PDF(Pubmed)
Abstract：
Acinetobacter baumannii poses a significant threat to public health due to the high rate of multidrug-resistant strains. However, information on the molecular characterization of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections in children is scarce. This study aimed to describe the molecular characterization of carbapenem-resistant A. baumannii infections in children from a hospital in Mexico. A retrospective study was conducted during the period 2017-2022. Clinical and demographic data were collected from the clinical records. Mass spectrometry was used for the identification of the strains. To confirm A. baumannii strains, a polymerase chain reaction (PCR) method was applied using a gyrB sequence. The carbapenemase-encoding resistance genes were detected by PCR. Six cases of CRAB were documented, including five in neonates. The median intensive care unit stay was 20 days, and all cases had an invasive medical device. Half of the patients had at least one medical condition. A high prevalence of coresistance was observed in most of the antibiotic groups. Three of the six strains coharbored carbapenemase genes: blaOXA-51, blaOXA-24, and blaIMP. Mortality was reported in two neonate patients. The present study shows a high rate of coharboring blaOXA-51, blaOXA-24, and blaIMP-1, which has a direct impact on therapeutic decisions. Implementation of antimicrobial stewardship programs is urgent to stop the spread of this microorganism.
摘要：
由于多重耐药菌株的高比率，鲍曼不动杆菌对公众健康构成重大威胁。然而,关于儿童耐碳青霉烯类鲍曼不动杆菌(CRAB)血流感染的分子特征的信息很少.这项研究旨在描述墨西哥一家医院的儿童耐碳青霉烯类鲍曼不动杆菌感染的分子特征。在2017-2022年期间进行了一项回顾性研究。从临床记录中收集临床和人口统计学数据。使用质谱法鉴定菌株。为了确认鲍曼不动杆菌菌株，使用gyrB序列应用聚合酶链反应（PCR）方法。通过PCR检测碳青霉烯酶编码抗性基因。记录了6例CRAB，包括五个新生儿。重症监护病房的平均住院时间为20天,所有病例都有侵入性医疗设备。一半的患者至少有一种疾病。在大多数抗生素组中观察到高的共抗性患病率。六个包含碳青霉烯酶基因的菌株中的三个：blaOXA-51，blaOXA-24和blaIMP。在两名新生儿患者中报告了死亡率。本研究表明，携带blaOXA-51，blaOXA-24和blaIMP-1的比率很高，这对治疗决策有直接影响。迫切需要实施抗菌药物管理计划，以阻止这种微生物的传播。
