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Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel
BACKGROUND: NDM-producing Acinetobacter baumannii (NDMAb) were reported sporadically worldwide but little is known about the transmission, epidemiology and clinical features of NDMAb-infected patients. The goals of this study were to characterize (1) the epidemiology and clinical features of NDMAb–i...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314562/ https://www.ncbi.nlm.nih.gov/pubmed/37391819 http://dx.doi.org/10.1186/s12941-023-00607-w |
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author | Adler, Amos Ghosh, Hiren Gross, Andrea Rechavi, Amit Lasnoy, Michal Assous, Marc V. Geffen, Yuval Darawsha, Basel Wiener-Well, Yonit Alony, Anat Grundmann, Hajo Reuter, Sandra |
author_facet | Adler, Amos Ghosh, Hiren Gross, Andrea Rechavi, Amit Lasnoy, Michal Assous, Marc V. Geffen, Yuval Darawsha, Basel Wiener-Well, Yonit Alony, Anat Grundmann, Hajo Reuter, Sandra |
author_sort | Adler, Amos |
collection | PubMed |
description | BACKGROUND: NDM-producing Acinetobacter baumannii (NDMAb) were reported sporadically worldwide but little is known about the transmission, epidemiology and clinical features of NDMAb-infected patients. The goals of this study were to characterize (1) the epidemiology and clinical features of NDMAb–infected patients; (2) the microbiological and molecular features of NDMAb isolates and (3) the transmission networks of NDMAb within healthcare facilities. METHODS: The study was conducted at the Tel-Aviv Sourasky, Rambam and Sha’are-Zedek Medical centers (TASMC, RMC and SZMC, respectively) in Israel. All cases detected between January 2018 and July 2019 were included. Phylogenetic analysis was based on core genome SNP distances. Clonal transmission was defined according to molecular (≤ 5 SNP) and epidemiological criteria (overlapping hospital stay). NDMAb cases were compared at a ratio of 1:2 with non-NDM carbapenem-resistant A. baumannii (CRAb) cases. RESULTS: The study included 54 NDMAb-positive out of 857 CRAb patients, including 6/179 (3.3%) in TASMC, 18/441 (4.0%) in SZMC and 30/237 (12.6%) in RMC. Patients infected by NDMAb had similar clinical features and risk factors as patients with non-NDM CRAb. The length-of-stay was higher in NDMAb cases (48.5 days vs. 36 days, respectively, p = 0.097) and the in-hospital mortality was similarly high in both groups. Most isolates (41/54, 76%) were first detected from surveillance culture. The majority of isolates harbored the bla(NDM−2 gene) allele (n = 33), followed by the bla(NDM−1) (n = 20) allele and the bla(NDM−4) allele (n = 1). The majority of isolates were related within the ST level to other isolates in SZMC and RMC: 17/18 and 27/30 isolates, respectfully. The common ST’s were the bla(NDM−1) harboring ST-2 (n = 3) and ST-107 (n = 8) in SZMC and the bla(NDM−2) harboring ST-103 in SZMC (n = 6) and in RMC (n = 27). All bla(NDM) alleles were located within a conserved mobile genetic environment flanked by the ISAb125 and IS91 family transposon. Clonal transmission was identified in most hospital-acquired cases in RMC and SZMC. CONCLUSION: NDMAb constitutes a minor part of CRAb cases and are clinically similar to non-NDM CRAb. Transmission of NDMAb occurs mostly by clonal spread. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12941-023-00607-w. |
format | Online Article Text |
id | pubmed-10314562 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103145622023-07-02 Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel Adler, Amos Ghosh, Hiren Gross, Andrea Rechavi, Amit Lasnoy, Michal Assous, Marc V. Geffen, Yuval Darawsha, Basel Wiener-Well, Yonit Alony, Anat Grundmann, Hajo Reuter, Sandra Ann Clin Microbiol Antimicrob Research BACKGROUND: NDM-producing Acinetobacter baumannii (NDMAb) were reported sporadically worldwide but little is known about the transmission, epidemiology and clinical features of NDMAb-infected patients. The goals of this study were to characterize (1) the epidemiology and clinical features of NDMAb–infected patients; (2) the microbiological and molecular features of NDMAb isolates and (3) the transmission networks of NDMAb within healthcare facilities. METHODS: The study was conducted at the Tel-Aviv Sourasky, Rambam and Sha’are-Zedek Medical centers (TASMC, RMC and SZMC, respectively) in Israel. All cases detected between January 2018 and July 2019 were included. Phylogenetic analysis was based on core genome SNP distances. Clonal transmission was defined according to molecular (≤ 5 SNP) and epidemiological criteria (overlapping hospital stay). NDMAb cases were compared at a ratio of 1:2 with non-NDM carbapenem-resistant A. baumannii (CRAb) cases. RESULTS: The study included 54 NDMAb-positive out of 857 CRAb patients, including 6/179 (3.3%) in TASMC, 18/441 (4.0%) in SZMC and 30/237 (12.6%) in RMC. Patients infected by NDMAb had similar clinical features and risk factors as patients with non-NDM CRAb. The length-of-stay was higher in NDMAb cases (48.5 days vs. 36 days, respectively, p = 0.097) and the in-hospital mortality was similarly high in both groups. Most isolates (41/54, 76%) were first detected from surveillance culture. The majority of isolates harbored the bla(NDM−2 gene) allele (n = 33), followed by the bla(NDM−1) (n = 20) allele and the bla(NDM−4) allele (n = 1). The majority of isolates were related within the ST level to other isolates in SZMC and RMC: 17/18 and 27/30 isolates, respectfully. The common ST’s were the bla(NDM−1) harboring ST-2 (n = 3) and ST-107 (n = 8) in SZMC and the bla(NDM−2) harboring ST-103 in SZMC (n = 6) and in RMC (n = 27). All bla(NDM) alleles were located within a conserved mobile genetic environment flanked by the ISAb125 and IS91 family transposon. Clonal transmission was identified in most hospital-acquired cases in RMC and SZMC. CONCLUSION: NDMAb constitutes a minor part of CRAb cases and are clinically similar to non-NDM CRAb. Transmission of NDMAb occurs mostly by clonal spread. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12941-023-00607-w. BioMed Central 2023-06-30 /pmc/articles/PMC10314562/ /pubmed/37391819 http://dx.doi.org/10.1186/s12941-023-00607-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Adler, Amos Ghosh, Hiren Gross, Andrea Rechavi, Amit Lasnoy, Michal Assous, Marc V. Geffen, Yuval Darawsha, Basel Wiener-Well, Yonit Alony, Anat Grundmann, Hajo Reuter, Sandra Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel |
title | Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel |
title_full | Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel |
title_fullStr | Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel |
title_full_unstemmed | Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel |
title_short | Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel |
title_sort | clinical and molecular features of ndm-producing acinetobacter baumannii in a multicenter study in israel |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314562/ https://www.ncbi.nlm.nih.gov/pubmed/37391819 http://dx.doi.org/10.1186/s12941-023-00607-w |
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