Acinetobacter baumannii in intensive care unit: A novel system to study clonal relationship among the isolates

doi:10.1186/1471-2334-8-79

BMC Infectious Diseases
Volume 8

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Fontana C
Favaro M
Minelli S
Bossa MC
Testore GP
Leonardis F
Natoli S
Favalli C

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Minelli S
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Testore GP
Leonardis F
Natoli S
Favalli C
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Research article

Acinetobacter baumannii in intensive care unit: A novel system to study clonal relationship among the isolates

Carla Fontana^*¹^,2 , Marco Favaro^*¹ , Silvia Minelli² , Maria Cristina Bossa² , Gian Piero Testore^*³ , Francesca Leonardis^*⁴ , Silvia Natoli^*⁴ and Cartesio Favalli^*¹^,2

¹Department of Experimental Medicine and Biochemical Sciences, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy

²Clinical Microbiology Laboratories, Polyclinic of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy

³Public Health Department, Infectious Diseases, Polyclinic of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy

⁴Department of Surgery, Intensive Care Unit – Polyclinic of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy

author email corresponding author email* Contributed equally

BMC Infectious Diseases 2008, 8:79doi:10.1186/1471-2334-8-79


Published:	8 June 2008

Abstract

Background

The nosocomial infections surveillance system must be strongly effective especially in highly critic areas, such as Intensive Care Units (ICU). These areas are frequently an epidemiological epicentre for transmission of multi-resistant pathogens, like Acinetobacter baumannii. As an epidemic outbreak occurs it is very important to confirm or exclude the genetic relationship among the isolates in a short time. There are several molecular typing systems used with this aim. The Repetitive sequence-based PCR (REP-PCR) has been recognized as an effective method and it was recently adapted to an automated format known as the DiversiLab system.

Methods

In the present study we have evaluated the combination of a newly introduced software package for the control of hospital infection (VIGI@ct) with the DiversiLab system. In order to evaluate the reliability of the DiversiLab its results were also compared with those obtained using f-AFLP.

Results

The combination of VIGI@ct and DiversiLab enabled an earlier identification of an A. baumannii epidemic cluster, through the confirmation of the genetic relationship among the isolates. This cluster regards 56 multi-drug-resistant A. baumannii isolates from several specimens collected from 13 different patients admitted to the ICU in a ten month period. The A. baumannii isolates were clonally related being their similarity included between 97 and 100%. The results of the DiversiLab were confirmed by f-AFLP analysis.

Conclusion

The early identification of the outbreak has led to the prompt application of operative procedures and precautions to avoid the spread of pathogen. To date, 6 months after the last A. baumannii isolate, no other related case has been identified.