Rieber Heime, Frontzek Andre, Pfeifer Yvonne
1 Division of Microbiology , Medizinisches Versorgungszentrum Dr. Stein, Mönchengladbach, Germany .
2 Robert Koch Institute , Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany .
Microb Drug Resist. 2017 Jan;23(1):25-31. doi: 10.1089/mdr.2016.0035. Epub 2016 Apr 19.
Emergence of carbapenem-resistant Acinetobacter spp., especially Acinetobacter baumannii, in hospitals has been increasingly detected worldwide. In the present study, we analyzed carbapenem-resistant isolates (70 A. baumannii and one Acinetobacter pittii) collected in a period of 4 years (February 2008 to January 2012) in one diagnostic laboratory in Germany. All isolates were carbapenemase positive with OXA-23 as by far the most common enzyme (n = 66, 93%). Carbapenemases OXA-24-like and OXA-58 were not present in the isolates, but genes bla and ISAba1+bla were found to be the cause of carbapenem resistance in one and four isolates, respectively. Polymerase chain reaction typing revealed that the majority of A. baumannii isolates could be assigned to the very successful international clone 2. ApaI-macrorestriction and pulsed-field gel electrophoresis (PFGE) indicated clonal transmission of resistant strains (eight different PFGE types) within several hospitals. By multilocus sequence typing, the isolates were to be assigned to ST195 (n = 44), ST236 (n = 12), ST208 (n = 4), ST437 (n = 3), ST231 (n = 3), ST448 (n = 2), ST556 (n = 1), and ST945 (n = 1). The wide spread of carbapenem-resistant clones of A. baumannii is facilitated by international travelling and needs continuous surveillance in hospitals and diagnostic laboratories.
全球范围内，医院中耐碳青霉烯类不动杆菌属细菌，尤其是鲍曼不动杆菌的出现日益增多。在本研究中，我们分析了德国一家诊断实验室在4年时间（2008年2月至2012年1月）内收集的耐碳青霉烯类分离株（70株鲍曼不动杆菌和1株皮氏不动杆菌）。所有分离株均为碳青霉烯酶阳性，其中OXA-23是迄今为止最常见的酶（n = 66，93%）。分离株中不存在OXA-24样和OXA-58碳青霉烯酶，但分别在1株和4株分离株中发现bla和ISAba1+bla基因是耐碳青霉烯的原因。聚合酶链反应分型显示，大多数鲍曼不动杆菌分离株可归为非常成功的国际克隆2型。ApaI酶切大片段限制性内切酶分析和脉冲场凝胶电泳（PFGE）表明，耐药菌株在几家医院内存在克隆传播（8种不同的PFGE型）。通过多位点序列分型，分离株可归为ST195（n = 44）、ST236（n = 12）、ST208（n = 4）、ST437（n = 3）、ST231（n = 3）、ST448（n = 2）、ST556（n = 1）和ST945（n = 1）。鲍曼不动杆菌耐碳青霉烯克隆的广泛传播因国际旅行而加剧，需要在医院和诊断实验室进行持续监测。
