Impact of an Intervention to Control Imipenem-Resistant Acinetobacter baumannii and Its Resistance Mechanisms: An 8-Year Survey

作者：Li‐Da Chen, Pinghai Tan, Jianming Zeng, Xuegao Yu, Yimei Cai, Kang Liao, Penghao Guo, Yili Chen, Zongwen Wu, Pinghua Qu, Renxin Cai, Chen Cha, Bin Huang · 发表于：Frontiers in Microbiology · 年份：2021 · DOI：10.3389/fmicb.2020.610109 · 被引用次数：21 · 研究领域：Antibiotic Resistance in Bacteria、Antibiotics Pharmacokinetics and Efficacy、Pneumonia and Respiratory Infections

Background This study aimed to examine the impact of an intervention carried out in 2011 to combat multi-drug resistance and outbreaks of imipenem-resistant Acinetobacter baumannii (IRAB), and to explore its resistance mechanism. Methods A total of 2572 isolates of A. baumannii , including 1673 IRAB isolates, were collected between 2007 and 2014. An intervention was implemented to control A. baumannii resistance and outbreaks. Antimicrobial susceptibility was tested by calculating minimal inhibitory concentrations (MICs), and outbreaks were typed using pulsed-field gel electrophoresis (PFGE). Resistance mechanisms were explored by polymerase chain reaction (PCR) and whole genome sequencing (WGS). Results Following the intervention in 2011, the resistance rates of A. baumannii to almost all tested antibiotics decreased, from 85.3 to 72.6% for imipenem, 100 to 80.8% for ceftriaxone, and 45.0 to 6.9% for tigecycline. The intervention resulted in a decrease in the number (seven to five), duration (8–3 months), and departments (five to three) affected by outbreaks; no outbreaks occurred in 2011. After the intervention, only bla AMPC (76.47 to 100%) and bla TEM– 1 (75.74 to 96.92%) increased ( P < 0.0001); whereas bla GES– 1 (32.35 to 3.07%), bla PER– 1 (21.32 to 1.54%), bla OXA– 58 (60.29 to 1.54%), carO (37.50 to 7.69%), and adeB (9.56 to 3.08%) decreased ( P < 0.0001). Interestingly, the frequency of class B β-lactamase genes decreased from 91.18% ( bla SPM– 1 ) an...