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

Authors
 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 
Citation
 International Journal of Antimicrobial Agents, Vol.36(5) : 430-435, 2010 
Journal Title
 International Journal of Antimicrobial Agents 
ISSN
 0924-8579 
Issue Date
2010
MeSH
Acinetobacter Infections/epidemiology* ; Acinetobacter Infections/microbiology* ; Acinetobacter Infections/pathology ; Acinetobacter baumannii/classification ; Acinetobacter baumannii/drug effects* ; Acinetobacter baumannii/enzymology* ; Acinetobacter baumannii/genetics ; Adult ; Aged ; Anti-Bacterial Agents/pharmacology* ; Bacterial Proteins/biosynthesis* ; Bacterial Typing Techniques ; Case-Control Studies ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Cross Infection/pathology ; DNA Fingerprinting ; Electrophoresis, Gel, Pulsed-Field ; Female ; Genotype ; Hospitals ; Humans ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; beta-Lactam Resistance* ; beta-Lactamases/biosynthesis*
Keywords
Risk factor ; Extensive drug resistance ; Acinetobacter baumannii ; OXA carbapenemase
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
Full Text
http://www.sciencedirect.com/science/article/pii/S0924857910003365
DOI
10.1016/j.ijantimicag.2010.06.049
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
Chin, Bum Sik(진범식)
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102014
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