Acinetobacter calcoaceticus - Acinetobacter baumannii (ACB) complex: occurrence and profile of resistance to carbapenems and polymixin B during SARS-CoV-2 pandemic in Pelotas, RS
DOI:
https://doi.org/10.33448/rsd-v11i1.25128Keywords:
HAI; Antimicrobial resistance; COVID-19; Bacterial coinfections.Abstract
Bacteria of the Acinetobacter calcoaceticus - Acinetobacter baumannii (ACB) complex are a frequent cause of the so-called Healthcare-Associated Infections (HAI). During the COVID-19 pandemic, caused by the SARS-CoV-2 virus, coinfections and increased bacterial resistance to antibiotics have been observed. Thus, the present study verified the occurrence and profile of resistance to carbapenems (in the year 2020) and polymyxin B (from October 2020 to March 2021) in bacteria of the ACB complex during the SARS-CoV-2 pandemic in the Hospital School (HE) of the Federal University of Pelotas (UFPel/EBSERH). Two methodologies were applied, the identification and evaluation of bacterial susceptibility by automation (BD Phoenix™), and the evaluation of resistance to polymyxin B using the microdilution panel (CIM POLYMIXIN B, Laborclin). Eighty-one isolates belonging to the ACB complex were identified, 69.1% (56) of the species A. baumannii, and 30.9% (25) of other species of the ACB complex. An increase in resistance to carbapenems from 75% in 2019 to 94.3% in 2020 was observed. Among the bacteria of the ACB complex resistant to carbapenems, 4 of them were resistant to polymyxin B. The bacteria of the ACB complex resistant to carbapenems were more frequent in the COVID-19 ICU, representing 44.9% in relation to other units. These resistant isolates were obtained from tracheal aspirate and blood samples. The data obtained reveal an increase in resistance to carbapenems, in addition to a higher incidence of positive tracheal aspirate for bacteria of the ACB complex in patients diagnosed with COVID-19, which may be related to Pneumonia Associated with Mechanical Ventilation (VAP).
References
Anvisa. Nota Técnica GVIMS/GGTES/ANVISA Nº 05/2021. Orientações para prevenção e controle da disseminação de microrganismos multirresistentes em serviços de saúde no contexto da pandemia da COVID-19 – 02/08/2021. https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/notas-tecnicas/nota-tecnica-gvims-ggtes-anvisa-no-05-2021-resistencia-microbiana-na-pandemia-da-covid-19.
Barnes, C. E., & MacIntyre, C. R. (2019). Risk modelling the mortality impact of antimicrobial resistance in secondary pneumococcal pneumonia infections during the 2009 influenza pandemic. International Journal of Infectious Diseases: IJID: Official Publication of the International Society for Infectious Diseases, 85, 1–6. https://doi.org/10.1016/j.ijid.2019.05.005
Bergogne-Bérézin, E., & Towner, K. J. (1996). Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clinical Microbiology Reviews, 9(2), 148–165. https://doi.org/10.1128/CMR.9.2.148
Bhatt, P. J., Shiau, S., Brunetti, L., Xie, Y., Solanki, K., Khalid, S., Mohayya, S., Au, P. H., Pham, C., Uprety, P., Nahass, R., & Narayanan, N. (2021). Risk Factors and Outcomes of Hospitalized Patients With Severe Coronavirus Disease 2019 (COVID-19) and Secondary Bloodstream Infections: A Multicenter Case-Control Study. Clinical Infectious Diseases: an official publication of the Infectious Diseases Society of America, 72(12), e995–e1003. https://doi.org/10.1093/cid/ciaa1748
Cantón, R., Gijón, D., & Ruiz-Garbajosa, P. (2020). Antimicrobial resistance in ICUs: an update in the light of the COVID-19 pandemic. Current Opinion in Critical Care, 26(5), 433–441. https://doi.org/10.1097/MCC.0000000000000755
Chapartegui-González, I., Lázaro-Díez, M., Bravo, Z., Navas, J., Icardo, J. M., & Ramos-Vivas, J. (2018). Acinetobacter baumannii maintains its virulence after long-time starvation. Plos One, 13(8), e0201961. https://doi.org/10.1371/journal.pone.0201961
Codjoe, F. S., & Donkor, E. S. (2017). Carbapenem Resistance: A Review. Medical sciences (Basel, Switzerland), 6(1), 1. https://doi.org/10.3390/medsci6010001
Oliveira Sá, P. K., Silva, S. A., Araújo, C., Cavalca, G., Lira, C., Silva, E., Leite, I. R., Nunes, M., & Nóbrega, R. (2021). Pneumonia associada à ventilação mecânica em pacientes com COVID‐19: avaliação das culturas de aspirados traqueais. The Brazilian Journal of Infectious Diseases, 25, 101089. https://doi.org/10.1016/j.bjid.2020.101089
DME, Diagnósticos Microbiológicos Especializados. Antibiograma das zonas de inibição e concentração inibitória mínima, CLSI 2021. https://www.dme.ind.br/wp-content/uploads/Bula-de-Bancada-CLSI-Edicao-2021.pdf
Fram, D. S., Ferreira, D. B., Matias, L., Coelho, W. E., Escudero, D. V., Antonelli, T. S., & Medeiros, E. A. (2021). Perfil Epidemiológico das IRAS notificadas em um hospital universitário durante a pandemia da COVID‐19. The Brazilian Journal of Infectious Diseases, 25, 101063. https://doi.org/10.1016/j.bjid.2020.101063
Gaspar, G. G., Bollela, V. R., & Martinez, R. (2021). Incidência de infecções relacionadas à saúde e perfil de sensibilidade de Staphylococcus aureus, Klebsiella pneumoniae e Acinetobacter baumannii no período pré e durante a pandemia de Covid‐19 em unidade de terapia intensiva adulto. The Brazilian Journal of Infectious Diseases, 25, 101062. https://doi.org/10.1016/j.bjid.2020.101062
Genteluci, G. L., de Souza, P. A., Gomes, D., Sousa, V. S., de Souza, M. J., Abib, J., de Castro, E., Rangel, K., & Villas Bôas, M. (2020). Polymyxin B Heteroresistance and Adaptive Resistance in Multidrug- and Extremely Drug-Resistant Acinetobacter baumannii. Current Microbiology, 77(9), 2300–2306. https://doi.org/10.1007/s00284-020-02064-6
Gerner-Smidt, P., Tjernberg, I., & Ursing, J. (1991). Reliability of phenotypic tests for identification of Acinetobacter species. Journal of Clinical Microbiology, 29(2), 277–282. https://doi.org/10.1128/jcm.29.2.277-282.1991
Gon, G., Dancer, S., Dreibelbis, R., Graham, W. J., & Kilpatrick, C. (2020). Reducing hand recontamination of healthcare workers during COVID-19. Infection Control and Hospital Epidemiology, 41(7), 870–871. https://doi.org/10.1017/ice.2020.111
Gottesman, T., Fedorowsky, R., Yerushalmi, R., Lellouche, J., & Nutman, A. (2021). An outbreak of carbapenem-resistant Acinetobacter baumannii in a COVID-19 dedicated hospital. Infection Prevention in Practice, 3(1), 100113. https://doi.org/10.1016/j.infpip.2021.100113
Kern, L. Hartwig, D.D.H. (no prelo). Ocorrência de bactérias do grupo ESKAPE, perfil de susceptibilidade aos antimicrobianos e relação com infecções relacionadas à assistência em saúde (IRAS) em um hospital de ensino de Pelotas, RS, Brasil.
Koirala, J., Tyagi, I., Guntupalli, L., Koirala, S., Chapagain, U., Quarshie, C., Akram, S., Sundareshan, V., Koirala, S., Lawhorn, J., Doi, Y., & Olson, M. (2020). OXA-23 and OXA-40 producing carbapenem-resistant Acinetobacter baumannii in Central Illinois. Diagnostic Microbiology and Infectious Disease, 97(1), 114999. https://doi.org/10.1016/j.diagmicrobio.2020.114999
Lee, C. R., Lee, J. H., Park, M., Park, K. S., Bae, I. K., Kim, Y. B., Cha, C. J., Jeong, B. C., & Lee, S. H. (2017). Biology of Acinetobacter baumannii: Pathogenesis, Antibiotic Resistance Mechanisms, and Prospective Treatment Options. Frontiers in Cellular and Infection Microbiology, 7, 55. https://doi.org/10.3389/fcimb.2017.00055
Li, Z., Cao, Y., Yi, L., Liu, J. H., & Yang, Q. (2019). Emergent Polymyxin Resistance: End of an Era?. Open Forum Infectious Diseases, 6(10), ofz368. https://doi.org/10.1093/ofid/ofz368
Lin, C., Chen, H., He, P., Li, Y., Ke, C., & Jiao, X. (2019). Etiology and characteristics of community-acquired pneumonia in an influenza epidemic period. Comparative Immunology, Microbiology and Infectious Diseases, 64, 153–158. https://doi.org/10.1016/j.cimid.2019.03.004
Manual do operador BD Phoenix System. Fabricado por: da Becton, Dickinson and Company. Registrado por: Becton Dickinson Industrias Cirúrgicas Ltda.
Monnet, D. L., & Harbarth, S. (2020). Will coronavirus disease (COVID-19) have an impact on antimicrobial resistance? Euro Surveillance: Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 25(45), 2001886. https://doi.org/10.2807/1560-7917.ES.2020.25.45.2001886
Morens, D. M., Taubenberger, J. K., & Fauci, A. S. (2008). Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. The Journal of Infectious Diseases, 198(7), 962–970. https://doi.org/10.1086/591708
Nemec, A., Krizova, L., Maixnerova, M., van der Reijden, T. J., Deschaght, P., Passet, V., Vaneechoutte, M., Brisse, S., & Dijkshoorn, L. (2011). Genotypic and phenotypic characterization of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex with the proposal of Acinetobacter pittii sp. nov. (formerly Acinetobacter genomic species 3) and Acinetobacter nosocomialis sp. nov. (formerly Acinetobacter genomic species 13TU). Research in Microbiology, 162(4), 393–404. https://doi.org/10.1016/j.resmic.2011.02.006
Peleg, A. Y., Seifert, H., & Paterson, D. L. (2008). Acinetobacter baumannii: emergence of a successful pathogen. Clinical Microbiology Reviews, 21(3), 538–582. https://doi.org/10.1128/CMR.00058-07
Perez, S., Innes, G. K., Walters, M. S., Mehr, J., Arias, J., Greeley, R., & Chew, D. (2020). Increase in Hospital-Acquired Carbapenem-Resistant Acinetobacter baumannii Infection and Colonization in an Acute Care Hospital During a Surge in COVID-19 Admissions - New Jersey, February-July 2020. MMWR. Morbidity and Mortality Weekly Report, 69(48), 1827–1831. https://doi.org/10.15585/mmwr.mm6948e1
Ramette, A., Kronenberg, A., & the Swiss Centre for Antibiotic Resistance (ANRESIS) (2018). Prevalence of carbapenem-resistant Acinetobacter baumannii from 2005 to 2016 in Switzerland. BMC Infectious Diseases, 18(1), 159. https://doi.org/10.1186/s12879-018-3061-5
Raro, O. H. F., Gallo, S. W., Ferreira, C. A. S., & Oliveira, S. D. D. (2017). Carbapenem-resistant Acinetobacter baumannii contamination in an intensive care unit. Revista da Sociedade Brasileira de Medicina Tropical, 50, 167-172. https://doi.org/10.1590/0037-8682-0329-2016
Ribeiro, T. D. S., Ribeiro, R. A. A. D. S., Batista, K. S., Aquino, S. R. D., & Naue, C. R. (2019). Ocorrência e perfil bacteriano de culturas coletadas em pacientes internados na unidade de terapia intensiva em um hospital terciário. HU rev, 122-133. https://doi.org/10.34019/1982-8047.2019.v45.25933
Ripa M et al. & COVID-BioB study group (2021). Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clinical Microbiology and Infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 27(3), 451–457. doi: https://doi.org/10.1016/j.cmi.2020.10.021.
Shamsizadeh, Z., Nikaeen, M., Nasr Esfahani, B., Mirhoseini, S. H., Hatamzadeh, M., & Hassanzadeh, A. (2017). Detection of antibiotic resistant Acinetobacter baumannii in various hospital environments: potential sources for transmission of Acinetobacter infections. Environmental Health and Preventive Medicine, 22(1), 44. https://doi.org/10.1186/s12199-017-0653-4
Shinohara, D. R., Dos Santos Saalfeld, S. M., Martinez, H. V., Altafini, D. D., Costa, B. B., Fedrigo, N. H., & Tognim, M. (2021). Outbreak of endemic carbapenem-resistant Acinetobacter baumannii in a coronavirus disease 2019 (COVID-19)-specific intensive care unit. Infection Control and Hospital Epidemiology, 1–3. https://doi.org/10.1017/ice.2021.98
Vaughn, V. M., Gandhi, T. N., Petty, L. A., Patel, P. K., Prescott, H. C., Malani, A. N., Ratz, D., McLaughlin, E., Chopra, V., & Flanders, S. A. (2021). Empiric Antibacterial Therapy and Community-onset Bacterial Coinfection in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19): A Multi-hospital Cohort Study. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 72(10), e533–e541. https://doi.org/10.1093/cid/ciaa1239
Vázquez-López, R., Solano-Gálvez, S. G., Juárez Vignon-Whaley, J. J., Abello Vaamonde, J. A., Padró Alonzo, L. A., Rivera Reséndiz, A., Muleiro Álvarez, M., Vega López, E. N., Franyuti-Kelly, G., Álvarez-Hernández, D. A., Moncaleano Guzmán, V., Juárez Bañuelos, J. E., Marcos Felix, J., González Barrios, J. A., & Barrientos Fortes, T. (2020). Acinetobacter baumannii Resistance: A Real Challenge for Clinicians. Antibiotics (Basel, Switzerland), 9(4), 205. https://doi.org/10.3390/antibiotics9040205
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Copyright (c) 2022 Luiza Oliveira Lemos Miller; Luiza de Souza Kern; Camila de David Tessele Martini; Róger Giusti Miller; Marta Pinho da Rosa; Daiane Drawanz Hartwig
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