Department of Medical Microbiology, Dokuz Eylul University School of Medicine.
Jpn J Infect Dis. 2013;66(5):439-42.
Carbapenem resistance due to OXA-type carbapenemases seriously limits therapeutic options in nosocomial infections caused by Acinetobacter baumannii. Previous studies have shown the presence of OXA-51, OXA-58, and OXA-23 carbapenemases but not OXA-24/40 in A. baumannii in Turkey. In this study, we investigated carbapenem-hydrolyzing class D β-lactamases (CHDLs) in A. baumannii and the molecular epidemiology of CHDL producers at the Dokuz Eylul Hospital, Izmir Turkey, and detected blaOXA-24/40 in a clinical isolate from a patient in the medical intensive care unit (ICU). The specific enzyme type was OXA-72. Additional studies revealed 22 more isolates from 20 patients and that the OXA-72-producing strain caused an outbreak in the medical ICU from September 2012 to March 2013, which still continues. To our knowledge, this is the first report of OXA-24/40 carbapenemases in A. baumannii in Turkey. Emergency infection control should be implemented following the arrival of a new OXA at a hospital where A. baumannii is highly endemic.
由于 OXA 型碳青霉烯酶导致的碳青霉烯类耐药严重限制了鲍曼不动杆菌引起的医院感染的治疗选择。先前的研究表明，在土耳其的鲍曼不动杆菌中存在 OXA-51、OXA-58 和 OXA-23 碳青霉烯酶，但不存在 OXA-24/40。在本研究中，我们调查了土耳其伊兹密尔的多乌泽伊莱尔医院鲍曼不动杆菌中碳青霉烯类水解酶（CHDLs）和 CHDL 产生菌的分子流行病学，并在一名来自重症监护病房（ICU）的患者的临床分离株中检测到 blaOXA-24/40。该特定酶型为 OXA-72。进一步的研究从 20 名患者中发现了 22 个更多的分离株，且 OXA-72 产生菌导致了 2012 年 9 月至 2013 年 3 月期间在 ICU 爆发的疫情，目前疫情仍在持续。据我们所知，这是在土耳其首次报告的鲍曼不动杆菌中存在 OXA-24/40 碳青霉烯酶。当一种新的 OXA 到达高度流行鲍曼不动杆菌的医院时，应立即采取紧急感染控制措施。
