Karampatakis Theodoros, Antachopoulos Charalampos, Tsakris Athanassios, Roilides Emmanuel
Infectious Diseases Unit, 3rd Department of Pediatrics, Medical Faculty, School of Health Sciences, Aristotle University, Hippokration General Hospital, Thessaloniki, Greece.
Microbiology Department, National & Kapodistrian University School of Medicine, Athens, Greece.
Future Microbiol. 2017 Jul;12:801-815. doi: 10.2217/fmb-2016-0200. Epub 2017 Jun 12.
Carbapenem-resistant Acinetobacter baumannii (CRAB) is endemic in Greece. CRAB initially emerged in 2000 and since then, carbapenemases still have a crucial role in CRAB appearance, except for a few cases resulting from efflux pump or outer-membrane protein mechanisms. OXA-type carbapenemases present the highest prevalence worldwide and bla and bla are the most important genes found; VIM-yielding CRAB have also been detected, while a single CRAB isolate producing NDM has quite recently emerged in Greece. The predominant OXA-23 producers are associated with multilocus sequence typing Pasteur scheme sequence type 2 clonal strains of the international clone II. The emergence of colistin-resistant CRAB has complicated the treatment of such infections and the interpretation of susceptibility data. Infection control measures and adjusted antimicrobial treatment strategies could confine CRAB spread. The aim of this review is to go through the molecular epidemiology of CRAB, in an endemic area and highlight its potential future evolution.
耐碳青霉烯鲍曼不动杆菌（CRAB）在希腊呈地方性流行。CRAB最初于2000年出现，从那时起，除了少数由外排泵或外膜蛋白机制导致的病例外，碳青霉烯酶在CRAB的出现中仍然起着关键作用。OXA型碳青霉烯酶在全球范围内的流行率最高，bla 和bla 是发现的最重要的基因；也检测到了产生VIM的CRAB，而最近在希腊出现了一株产生NDM的CRAB分离株。主要的OXA-23产生菌与国际克隆II的多位点序列分型巴斯德方案序列类型2克隆菌株有关。耐黏菌素CRAB的出现使此类感染的治疗和药敏数据的解读变得复杂。感染控制措施和调整后的抗菌治疗策略可以限制CRAB的传播。本综述的目的是梳理地方性流行地区CRAB的分子流行病学，并突出其未来可能的演变。
