Multidrug-resistant <i>Acinetobacter baumannii</i> outbreaks: a global problem in healthcare settings

Kurihara, Mariana Neri Lucas; Sales, Romário Oliveira de; Silva, Késia Esther da; Maciel, Wirlaine Glauce; Simionatto, Simone

doi:10.1590/0037-8682-0248-2020

Mariana Neri Lucas Kurihara

Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

Romário Oliveira de Sales

Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

Késia Esther da Silva

Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

Wirlaine Glauce Maciel

Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

Simone Simionatto

Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

http://orcid.org/0000-0003-2367-0915

Corresponding author: Dra. Simone Simionatto. e-mail: simonesimionatto@ufgd.edu.br

Authors’ contribution: WGM: Study conception and design; WGM, MNLK: Acquisition of data; MNLK, ROS, KES: Analysis and interpretation of data; MNLK, SS: Drafting of manuscript; SS: Critical revision. Authors give final approval of the version to be submitted and any revised version.

Conflict of Interest: The authors declare that there is no conflict of interest.

Study	Place of Study	Study Period	No. of Patients	Cases	Controls	Risk Factors	P-value
JANG et al., 2009	Taiwan	1997-2006	154	77 patients with AB bloodstream infection.	77 patients with bloodstream infection without AB.	Use of central venous catheter, mechanical ventilation, colonization by AB, respiratory failure, cardiovascular failure.	P < 0.05
YE et al., 2010	Germany	2001-2005	209	49 patients with MDRAB.	160 patients with CSAB.	Previous use of antibiotics, use of mechanical ventilation, > 60 years, length of hospital stay.	P < 0.05
ROCHA et al., 2008	Brazil	2005-2006	275	84 patients with PAVM.	191 patients without PAVM.	Stay > 7 days in hospital, use of corticoids, invasive procedures, use of central venous catheter, and tracheostomy.	P < 0.05
BROTFAIN et al, 2016	Israel	2005-2011	129	46 patients with pneumonia and positive sputum culture for MDRAB 72 h after MV onset and bacteremia.	83 patients with pneumonia and positive sputum culture for MDRAB 72 h after the onset of MV, without developing bacteremia.	Hospitalization > 3 days in the ICU, advanced age, and recent bacteremia.	P < 0.05
BLANCO et al., 2017	United States	2005-2009	101	90 patients with MDRAB.	11 patients with CSAB.	Advanced age, previous hospitalization, heart failure, paralysis, HIV-AIDS, and rheumatoid arthritis.	P < 0.05
ELLIS et al., 2015	United States	2006-2012	671	302 patients with infection caused by MDRAB.	369 patients with infection caused by CSAB.	Length of hospital stay, transfer from another hospital, previous use of antibiotics	P < 0.25
HENIG et al., 2015	Israel	2007-2012	2380	1190 patients with CRAB.	1190 patients without AB.	Chemotherapy, organ transplant, chronic diseases, invasive procedures, recent bacteremia, tumor, hematological diseases, and recurrent hospitalizations.	P < 0.05
JUNG et al., 2010	South Korea	2008-2009	200	108 patients with bacteremia caused by AB.	92 patients without bacteremia.	Respiratory failure, mechanical ventilation, tracheal tube, central venous catheter, bacteremia caused by other microorganisms, previous use of antibiotics.	P < 0.05
NUTMAN et al., 2014	Israel	2008-2011	172	83 patients with bacteremia who died within 14 days.	89 patients with bacteremia who survived after 14 days.	Disease severity and surgical procedure.	P ≤ 0.10
CHUSRI et al., 2015	Thailand	2010-2011	394	139 patients with CRAB.	197 patients without AB and 58 patients with CSAB.	Use of fluoroquinolones, broad spectrum cephalosporins, and carbapenems > 3 days.	P < 0.05
MOGHNIEH et al., 2016	Lebanon	2012-2013	257	40 patients with AB.	217 patients without AB.	Use of urinary catheter, ICU contact pressure, gastrectomy tube, and carbapenem use.	P < 0.05
GUO et al., 2016	China	2012-2015	87	64 patients with bloodstream infection by MDRAB.	23 patients with bloodstream infection by CSAB.	Pneumonia, drain use, ICU stay> 7 days, and use of mechanical ventilation.	P < 0.05

Study	Place of study	Study period	No. of patients	Cases	Controls	Risk factors	P-value
BRITO et al., 2010	Brazil	2001-2002	33	11 patients with infectious conditions caused by AB.	22 patients without infectious conditions caused by AB.	Birth weight <2500 grams, respiratory syndromes, parental feeding, re-intubation, carbapenem use, and mechanical ventilation.	P < 0.05
DENG et al., 2011	China	2002-2008	349	117 patients with PAVM caused by AB.	232 patients without PAVM caused by AB.	Use of mechanical ventilation> 7 days.	P < 0.01
HSU et al., 2014	Taiwan	2004-2010	248	37 patients with bacteremia caused by AB.	74 patients without bacteremia and 137 patients with bacteremia caused by Escherichia coli or Klebsiella spp.	Cholestasis, gestational age < 29 weeks.	P < 0.05
LEE et al., 2017	China	2004-2014	40	37 patients with AB susceptible to imipenem	3 patients with AB resistant to imipenem	Prematurity, low birth weight (70% < 1500 g), prolonged intubation, percutaneous use of central venous catheter, inappropriate initial therapy, infection within the first 10 days of life, use of imipenem for up to 5 days, and high frequency oscillation ventilation.	P < 0.05
PUNPANICH et al., 2012	Thailand	2005-2010	176	91 patients with bacteremia caused by CRAB.	85 patients with bacteremia caused by CSAB.	Prematurity, use of mechanical ventilation, previous exposure to carbapenems.	P < 0.05
HOSOGLU et al., 2012	Turkey	2006-2007	192	64 patients with AB sepsis.	128 patients with blood samples without AB.	Stay in the ICU> 7 days, re-intubation.	P < 0.001
De OLIVEIRA COSTA et al., 2015	Brazil	2009-2012	101	47 patients with infection caused by BGN.	54 patients without infection caused by BGN.	Hematologic diseases, neutropenia > 3 days, previous use of antibiotics, previous hospitalization, stay in the ICU > 3 days.	P < 0.05
THATRIMONTRICHAI et al., 2013	Thailand	2009-2014	101	63 patients with CRAB pneumonia and 13 patients with CSAB.	25 patients with pneumonia without bacterial growth or caused by other microorganisms.	Weight of newborns, previous use of cephalosporins, surfactant replacement therapy, re-intubation, umbilical artery catheterization.	P < 0.05
REDDY et al., 2015	South Africa	2010	388	194 patients with blood culture or respiratory sample positive for AB.	194 patients with blood culture or negative respiratory sample for AB.	Mechanical ventilation and traumatic brain injury.	P < 0.05
ZARRILLI et al., 2012	Italy	2010-2011	161	22 patients with AB.	139 patients without AB in the first 48 h.	Use of mechanical ventilation and central venous catheter.
TRAN et al., 2015	Vietnam	2010-2011	2555	69 patients with sepsis caused by AB.	2486 patients without sepsis caused by AB.	Maternal infection, gestational age, central catheter, surgical procedure, and blood transfusion.	P < 0.05
KUMAR et al., 2014	India	2010-2012	65	33 patients with CRAB bloodstream infection.	32 patients without CSAB bloodstream infection.	Previous use of antibiotics, hospitalization > 7 days, use of mechanical ventilation > 7 days.	P < 0.05
WEI et al., 2014	Taiwan	2010-2013	59	12 deaths due to sepsis caused by MDRAB.	47 deaths due to sepsis caused by other microorganisms.	Prolonged intubation, mechanical ventilation, peripheral central venous catheter, umbilical catheter, total parental nutrition, ICU stay > 7 days, surgical procedure, and bronchopulmonary dysplasia.	P < 0.05
MACIEL et al., 2017	Brazil	2013-2015	21	21 patients with AB colonization without clinical manifestation.	17 patients without sepsis.	Low birth weight, prematurity, hospitalization time, previous exposure to beta-lactams, use of peripheral access, and respiratory syndromes.	P < 0.05

Study	Place of study	Year of outbreak	Place of outbreak	No. of patients	Antibiotic Resistance	Reported genes
DALIA-COSTA et al., 2003	Curitiba	1999	Ward	8	IPM, MEM, CIP, and AMG	bla _OXA-23
BRITO et al., 2005	Uberlândia	2005	NICU	11	GEN, CIP, CAZ, FEP, and ATM	-
TAKAGI et al., 2009	São Paulo	2005-2006	ICU	8	PIP, TZP, CAZ, CTX, ATM, IPM, MEM, CIP, AMK, GEN, and SXT	bla _OXA-51
MARTINS et al., 2009	Porto Alegre	2007	DHW	53	CIP, GEN, TZP, and SXT	bla _OXA-51, bla _OXA-23
GUSATTI et al., 2012	Porto Alegre	2007	Ward	74	IPM, MEM, AMK, CIP, GEN, CET, AMA, SXT, and TIM	bla_OXA-51,bla_OXA-58,bla_OXA-65,ISAba1/OXA-51
PAGANO et al., 2015	Porto Alegre	2011	DHW	122	FEP, CIP, CAZ, AMA, AMK, PMB, IMP and MEM	bla _OXA-23
CASTILHO et al., 2017	Goiás	2010	ICU	64	AMA, FEP, AMK, PMB, and TGC	ISAba1/OXA-23 and ISAba1/OXA-51, bla_OXA-51,bla_OXA-23,bla_OXA-58
MACIEL et al., 2017	Dourados	2013-2015	NICU	21	AMA, TZP, CAZ, CRO, FEP, GEN, AMK, CIP, and TGC.	ISAba1/OXA-23 and ISAba1/OXA-51

[1] Corresponding author: Dra. Simone Simionatto. e-mail: simonesimionatto@ufgd.edu.br

Brasil

Brasil

Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Abstract

INTRODUCTION:

METHODS:

CONCLUSIONS: