RESUMO
Se estudiaron 100 aislados consecutivos y no epidemiológicamente relacionados de Acinetobacter baumannii resistentes a los carbapenems, recuperados entre enero y agosto de 2016 de muestras clínicas en 11 hospitales de 10 provincias de la Argentina, ubicadas en distintas regiones del país. Los genes que codifican las carbapenemasas de Ambler clase D y clase B se investigaron mediante la técnica de PCR utilizando cebadores específicos. Todos los aislados se agruparon mediante las técnicas de 3-locus sequence typing y la secuenciación del gen blaOXA-51-like. El gen blaOXA-23 se recuperó en todos los aislados estudiados. La población de A. baumannii resistente a carbapenems en Argentina estuvo asociada, principalmente, con ST1 (45%), ST25 (34%) y ST79 (15%). ST25 se recuperó en todas las regiones estudiadas y no se detectó CC2.
One hundred sequential, epidemiologically unrelated carbapenem-resistant- Acinetobacter baumannii isolates from 11 hospitals in 10 Argentine provinces were collected between January and August 2016. Genes coding for Ambler class D and B carbapenemases were investigated by PCR using specific primers. All isolates were typed using the 3-locus sequence typing and b/aOXA-51-like sequence-based typing techniques. The blaOXA-23 gene was recovered in all isolates studied. The population of carbapenem-resistant- A. baumannii in Argentina was principally associated with ST1 (45%), ST25 (34%) and ST79 (15%). ST25 was recovered in all the regions studied and CC2 was not detected.
Assuntos
Humanos , Proteínas de Bactérias/genética , beta-Lactamases/genética , Infecções por Acinetobacter/microbiologia , Carbapenêmicos/farmacologia , Infecção Hospitalar/microbiologia , Resistência beta-Lactâmica , Acinetobacter baumannii/isolamento & purificação , Argentina/epidemiologia , Infecções por Acinetobacter/epidemiologia , Infecção Hospitalar/epidemiologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/enzimologia , Acinetobacter baumannii/genéticaRESUMO
One hundred sequential, epidemiologically unrelated carbapenem-resistant- Acinetobacter baumannii isolates from 11 hospitals in 10 Argentine provinces were collected between January and August 2016. Genes coding for Ambler class D and B carbapenemases were investigated by PCR using specific primers. All isolates were typed using the 3-locus sequence typing and blaOXA-51-like sequence-based typing techniques. The blaOXA-23 gene was recovered in all isolates studied. The population of carbapenem-resistant- A. baumannii in Argentina was principally associated with ST1 (45%), ST25 (34%) and ST79 (15%). ST25 was recovered in all the regions studied and CC2 was not detected.
Assuntos
Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/isolamento & purificação , Proteínas de Bactérias/genética , Carbapenêmicos/farmacologia , Infecção Hospitalar/microbiologia , Resistência beta-Lactâmica , beta-Lactamases/genética , Infecções por Acinetobacter/epidemiologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/enzimologia , Acinetobacter baumannii/genética , Argentina/epidemiologia , Infecção Hospitalar/epidemiologia , HumanosRESUMO
BACKGROUND: Multidrug-resistant strains of Acinetobacter baumannii have been reported increasingly around the world. The administration of an association of antibiotics has been proposed to create an active combination and to prevent the emergence of resistance. METHODOLOGY: The activity of colistin, rifampicin, gentamicin, imipenem and their associations was evaluated by means of killing curves in fourteen isolates belonging to three endemic PFGE types, in a university hospital of Buenos Aires city. The 14 isolates were selected on the basis of different mechanisms responsible for resistance to carbapenems and different susceptibility to colistin. RESULTS: The mechanism responsible for the resistance to imipenem was the production of OXA-23 and OXA-58 carbapenemases. Heteroresistance to colistin was observed in six isolates. The associations colistin-rifampicin and colistin-imipenem were synergistic in heteroresistant isolates and prevented the development of colistin-resistant mutants. The association imipenem-gentamicin was bactericidal in gentamicin susceptible isolates, whereas the association imipenem-rifampicin was always indifferent. CONCLUSION: The antimicrobial activity and the presence of synergy are related to the antimicrobials' susceptibilities irrespective of the PFGE type or the OXA-carbapenemase produced.
