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Bacteremia caused by Acinetobacter junii at a medical center in Taiwan, 2000–2010

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Abstract

We investigated the clinical characteristics and outcomes of 43 patients with Acinetobacter junii bacteremia at a 2,500-bed tertiary care center in northern Taiwan. These organisms were confirmed to the species level by an array assay and 16S rRNA gene sequence analysis. The antimicrobial susceptibilities of the 43 A. junii isolates to 13 agents were determined using the agar dilution method. Susceptibility testing for tigecycline was determined using the broth microdilution method. Most of the patients were hospital-acquired (n = 36, 83.7 %) or healthcare facility-related infections (n = 6, 13.9 %), and 55.8 % had impaired immunity. Central venous access devices were present in 35 (81.4 %) patients; among the total of 43 patients with A. junii bacteremia, 8 patients were diagnosed as catheter-related bloodstream infection and 19 patients were diagnosed as catheter-associated bloodstream infection. Shock requiring inotropic agents occurred in 2 patients (4.6 %). Most patients developed bacteremia in general wards (n = 36, 83.7 %). The overall in-hospital mortality rate was low (7 %), despite the low rate of removal of central venous devices, low rate of holding usage of original central venous devices, and high rate of inappropriate antimicrobial regimens. Carbapenems, fluoroquinolones, and amikacin had potent activity (>95 % susceptible rate) against A. junii isolates. Interestingly, 35 % of the A. junii isolates were resistant to colistin. Tigecycline exhibited low minimum inhibitory concentration (MIC) values (range, 0.06–2 μg/ml, MIC90, 1 μg/ml) against the A. junii isolates.

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References

  1. Bergogne-Bérézin E, Towner KJ (1996) Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Microbiol Rev 9:148–165

    PubMed  Google Scholar 

  2. Turton JF, Shah J, Ozongwu C, Pike R (2010) Incidence of Acinetobacter species other than A. baumannii among clinical isolates of Acinetobacter: evidence for emerging species. J Clin Microbiol 48:1445–1449

    Article  PubMed  Google Scholar 

  3. Jung JY, Park MS, Kim SE, Park BH, Son JY, Kim EY et al (2010) Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit. BMC Infect Dis 10:228

    Article  PubMed  Google Scholar 

  4. Dijkshoorn L, Nemec A, Seifert H (2007) An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol 5:939–951

    Article  PubMed  CAS  Google Scholar 

  5. Bernards AT, de Beaufort AJ, Dijkshoorn L, van Boven CP (1997) Outbreak of septicaemia in neonates caused by Acinetobacter junii investigated by amplified ribosomal DNA restriction analysis (ARDRA) and four typing methods. J Hosp Infect 35:129–140

    Article  PubMed  CAS  Google Scholar 

  6. Kappstein I, Grundmann H, Hauer T, Niemeyer C (2000) Aerators as a reservoir of Acinetobacter junii: an outbreak of bacteraemia in paediatric oncology patients. J Hosp Infect 44:27–30

    Article  PubMed  CAS  Google Scholar 

  7. Linde HJ, Hahn J, Holler E, Reischl U, Lehn N (2002) Septicemia due to Acinetobacter junii. J Clin Microbiol 40:2696–2697

    Article  PubMed  Google Scholar 

  8. Cayô R, Yañez San Segundo L, Pérez del Molino Bernal IC, García de la Fuente C, Bermúdez Rodríguez MA, Calvo J et al (2011) Bloodstream infection caused by Acinetobacter junii in a patient with acute lymphoblastic leukaemia after allogenic haematopoietic cell transplantation. J Med Microbiol 60:375–377

    Article  PubMed  Google Scholar 

  9. Prashanth K, Ranga MP, Rao VA, Kanungo R (2000) Corneal perforation due to Acinetobacter junii: a case report. Diagn Microbiol Infect Dis 37:215–217

    Article  PubMed  CAS  Google Scholar 

  10. Hung YT, Lee YT, Huang LJ, Chen TL, Yu KW, Fung CP et al (2009) Clinical characteristics of patients with Acinetobacter junii infection. J Microbiol Immunol Infect 42:47–53

    PubMed  Google Scholar 

  11. Ibrahim A, Gerner-Smidt P, Liesack W (1997) Phylogenetic relationship of the twenty-one DNA groups of the genus Acinetobacter as revealed by 16S ribosomal DNA sequence analysis. Int J Syst Bacteriol 47:837–841

    Article  PubMed  CAS  Google Scholar 

  12. Horrevorts A, Bergman K, Kollée L, Breuker I, Tjernberg I, Dijkshoorn L (1995) Clinical and epidemiological investigations of Acinetobacter genomospecies 3 in a neonatal intensive care unit. J Clin Microbiol 33:1567–1572

    PubMed  CAS  Google Scholar 

  13. Lai CC, Cheng A, Liu WL, Tan CK, Huang YT, Chung KP et al (2011) Infections caused by unusual Methylobacterium species. J Clin Microbiol 49:3329–3331

    Article  PubMed  Google Scholar 

  14. Lee YC, Huang YT, Tan CK, Kuo YW, Liao CH, Lee PI et al (2011) Acinetobacter baumannii and Acinetobacter genospecies 13TU and 3 bacteraemia: comparison of clinical features, prognostic factors and outcomes. J Antimicrob Chemother 66:1839–1846

    Article  PubMed  CAS  Google Scholar 

  15. Chang HC, Wei YF, Dijkshoorn L, Vaneechoutte M, Tang CT, Chang TC (2005) Species-level identification of isolates of the Acinetobacter calcoaceticusAcinetobacter baumannii complex by sequence analysis of the 16S-23S rRNA gene spacer region. J Clin Microbiol 43:1632–1639

    Article  PubMed  CAS  Google Scholar 

  16. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  PubMed  CAS  Google Scholar 

  17. Chow JW, Fine MJ, Shlaes DM, Quinn JP, Hooper DC, Johnson MP et al (1991) Enterobacter bacteremia: clinical features and emergence of antibiotic resistance during therapy. Ann Intern Med 115:585–590

    PubMed  CAS  Google Scholar 

  18. Pearson ML (1996) Guideline for prevention of intravascular device-related infections. Part I. Intravascular device-related infections: an overview. The Hospital Infection Control Practices Advisory Committee. Am J Infect Control 24:262–277

    Article  PubMed  CAS  Google Scholar 

  19. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM (1988) CDC definitions for nosocomial infections, 1988. Am J Infect Control 16:128–140

    Article  PubMed  CAS  Google Scholar 

  20. Tomlinson D, Mermel LA, Ethier MC, Matlow A, Gillmeister B, Sung L (2011) Defining bloodstream infections related to central venous catheters in patients with cancer: a systematic review. Clin Infect Dis 53:697–710

    Article  PubMed  Google Scholar 

  21. Clinical and Laboratory Standards Institute (CLSI) (2012) Performance standards for antimicrobial susceptibility testing. Twenty-second informational supplement. CLSI document M100-S22. CLSI, Wayne, PA

    Google Scholar 

  22. van den Broek PJ, van der Reijden TJ, van Strijen E, Helmig-Schurter AV, Bernards AT, Dijkshoorn L (2009) Endemic and epidemic Acinetobacter species in a university hospital: an 8-year survey. J Clin Microbiol 47:3593–3599

    Article  PubMed  Google Scholar 

  23. Fagon JY, Chastre J, Hance AJ, Montravers P, Novara A, Gibert C (1993) Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med 94:281–288

    Article  PubMed  CAS  Google Scholar 

  24. Siau H, Yuen KY, Ho PL, Wong SS, Woo PC (1999) Acinetobacter bacteremia in Hong Kong: prospective study and review. Clin Infect Dis 28:26–30

    Article  PubMed  CAS  Google Scholar 

  25. Valero C, García Palomo JD, Matorras P, Fernández-Mazarrasa C, González Fernández C, Fariñas MC (2001) Acinetobacter bacteraemia in a teaching hospital, 1989–1998. Eur J Intern Med 12:425–429

    Article  PubMed  Google Scholar 

  26. Sheng WH, Liao CH, Lauderdale TL, Ko WC, Chen YS, Liu JW et al (2010) A multicenter study of risk factors and outcome of hospitalized patients with infections due to carbapenem-resistant Acinetobacter baumannii. Int J Infect Dis 14:e764–e769

    Article  PubMed  Google Scholar 

  27. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP et al (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 49:1–45

    Article  PubMed  CAS  Google Scholar 

  28. Seifert H, Strate A, Pulverer G (1995) Nosocomial bacteremia due to Acinetobacter baumannii. Clinical features, epidemiology, and predictors of mortality. Medicine (Baltimore) 74:340–349

    Article  CAS  Google Scholar 

  29. Chang KC, Lin MF, Lin NT, Wu WJ, Kuo HY, Lin TY et al (2012) Clonal spread of multidrug-resistant Acinetobacter baumannii in eastern Taiwan. J Microbiol Immunol Infect 45:37–42

    Article  PubMed  CAS  Google Scholar 

  30. Al-Sweih NA, Al-Hubail MA, Rotimi VO (2011) Emergence of tigecycline and colistin resistance in Acinetobacter species isolated from patients in Kuwait hospitals. J Chemother 23:13–16

    PubMed  CAS  Google Scholar 

  31. Chung DR, Song JH, Kim SH, Thamlikitkul V, Huang SG, Wang H et al (2011) High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia. Am J Respir Crit Care Med 184:1409–1417

    Article  PubMed  Google Scholar 

  32. Park YK, Lee GH, Baek JY, Chung DR, Peck KR, Song JH et al (2010) A single clone of Acinetobacter baumannii, ST22, is responsible for high antimicrobial resistance rates of Acinetobacter spp. isolates that cause bacteremia and urinary tract infections in Korea. Microb Drug Resist 16:143–149

    Article  PubMed  CAS  Google Scholar 

  33. Adams MD, Nickel GC, Bajaksouzian S, Lavender H, Murthy AR, Jacobs MR et al (2009) Resistance to colistin in Acinetobacter baumannii associated with mutations in the PmrAB two-component system. Antimicrob Agents Chemother 53:3628–3634

    Article  PubMed  CAS  Google Scholar 

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Correspondence to C.-H. Liao or P.-R. Hsueh.

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Tsai, HY., Cheng, A., Liu, CY. et al. Bacteremia caused by Acinetobacter junii at a medical center in Taiwan, 2000–2010. Eur J Clin Microbiol Infect Dis 31, 2737–2743 (2012). https://doi.org/10.1007/s10096-012-1622-x

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  • DOI: https://doi.org/10.1007/s10096-012-1622-x

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