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Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018)
Acinetobacter (A.) baumannii has gained global notoriety as a significant nosocomial pathogen because it is frequently associated with multi-drug resistance and hospital-based outbreaks. There is a substantial difference in the incidence of A. baumannii infections between different countries and wit...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143851/ https://www.ncbi.nlm.nih.gov/pubmed/32155886 http://dx.doi.org/10.3390/microorganisms8030375 |
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author | Wareth, Gamal Brandt, Christian Sprague, Lisa D. Neubauer, Heinrich Pletz, Mathias W. |
author_facet | Wareth, Gamal Brandt, Christian Sprague, Lisa D. Neubauer, Heinrich Pletz, Mathias W. |
author_sort | Wareth, Gamal |
collection | PubMed |
description | Acinetobacter (A.) baumannii has gained global notoriety as a significant nosocomial pathogen because it is frequently associated with multi-drug resistance and hospital-based outbreaks. There is a substantial difference in the incidence of A. baumannii infections between different countries and within Germany. However, its continuous spread within Germany is a matter of concern. A systematic literature search and analysis of the literature published between 2000 and 2018 on A. baumannii in humans was performed. Forty-four studies out of 216 articles met the criteria for inclusion, and were selected and reviewed. The number of published articles is increasing over time gradually. Case reports and outbreak investigations are representing the main body of publications. North Rhine-Westphalia, Hesse and Baden-Wuerttemberg were states with frequent reports. Hospitals in Cologne and Frankfurt were often mentioned as specialized institutions. Multiresistant strains carrying diverse resistance genes were isolated in 13 of the 16 German states. The oxacillinase blaOXA-23-like, intrinsic blaOXA-51-like, blaOXA-58 variant, blaNDM-1, blaGES-11, blaCTX-M and blaTEM are the most predominant resistance traits found in German A. baumannii isolates. Five clonal lineages IC-2, IC-7, IC-1, IC-4 and IC-6 and six sequence types ST22, ST53, ST195, ST218, ST944/ST78 and ST348/ST2 have been reported. Due to multidrug resistance, colistin, tigecycline, aminoglycosides, fosfomycin, ceftazidime/avibactam and ceftolozan/tazobactam were often reported to be the only effective antibiotics left to treat quadruple multi-resistant Gram-negative (4MRGN) A. baumannii. Dissemination and infection rates of A. baumannii are on the rise nationwide. Hence, several aspects of resistance development and pathogenesis are not fully understood yet. Increased awareness, extensive study of mechanisms of resistance and development of alternative strategies for treatment are required. One-Health genomic surveillance is needed to understand the dynamics of spread, to identify the main reservoirs and routes of transmission and to develop targeted intervention strategies. |
format | Online Article Text |
id | pubmed-7143851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-71438512020-04-14 Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018) Wareth, Gamal Brandt, Christian Sprague, Lisa D. Neubauer, Heinrich Pletz, Mathias W. Microorganisms Review Acinetobacter (A.) baumannii has gained global notoriety as a significant nosocomial pathogen because it is frequently associated with multi-drug resistance and hospital-based outbreaks. There is a substantial difference in the incidence of A. baumannii infections between different countries and within Germany. However, its continuous spread within Germany is a matter of concern. A systematic literature search and analysis of the literature published between 2000 and 2018 on A. baumannii in humans was performed. Forty-four studies out of 216 articles met the criteria for inclusion, and were selected and reviewed. The number of published articles is increasing over time gradually. Case reports and outbreak investigations are representing the main body of publications. North Rhine-Westphalia, Hesse and Baden-Wuerttemberg were states with frequent reports. Hospitals in Cologne and Frankfurt were often mentioned as specialized institutions. Multiresistant strains carrying diverse resistance genes were isolated in 13 of the 16 German states. The oxacillinase blaOXA-23-like, intrinsic blaOXA-51-like, blaOXA-58 variant, blaNDM-1, blaGES-11, blaCTX-M and blaTEM are the most predominant resistance traits found in German A. baumannii isolates. Five clonal lineages IC-2, IC-7, IC-1, IC-4 and IC-6 and six sequence types ST22, ST53, ST195, ST218, ST944/ST78 and ST348/ST2 have been reported. Due to multidrug resistance, colistin, tigecycline, aminoglycosides, fosfomycin, ceftazidime/avibactam and ceftolozan/tazobactam were often reported to be the only effective antibiotics left to treat quadruple multi-resistant Gram-negative (4MRGN) A. baumannii. Dissemination and infection rates of A. baumannii are on the rise nationwide. Hence, several aspects of resistance development and pathogenesis are not fully understood yet. Increased awareness, extensive study of mechanisms of resistance and development of alternative strategies for treatment are required. One-Health genomic surveillance is needed to understand the dynamics of spread, to identify the main reservoirs and routes of transmission and to develop targeted intervention strategies. MDPI 2020-03-06 /pmc/articles/PMC7143851/ /pubmed/32155886 http://dx.doi.org/10.3390/microorganisms8030375 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Wareth, Gamal Brandt, Christian Sprague, Lisa D. Neubauer, Heinrich Pletz, Mathias W. Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018) |
title | Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018) |
title_full | Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018) |
title_fullStr | Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018) |
title_full_unstemmed | Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018) |
title_short | Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018) |
title_sort | spatio-temporal distribution of acinetobacter baumannii in germany—a comprehensive systematic review of studies on resistance development in humans (2000–2018) |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143851/ https://www.ncbi.nlm.nih.gov/pubmed/32155886 http://dx.doi.org/10.3390/microorganisms8030375 |
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