aztreonam treatment alone.Mechanism studies indicate that 2d inhibits the drug efflux and iron acquisition of the bacteria by targeting the AdeB transporter protein,thus achieving a synergistic antimicrobial efficacy with different antibacterial agents.Therefore,berberine derivatives represent a new family of antimicrobial adjuvants against A.baumannii,with the advantage of dual-function antibacterial effect,and are worthy of further investigation.展开更多
Acinetobacter baumannii(A.baumannii)is well known for its virulence and persistence,particularly in intensive care units.Therefore,new strategies and candidates to treat A.baumannii infection are urgently needed consi...Acinetobacter baumannii(A.baumannii)is well known for its virulence and persistence,particularly in intensive care units.Therefore,new strategies and candidates to treat A.baumannii infection are urgently needed considering the emergence of drug-resistant bacteria.Polyphosphate kinase 1(PPK1)is required for bacterial survival as it is involved in maintaining antibiotic resistance or tolerance,pathogenesis,and adversity resistance.Multiple phenotypic assays related to virulence and persistence were performed in this study,and phloretin was shown to attenuate A.baumannii virulence and persistence by inhibiting PPK1 activity.Phloretin hampered mobility,interfered with biofilm formation and decreased resistance to ampicillin,heat,and hydrogen peroxide stress in A.baumannii.The therapeutic effect was also examined in a mouse pneumonia infection model.Molecular simulation and site-directed mutagenesis revealed that ARG-22,MET-622,ASN-57,and ARG-65 were the sites of phloretin action against PPK1.Phloretin treatment led to changes in metabolic pathways associated with A.baumannii virulence and persistence,including glycerophospholipid metabolism and fatty acid biosynthesis.Furthermore,phloretin alleviated pneumonic injury in a mouse pneumonia infection model in vivo,indicating that phloretin is a promising compound for preventing A.baumannii infection resistance by targeting PPK1.展开更多
Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resi...Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resistance necessitates updating diagnostic techniques to ensure higher sensitivity and specificity, especially with advancements in science and medicine. This study aimed to evaluate the prevalence of UTIs and antibiotic resistance profiles through urine culture, as well as to identify Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp. in urine samples using a molecular approach with multiplex real-time PCR. From May 3 to July 25, 2023, at the Pietro Annigoni Biomolecular Research Center (CERBA) and Saint Camille Hospital of Ouagadougou (HOSCO), 209 urine samples collected from patients with suspected UTIs were analyzed using both urine culture and multiplex real-time PCR. Among the 209 patients, 52.15% were male and 47.85% female, with an average age of 46.87 ± 21.33 years. Urine cultures revealed an overall UTI prevalence of 23.44%, with a prevalence of 8.13% in men versus 15.31% in women (P = 0.023). The bacterial prevalence rates were as follows: Escherichia coli (12.92%), Klebsiella spp. (7.18%), Enterobacter cloacae (1.44%), Staphylococcus aureus (0.96%), and other bacteria. Klebsiella spp. demonstrated 100% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, while Escherichia coli showed 96.2% and 65.4% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, respectively. PCR analysis of the target bacteria revealed mono-infection prevalence rates of Klebsiella pneumoniae (10.39%), Klebsiella oxytoca (7.79%), and Acinetobacter spp. (7.79%), along with a co-infection prevalence rate of Klebsiella pneumoniae/Acinetobacter spp. (1.30%). This study demonstrated that PCR, with its high sensitivity and specificity, could effectively distinguish Klebsiella pneumoniae from Klebsiella oxytoca and detect Acinetobacter spp. in less than 24 hours—something urine culture alone could not achieve. The relative ease of automating urine PCR testing, combined with its diagnostic accuracy and rapid turnaround time, makes it a valuable addition to modern medical practice for the laboratory diagnosis of UTIs.展开更多
Background:Acinetobacter baumannii(A.baumannii)is known as an opportunistic pathogen related to health-care-associated infection that has a high antibiotic resistance potential,notably against carbapenems that are wid...Background:Acinetobacter baumannii(A.baumannii)is known as an opportunistic pathogen related to health-care-associated infection that has a high antibiotic resistance potential,notably against carbapenems that are widely used to combat A.baumannii infections.This study aimed to detect oxacillin-hydrolyzing(OXA)carbapenemases and metallo-β-lactamases(MBL)among carbapenem-resistant A.baumannii isolated strains and to determine their clonal relationship by repetitive extragenic palindromic PCR(rep-PCR).Methods:In the present study,a total of 211 non-repetitive isolates of A.baumannii were collected from Qazvin educational hospitals(2016–2017).The disk diffusion method was used to investigate the antibiotic susceptibility of studied strains,followed by the detection of MBL and OXA-type genes using polymerase chain reaction(PCR)and sequencing methods.The rep-PCR method assessed the clonal relationship of carbapenem-non-susceptible A.baumannii isolates.Result:The obtained results showed that 87.2%and 86.7%of isolates were non-susceptible to imipenem and meropenem.The blaOXA-24(93.5%)was the most frequent gene,followed by the blaOXA-23(4.34%),blaIMP-1(1.63%),and blaVIM-1(0.54%).Meanwhile,blaOXA-58 and blaOXA-143 genes were not found.81.5%and 66.1%of isolates contained ISAba1 upstream of the blaOXA-23 and blaOXA-58 genes,respectively.Rep-PCR results revealed the carbapenem non-susceptible isolates belonged to three distinct clones:A 171(81%),B 34(16.1%),and C 6(2.8%).Conclusions:The results indicated a high prevalence of carbapenem-non-susceptible A.baumannii,with the emergence of the blaOXA-24 gene as the most common gene and the notable prevalence of MBL genes.These results revealed the need for appropriate therapeutic and infection control strategies and monitoring susceptibility patterns for controlling A.baumannii infections.展开更多
BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-...BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all HAIs.These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune systems.AIM To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted interventions.METHODS We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index Me-dicus.Studies were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB colonization.We excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary data.The study selection and quality assessment were conducted independently by two reviewers.Data extraction involved collecting comprehensive details about each study.Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional location.We assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication bias.RESULTS We analyzed 737 records from five databases,ultimately including 13 studies from ten countries.For neonates,the pooled prevalence was 4.8%(95%CI:1.1%to 10.5%)with the highest rates observed in South-East Asia(10.5%;95%CI:2.4%to 23.3%).Among HCWs,a single Indian study reported a 3.3%prevalence.Environmental samples showed a prevalence of 2.3%(95%CI:0%to 9.3%),with the highest rates in South-East Asia(10%;95%CI:4.2%to 17.7%).Significant heterogeneity was found across studies,and no publication bias was detected.CONCLUSION This systematic review highlights a significant prevalence of CRAB colonization in neonates across various regions,particularly in South-East Asia,contrasting with lower rates in high-income countries.The study reveals a gap in research on HCWs colonization,with only a single study from India reporting moderate prevalence.Environmental samples indicate moderate levels of CRAB contamination,again higher in South-East Asia.These findings underscore the need for more extensive and focused research on CRAB colonization in NICUs,including exploring the roles of HCWs and the environment in transmission,understanding antimicrobial resistance patterns,and developing effective prevention measures.展开更多
BACKGROUND:The Acinetobacter baumannii group,including Acinetobacter baumannii,Acinetobacter genomospecies 3 and 13 TU,is phenotypically indistinguishable and uniformly identified as Acinetobacter baumannii by laborat...BACKGROUND:The Acinetobacter baumannii group,including Acinetobacter baumannii,Acinetobacter genomospecies 3 and 13 TU,is phenotypically indistinguishable and uniformly identified as Acinetobacter baumannii by laboratories of clinical microbiology.This review aimed to demonstrate the differences among them.METHODS:Literatures associated with the Acinetobacter baumannii group were identified and selected from PubMed databases and relevant journals.RESULTS:Acinetobacter genospecies 3 and 13 TU possess a certain proportion in clinical isolates.There were considerable differences in epidemiologic features,clinical manifestations,antimicrobial resistances and therapeutic options among the Acinetobacter baumannii group.Compared with Acinetobacter genomospecies 3 and 13 TU,Acinetobacter baumannii with a higher resistance to antimicrobial agents are easier to be treated inappropriately,and present a worse outcome in patients.CONCLUSION:The Acinetobacter baumannii group comprises three distinct clinical entities,and their clinical value are not equal.展开更多
Objective Gas chromatography （GC） was used to investigate the cellular fatty acid （CFA） composition of 141 Acinetobacter boumannii and 32 A. calcoaceticus isolates from different locations in China and to find che...Objective Gas chromatography （GC） was used to investigate the cellular fatty acid （CFA） composition of 141 Acinetobacter boumannii and 32 A. calcoaceticus isolates from different locations in China and to find chemical markers to differentiate these two closely related bacteria. Methods Whole cell fatty acid methyl esters （FAMEs） were obtained by saponification, methylation, and extraction for GC analysis, followed by a standardized Microbial Identification System （MIS） analysis. Results All A. baumannii and A. calcoaceticus strains contained some major fatty acids, namely, 18：1 co9c, 16：0, Sum In Feature 3, 12：0, 17：1co8c, 3-OH-12：0, 17：0, Sum In Feature 2, 2-OH-12：0, and 18：0 compounds. Although most of the total CFAs are similar between A. baumannii and A. calcoaceticus strains, the ratios of two pairs of CFAs, i.e., Sum In Feature 3/18：1 co9c versus 16：0/18：1 co9c and Sum In Feature 3/18：1 co9c versus unknown 12.484/18：1 co9c fatty acids, could differentiate these two closely related bacteria. A. baumannii could be easily classified into two subgroups by plotting some ratios such as Sum In Feature 3/16：0 versus 17：0 and Sum In Feature 3/2-OH-12：0 versus17：0 fatty acids. Conclusion The ratios of some CFAs could be used as chemical markers to distinguish A. baumannii from A. colcoaceticus.展开更多
Objective: To determine the antibiotic resistance patterns of the Acinetobacter(A.) baumannii complex isolates that cause the confirmed infection. Methods: The present descriptive study was performed from March 2016 t...Objective: To determine the antibiotic resistance patterns of the Acinetobacter(A.) baumannii complex isolates that cause the confirmed infection. Methods: The present descriptive study was performed from March 2016 to March 2018 in three referral hospitals in Isfahan, Iran. All A. baumannii complex strains isolated from different clinical samples were identified by conventional phenotypic methods and antibiotic susceptibility pattern was detected. After the clinical investigation, contaminated samples were excluded and the source(hospital/community) and site of the infection were determined. Data on antibiotic susceptibility testing were extracted from WHONET software and analysis was done with SPSS.Results: From 254 patients who had confirmed A. baumannii complex infection, 158(62.20%) cases were male, 27(10.63%) were less than 20 years old, 172(67.72%) had healthcare-associated infections and 96(37.79%) were admitted in intensive care units. The most frequent infection was bloodstream infections(111, 43.70%). Our results showed that most of the isolates were resistant to most of the antibiotics(more than 75.00%) and a lower rate of non-susceptibility was observed against minocycline(20, 44.44%) and colistin(0%). The rate of multidrug-resistant isolates was 88.97%. There was no significant difference between resistance of A. baumannii complex isolates according to age. However, the resistance to amikacin and minocycline and the rate of multidrug resistance(MDR) were significantly different between males and females. In patients with healthcare associated infection(HAI), MDR isolates were significantly different regarding admission in ICU ward. Resistance to levofloxacin and ciprofloxacin were lower in isolates from patients with bloodstream infections in comparison to other diagnoses.Conclusions: In our study, a high level of antibiotic resistance was detected in both community-acquired and healthcare-associated A. baumannii complex infections. Appropriate antibiotic prescription in a clinical setting is an essential need for the control and prevention of A. baumannii resistant infections.展开更多
基金This study was financially supported by the Vice Chancellor for Research Affairs,Ilam University of Medical Sciences,Ilam,Iran(Project No.1326).
文摘Objective:To investigate the pattern of antibiotic resistance and biofilm production capabilities of clinical Acinetobacter baumannii(A.baumannii)isolates in this study.Methods:A.baumannii isolates were collected from Tehran Imam Khomeini Hospital in this cross-sectional study,and the minimum inhibitory concentrations for 16 antibiotics were determined using Vitek2®systems.All isolates were analyzed for biofilm production,then presence of biofilm-associated genes,and class Ⅰ and Ⅱ integron genes.Results:60 non-replicate A.baumannii isolates were included in this study.The resistance rates reached 100%for aztreonam,cefepime,ceftazidime,ciprofloxacin,piperacillin-tazobactam,piperacillin,ticarcillin,and trimethoprim-sulfamethoxazole.A.baumannii isolates were most sensitive to colistin and rifampicin being the most effective treatments.Multi-drug resistant and extensively drug-resistant isolates accounted for 83.3%and 16.7%,respectively.Of the isolates,91.6%formed biofilms,categorized as 10%strong,31.6%moderate,and 50%weak.No correlation was found between antibiotic resistance and biofilm formation.The genes csuE,abaI,and ompA were prevalent,but their distribution was similar across biofilm categories.A relationship between Int1 and biofilm production was noted.Conclusions:The high rates of antibiotic resistance and biofilm formation,alongside the presence of integrons including class Ⅰ and Ⅱ,underscore the necessity for ongoing monitoring of A.baumannii.Notably,classⅠintegron presence was significantly linked to biofilm formation.Further research is needed to explore the connection between antibiotic resistance and biofilm production in A.baumannii.
文摘Objective:To study the clinical efficacy and safety of tigecycline in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)combined with multidrug-resistant Acinetobacter baumannii infection.Methods:113 patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection were recruited between January 2021 and January 2023,and given tigecycline treatment.The total effective rate,lung function indexes,related biochemical index levels,and the incidence rate of adverse reactions were observed after the treatment.Results:After the treatment,100 patients were cured,1 case with apparent effect,2 cases were effective,10 cases were ineffective,and the total effective rate was 91.15%.The post-treatment CRP(21.22±3.35 mg/L),PCT(3.18±1.11 ng/L),CRE(76.36±9.24μmol/L),and ALT(37.76±6.99 U/L)were significantly improved as compared to the pre-treatment(P<0.05).After treatment,10 cases of vomiting(8.85%),13 cases of nausea(11.50%),4 cases of diarrhea(3.53%),1 case of abdominal pain(0.88%),and 2 cases of allergy(1.77%)were observed in 113 patients.Conclusion:Tigecycline therapy for patients with acute exacerbation of COPD combined with multidrug-resistant Acinetobacter baumannii infection not only has significant therapeutic efficacy but also has a high degree of safety.
基金supported by grants from National Natural Science Foundation of China(Nos.32141003,82104013)CAMS Initiative for Innovative Medicine(Nos.2021-1-I2M-070,2021-1-I2M-039,China)。
文摘The development of resistance against most of the available antibiotics has made Acinetobacter baumannii(A.baumannii)a pathogen of high risk.In this study,thirty novel berberine derivatives are rationally designed,synthesized,and evaluated for their synergistic antibacterial activities against A.baumannii.Among them,compound 2d shows the most potent synergetic effect to aztreonam against A.baumannii,including carbapenem-resistant and extended-spectrumβ-lactamases-producing strains.Moreover,synergistic effects were observed for the combinations of 2d and different antibacterial used in clinical practices,indicating its potent broad-spectrum antibiotic-sensitizing effects against A.baumannii.The combination of 2d and aztreonam significantly improves the survival rates of G.mellonella larvae compared with aztreonam treatment alone.Mechanism studies indicate that 2d inhibits the drug efflux and iron acquisition of the bacteria by targeting the AdeB transporter protein,thus achieving a synergistic antimicrobial efficacy with different antibacterial agents.Therefore,berberine derivatives represent a new family of antimicrobial adjuvants against A.baumannii,with the advantage of dual-function antibacterial effect,and are worthy of further investigation.
基金supported by the National Natural Science Foundation of China(U23A20242 and U22A20523)the Fundamental Research Funds for the Central Universities under Grant 2023JCXK-01。
文摘Acinetobacter baumannii(A.baumannii)is well known for its virulence and persistence,particularly in intensive care units.Therefore,new strategies and candidates to treat A.baumannii infection are urgently needed considering the emergence of drug-resistant bacteria.Polyphosphate kinase 1(PPK1)is required for bacterial survival as it is involved in maintaining antibiotic resistance or tolerance,pathogenesis,and adversity resistance.Multiple phenotypic assays related to virulence and persistence were performed in this study,and phloretin was shown to attenuate A.baumannii virulence and persistence by inhibiting PPK1 activity.Phloretin hampered mobility,interfered with biofilm formation and decreased resistance to ampicillin,heat,and hydrogen peroxide stress in A.baumannii.The therapeutic effect was also examined in a mouse pneumonia infection model.Molecular simulation and site-directed mutagenesis revealed that ARG-22,MET-622,ASN-57,and ARG-65 were the sites of phloretin action against PPK1.Phloretin treatment led to changes in metabolic pathways associated with A.baumannii virulence and persistence,including glycerophospholipid metabolism and fatty acid biosynthesis.Furthermore,phloretin alleviated pneumonic injury in a mouse pneumonia infection model in vivo,indicating that phloretin is a promising compound for preventing A.baumannii infection resistance by targeting PPK1.
文摘Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resistance necessitates updating diagnostic techniques to ensure higher sensitivity and specificity, especially with advancements in science and medicine. This study aimed to evaluate the prevalence of UTIs and antibiotic resistance profiles through urine culture, as well as to identify Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp. in urine samples using a molecular approach with multiplex real-time PCR. From May 3 to July 25, 2023, at the Pietro Annigoni Biomolecular Research Center (CERBA) and Saint Camille Hospital of Ouagadougou (HOSCO), 209 urine samples collected from patients with suspected UTIs were analyzed using both urine culture and multiplex real-time PCR. Among the 209 patients, 52.15% were male and 47.85% female, with an average age of 46.87 ± 21.33 years. Urine cultures revealed an overall UTI prevalence of 23.44%, with a prevalence of 8.13% in men versus 15.31% in women (P = 0.023). The bacterial prevalence rates were as follows: Escherichia coli (12.92%), Klebsiella spp. (7.18%), Enterobacter cloacae (1.44%), Staphylococcus aureus (0.96%), and other bacteria. Klebsiella spp. demonstrated 100% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, while Escherichia coli showed 96.2% and 65.4% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, respectively. PCR analysis of the target bacteria revealed mono-infection prevalence rates of Klebsiella pneumoniae (10.39%), Klebsiella oxytoca (7.79%), and Acinetobacter spp. (7.79%), along with a co-infection prevalence rate of Klebsiella pneumoniae/Acinetobacter spp. (1.30%). This study demonstrated that PCR, with its high sensitivity and specificity, could effectively distinguish Klebsiella pneumoniae from Klebsiella oxytoca and detect Acinetobacter spp. in less than 24 hours—something urine culture alone could not achieve. The relative ease of automating urine PCR testing, combined with its diagnostic accuracy and rapid turnaround time, makes it a valuable addition to modern medical practice for the laboratory diagnosis of UTIs.
基金Qazvin University of Medical Sciences for supporting the project(Grant number:10016).
文摘Background:Acinetobacter baumannii(A.baumannii)is known as an opportunistic pathogen related to health-care-associated infection that has a high antibiotic resistance potential,notably against carbapenems that are widely used to combat A.baumannii infections.This study aimed to detect oxacillin-hydrolyzing(OXA)carbapenemases and metallo-β-lactamases(MBL)among carbapenem-resistant A.baumannii isolated strains and to determine their clonal relationship by repetitive extragenic palindromic PCR(rep-PCR).Methods:In the present study,a total of 211 non-repetitive isolates of A.baumannii were collected from Qazvin educational hospitals(2016–2017).The disk diffusion method was used to investigate the antibiotic susceptibility of studied strains,followed by the detection of MBL and OXA-type genes using polymerase chain reaction(PCR)and sequencing methods.The rep-PCR method assessed the clonal relationship of carbapenem-non-susceptible A.baumannii isolates.Result:The obtained results showed that 87.2%and 86.7%of isolates were non-susceptible to imipenem and meropenem.The blaOXA-24(93.5%)was the most frequent gene,followed by the blaOXA-23(4.34%),blaIMP-1(1.63%),and blaVIM-1(0.54%).Meanwhile,blaOXA-58 and blaOXA-143 genes were not found.81.5%and 66.1%of isolates contained ISAba1 upstream of the blaOXA-23 and blaOXA-58 genes,respectively.Rep-PCR results revealed the carbapenem non-susceptible isolates belonged to three distinct clones:A 171(81%),B 34(16.1%),and C 6(2.8%).Conclusions:The results indicated a high prevalence of carbapenem-non-susceptible A.baumannii,with the emergence of the blaOXA-24 gene as the most common gene and the notable prevalence of MBL genes.These results revealed the need for appropriate therapeutic and infection control strategies and monitoring susceptibility patterns for controlling A.baumannii infections.
文摘BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all HAIs.These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune systems.AIM To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted interventions.METHODS We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index Me-dicus.Studies were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB colonization.We excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary data.The study selection and quality assessment were conducted independently by two reviewers.Data extraction involved collecting comprehensive details about each study.Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional location.We assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication bias.RESULTS We analyzed 737 records from five databases,ultimately including 13 studies from ten countries.For neonates,the pooled prevalence was 4.8%(95%CI:1.1%to 10.5%)with the highest rates observed in South-East Asia(10.5%;95%CI:2.4%to 23.3%).Among HCWs,a single Indian study reported a 3.3%prevalence.Environmental samples showed a prevalence of 2.3%(95%CI:0%to 9.3%),with the highest rates in South-East Asia(10%;95%CI:4.2%to 17.7%).Significant heterogeneity was found across studies,and no publication bias was detected.CONCLUSION This systematic review highlights a significant prevalence of CRAB colonization in neonates across various regions,particularly in South-East Asia,contrasting with lower rates in high-income countries.The study reveals a gap in research on HCWs colonization,with only a single study from India reporting moderate prevalence.Environmental samples indicate moderate levels of CRAB contamination,again higher in South-East Asia.These findings underscore the need for more extensive and focused research on CRAB colonization in NICUs,including exploring the roles of HCWs and the environment in transmission,understanding antimicrobial resistance patterns,and developing effective prevention measures.
基金supported by a from grant Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)
文摘BACKGROUND:The Acinetobacter baumannii group,including Acinetobacter baumannii,Acinetobacter genomospecies 3 and 13 TU,is phenotypically indistinguishable and uniformly identified as Acinetobacter baumannii by laboratories of clinical microbiology.This review aimed to demonstrate the differences among them.METHODS:Literatures associated with the Acinetobacter baumannii group were identified and selected from PubMed databases and relevant journals.RESULTS:Acinetobacter genospecies 3 and 13 TU possess a certain proportion in clinical isolates.There were considerable differences in epidemiologic features,clinical manifestations,antimicrobial resistances and therapeutic options among the Acinetobacter baumannii group.Compared with Acinetobacter genomospecies 3 and 13 TU,Acinetobacter baumannii with a higher resistance to antimicrobial agents are easier to be treated inappropriately,and present a worse outcome in patients.CONCLUSION:The Acinetobacter baumannii group comprises three distinct clinical entities,and their clinical value are not equal.
基金supported by the Innovation Foundation of Shanxi Medical University for undergraduate students (No. 2009056)the National Key Program for Infectious Diseases of China (No. 2008ZX10004-009)
文摘Objective Gas chromatography （GC） was used to investigate the cellular fatty acid （CFA） composition of 141 Acinetobacter boumannii and 32 A. calcoaceticus isolates from different locations in China and to find chemical markers to differentiate these two closely related bacteria. Methods Whole cell fatty acid methyl esters （FAMEs） were obtained by saponification, methylation, and extraction for GC analysis, followed by a standardized Microbial Identification System （MIS） analysis. Results All A. baumannii and A. calcoaceticus strains contained some major fatty acids, namely, 18：1 co9c, 16：0, Sum In Feature 3, 12：0, 17：1co8c, 3-OH-12：0, 17：0, Sum In Feature 2, 2-OH-12：0, and 18：0 compounds. Although most of the total CFAs are similar between A. baumannii and A. calcoaceticus strains, the ratios of two pairs of CFAs, i.e., Sum In Feature 3/18：1 co9c versus 16：0/18：1 co9c and Sum In Feature 3/18：1 co9c versus unknown 12.484/18：1 co9c fatty acids, could differentiate these two closely related bacteria. A. baumannii could be easily classified into two subgroups by plotting some ratios such as Sum In Feature 3/16：0 versus 17：0 and Sum In Feature 3/2-OH-12：0 versus17：0 fatty acids. Conclusion The ratios of some CFAs could be used as chemical markers to distinguish A. baumannii from A. colcoaceticus.
文摘Objective: To determine the antibiotic resistance patterns of the Acinetobacter(A.) baumannii complex isolates that cause the confirmed infection. Methods: The present descriptive study was performed from March 2016 to March 2018 in three referral hospitals in Isfahan, Iran. All A. baumannii complex strains isolated from different clinical samples were identified by conventional phenotypic methods and antibiotic susceptibility pattern was detected. After the clinical investigation, contaminated samples were excluded and the source(hospital/community) and site of the infection were determined. Data on antibiotic susceptibility testing were extracted from WHONET software and analysis was done with SPSS.Results: From 254 patients who had confirmed A. baumannii complex infection, 158(62.20%) cases were male, 27(10.63%) were less than 20 years old, 172(67.72%) had healthcare-associated infections and 96(37.79%) were admitted in intensive care units. The most frequent infection was bloodstream infections(111, 43.70%). Our results showed that most of the isolates were resistant to most of the antibiotics(more than 75.00%) and a lower rate of non-susceptibility was observed against minocycline(20, 44.44%) and colistin(0%). The rate of multidrug-resistant isolates was 88.97%. There was no significant difference between resistance of A. baumannii complex isolates according to age. However, the resistance to amikacin and minocycline and the rate of multidrug resistance(MDR) were significantly different between males and females. In patients with healthcare associated infection(HAI), MDR isolates were significantly different regarding admission in ICU ward. Resistance to levofloxacin and ciprofloxacin were lower in isolates from patients with bloodstream infections in comparison to other diagnoses.Conclusions: In our study, a high level of antibiotic resistance was detected in both community-acquired and healthcare-associated A. baumannii complex infections. Appropriate antibiotic prescription in a clinical setting is an essential need for the control and prevention of A. baumannii resistant infections.
