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Cross-transmission of a multidrug-resistant Acinetobacter baumannii clone produced endemic nosocomial bacteraemia and one outbreak in a Mexican Hospital

Abstract number: P792

Alcantar-Curiel M.D., Morfin-Otero R., Jarillo M.D., Rodriguez-Noriega E., Araiza J.R., Real B.E., Gayosso C., Santos J.I., Alpuche-Aranda C.M.

Background: Multidrug-resistant Acinetobacter baumannii (Aba) has emerged as an important cause of endemic nosocomial infections and epidemic outbreaks.

Objectives: To describe the antimicrobial susceptibility profile associated to genotyping of Aba causing nosocomial infections and outbreaks in one Mexican Hospital.

Methods: This is a descriptive molecular epidemiology study performed in a 1,000-bed tertiary care University Hospital in Guadalajara, Jalisco, Mexico. From December 2002 to August 2007, one hundred Aba isolates from nosocomial infections were detected from several wards in Hospital Civil de Guadalajara. Clinical data were collected from medical records. Antibiotic susceptibility testing was performed by disc diffusion method according to CLSI guidelines. Clonal analysis was determined by ApaI – Pulsed Field Gel Electrophoresis (PFGE).

Results: Sites of isolation included: Skin and soft tissue (46%), bloodstream (42%), sterile fluids (8%), and respiratory tract (4%). All Aba isolates were resistant to all quinolones, aminoglycosides, and b-lactam antibiotics, with 50% resistance to carbapenems. Genetic fingerprinting by PFGE of these isolates showed extensive heterogeneity between isolates, although one major cluster involving 37 patients belonged to a single clonal type. This Aba clone was an endemic in 2005 and 2006, and produced an outbreak in 2007. This clone was detected in the majority of the hospital wards.

Conclusions: Proper control of this multidrug-resistant Aba will require a multidisciplinary approach, including identification of resistance mechanisms, optimising antibiotic use based on local epidemiology and vigorous implementation of infection control procedures.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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