Extensively drug-resistant Acinetobacter baumannii: Risk factors for acquisition and prevalent OXA-type carbapenemases-a multicentre study

Yoon Soo Park, Hyukmin Lee, Kkot Sil Lee, Seung Sik Hwang, Yong Kyun Cho, Hyo Youl Kim, Young Uh, Bum Sik Chin, Sang Hoon Han, Seok Hoon Jeong, Kyungwon Lee, June Myung Kim

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34 Citations (Scopus)

Abstract

In this study, we investigated the risk factors for and carbapenem resistance mechanisms of extensively drug-resistant Acinetobacter baumannii (XDR-AB). Isolates of XDR-AB were collected from seven tertiary care hospitals in South Korea. A case-control study for risk factor analysis was performed and the presence of the metallo-β-lactamase (MBL) and OXA genes was examined. The control group consisted of adult inpatients receiving care from the same hospital. XDR-AB were isolated from 26 patients who were studied for risk factor analysis. Third-generation cephalosporin use [odds ratio (OR) = 9.6, 95% confidence interval (CI) 1.3-171.3 P= 0.02] and Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR = 1.2, 95% CI 1.1-1.5; P= 0.004) were identified as risk factors for acquisition of XDR-AB. Pulsed-field gel electrophoresis (PFGE) showed clonal epidemic isolates in hospitals. MBLs were not detected, and all 30 XDR-AB isolates had upregulated OXA-type carbapenemase genes. These results suggest that third-generation cephalosporin use and disease severity are associated with XDR-AB acquisition amongst typical adult inpatients. This study also points to intrahospital spread of XDR-AB. Upregulated OXA-type carbapenemases are prevalent in XDR-AB founded in South Korean hospitals.

Original languageEnglish
Pages (from-to)430-435
Number of pages6
JournalInternational Journal of Antimicrobial Agents
Volume36
Issue number5
DOIs
Publication statusPublished - 2010 Nov

Bibliographical note

Funding Information:
Funding : This work was partly supported by the National Institute of Health, Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea (grant no. 2007-S3-G-004 ).

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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