Eighteen years of experience with acinetobacter baumannii in a tertiary care hospital*

Luisa Munoz-Price, Kristopher Arheart, Patrice Nordmann, Anne E. Boulanger, Timothy Cleary, Rebeca Alvarez, Louis R Pizano, Nicholas Namias, Daniel H Kett, Laurent Poirel

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

OBJECTIVE:: To characterize the descriptive and molecular epidemiology of Acinetobacter baumannii in our hospital. DESIGN:: Longitudinal analysis of electronic microbiology laboratory records and isolates. SETTING:: A 1,500 bed public teaching hospital in the Miami area. PATIENTS:: Consecutive patients with A. baumannii from January 1994 to December 2011. INTERVENTIONS:: None MEASUREMENTS AND MAIN RESULTS:: Data on all A. baumannii isolates were clustered at the patient level, and the first isolate per single patient was determined. Yearly trends were analyzed based on carbapenem susceptibilities and originating units for all first isolates and first blood isolates per unique patient. Additionally, carbapenem nonsusceptible isolates frozen in the microbiology laboratory since 1998 were retrieved and evaluated using polymerase chain reaction and randomly amplified polymorphic DNA techniques. A total of 9,334 A. baumannii isolates were detected, of which 4,484 isolates (48%) were identified as first positive isolates per unique patient. Most of the burden of disease was located in the ICUs (odds ratio, 2.64 [95% CI, 2.17-3.22]; p < 0.0001) and in the adult wards (odds ratio, 3.867 [95% CI, 2.71-5.52]; p < 0.0001). Respiratory specimens constituted the most frequent source (49%; odds ratio, 1.619 [95% CI, 1.391-1.884]; p < 0.0001). Of the 4,484 first isolates, 846 isolates (18.9%) were carbapenem nonsusceptible and 3,638 isolates (81.1%) were carbapenem susceptible. Over the years, the number of carbapenem nonsusceptible isolates increased, whereas the number of carbapenem susceptible decreased (p < 0.0001). The trauma ICU had the highest burden of carbapenem nonsusceptible first isolates (205 of 846; 24.2%). Seven clones were discovered among 144 carbapenem nonsusceptible isolates; one of these clones was found from 1999 to 2005. OXA-23 and OXA-40 were identified in 96 and 13 isolates, respectively. One isolate harbored a novel CTX-M-115 enzyme. CONCLUSIONS:: This constitutes the largest experience with A. baumannii reported to date from a single center. Half of all isolates were respiratory specimens and were from adult ICUs, especially trauma. Even though this was a polyclonal process, a single clone was identified in the hospital through a 6-year span.

Original languageEnglish
Pages (from-to)2733-2742
Number of pages10
JournalCritical Care Medicine
Volume41
Issue number12
DOIs
StatePublished - Dec 1 2013

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Acinetobacter baumannii
Carbapenems
Tertiary Healthcare
Tertiary Care Centers
Clone Cells
Odds Ratio
Microbiology
Molecular Epidemiology
Public Hospitals
Wounds and Injuries
Teaching Hospitals
Polymerase Chain Reaction
DNA
Enzymes

Keywords

  • Acinetobacter baumannii
  • Carbapenem resistant
  • Epidemiology
  • Intensive care unit
  • Molecular genetics
  • Outbreak

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Munoz-Price, L., Arheart, K., Nordmann, P., Boulanger, A. E., Cleary, T., Alvarez, R., ... Poirel, L. (2013). Eighteen years of experience with acinetobacter baumannii in a tertiary care hospital*. Critical Care Medicine, 41(12), 2733-2742. https://doi.org/10.1097/CCM.0b013e318298a541

Eighteen years of experience with acinetobacter baumannii in a tertiary care hospital*. / Munoz-Price, Luisa; Arheart, Kristopher; Nordmann, Patrice; Boulanger, Anne E.; Cleary, Timothy; Alvarez, Rebeca; Pizano, Louis R; Namias, Nicholas; Kett, Daniel H; Poirel, Laurent.

In: Critical Care Medicine, Vol. 41, No. 12, 01.12.2013, p. 2733-2742.

Research output: Contribution to journalArticle

Munoz-Price, L, Arheart, K, Nordmann, P, Boulanger, AE, Cleary, T, Alvarez, R, Pizano, LR, Namias, N, Kett, DH & Poirel, L 2013, 'Eighteen years of experience with acinetobacter baumannii in a tertiary care hospital*', Critical Care Medicine, vol. 41, no. 12, pp. 2733-2742. https://doi.org/10.1097/CCM.0b013e318298a541
Munoz-Price L, Arheart K, Nordmann P, Boulanger AE, Cleary T, Alvarez R et al. Eighteen years of experience with acinetobacter baumannii in a tertiary care hospital*. Critical Care Medicine. 2013 Dec 1;41(12):2733-2742. https://doi.org/10.1097/CCM.0b013e318298a541
Munoz-Price, Luisa ; Arheart, Kristopher ; Nordmann, Patrice ; Boulanger, Anne E. ; Cleary, Timothy ; Alvarez, Rebeca ; Pizano, Louis R ; Namias, Nicholas ; Kett, Daniel H ; Poirel, Laurent. / Eighteen years of experience with acinetobacter baumannii in a tertiary care hospital*. In: Critical Care Medicine. 2013 ; Vol. 41, No. 12. pp. 2733-2742.
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AU - Cleary, Timothy

AU - Alvarez, Rebeca

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KW - Outbreak

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