Bošnjak Zrinka, Plecko Vanda, Budimir Ana, Mareković Ivana, Bedenić Branka
Department of Clinical and Molecular Microbiology, University Hospital Center Zagreb and School of Medicine Zagreb, Croatia.
Chemotherapy. 2014;60(4):250-2. doi: 10.1159/000381256. Epub 2015 Apr 25.
Acinetobacter spp. is an opportunistic pathogen that has demonstrated increasing relevance in nosocomial infections. Carbapenem-resistant strains have been reported worldwide.
Since 2014, screening for metallo-β-lactamases (MBLs) in all Acinetobacter spp. isolates using phenotypic methods and PCR has been implemented at the University Hospital Center Zagreb.
The bacterial strain was isolated from the drain of a child hospitalized in a paediatric intensive care unit and identified as Acinetobacter guillouiae using a MALDI TOF automated system. The strain was resistant to meropenem, ceftazidime, cefotaxime, ceftriaxone, cefepime, sulbactam/ampicillin, gentamicin and ciprofloxacin, intermediately susceptible to piperacillin/tazobactam and imipenem, and susceptible to amikacin and colistin. The Hodge test and combined disk test with EDTA were positive. The MICs of meropenem and imipenem were not reduced by cloxacillin, but a small reduction of two dilutions was observed following the addition of sodium chloride, which indicated that OXA-58 was produced. PCR and sequencing of chromosomal DNA from boiled colonies revealed blaOXA-58 and blaNDM-1 genes.
This is the first report of NDM-1 in Acinetobacter spp. in Croatia. The early detection of these genes will aid in the prevention and in the achievement of adequate infection control by limiting the spread of these organisms.
不动杆菌属是一种机会致病菌，在医院感染中的相关性日益增加。耐碳青霉烯类菌株已在全球范围内报道。
自2014年以来，萨格勒布大学医院中心已采用表型方法和聚合酶链反应（PCR）对所有不动杆菌属分离株进行金属β-内酰胺酶（MBL）筛查。
该菌株从一名入住儿科重症监护病房的儿童引流液中分离得到，使用基质辅助激光解吸电离飞行时间（MALDI TOF）自动化系统鉴定为吉洛不动杆菌。该菌株对美罗培南、头孢他啶、头孢噻肟、头孢曲松、头孢吡肟、舒巴坦/氨苄西林、庆大霉素和环丙沙星耐药，对哌拉西林/他唑巴坦和亚胺培南中度敏感，对阿米卡星和黏菌素敏感。Hodge试验和EDTA联合纸片扩散试验均为阳性。氯唑西林未降低美罗培南和亚胺培南的最低抑菌浓度（MIC），但添加氯化钠后观察到MIC有两个稀释度的小幅降低，这表明产生了OXA-58。对煮沸菌落染色体DNA进行PCR和测序，发现了blaOXA-58和blaNDM-1基因。
这是克罗地亚首次报道不动杆菌属中存在NDM-1。这些基因的早期检测将有助于预防并通过限制这些微生物的传播实现充分的感染控制。
