Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center

Kristine M. Hujer, Andrea M. Hujer, Edward A. Hulten, Saralee Bajaksouzian, Jennifer M. Adams, Curtis J. Donskey, David J. Ecker, Christian Massire, Mark W. Eshoo, Rangarajan Sampath, Jodi M. Thomson, Philip N. Rather, David W. Craft, Joel T. Fishbain, Allesa J. Ewell, Michael R. Jacobs, David L. Paterson, Robert A. Bonomo

Research output: Contribution to journalArticle

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Abstract

Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multidrug-resistant (MDR) Acinetobacter baumannii isolates. In order to anticipate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter sp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC). Susceptibility testing, PCR amplification of the genetic determinants of resistance, and clonality were determined. Seventy-five unique patient isolates were included in this study: 53% were from bloodstream infections, 89% were resistant to at least three classes of antibiotics, and 15% were resistant to all nine antibiotics tested. Thirty-seven percent of the isolates were recovered from patients nosocomially infected or colonized at the WRAMC. Sixteen unique resistance genes or gene families and four mobile genetic elements were detected. In addition, this is the first report of blaOXA-58-like and blaPER-like genes in the U.S. MDRA baumannii isolates with at least eight identified resistance determinants were recovered from 49 of the 75 patients. Molecular typing revealed multiple clones, with eight major clonal types being nosocomially acquired and with more than 60% of the isolates being related to three pan-European types. This report gives a "snapshot" of the complex genetic background responsible for antimicrobial resistance in Acinetobacter spp. from the WRAMC. Identifying genes associated with the MDR phenotype and defining patterns of transmission serve as a starting point for devising strategies to limit the clinical impact of these serious infections.

Original languageEnglish (US)
Pages (from-to)4114-4123
Number of pages10
JournalAntimicrobial agents and chemotherapy
Volume50
Issue number12
DOIs
StatePublished - Dec 1 2006

Fingerprint

Acinetobacter
Microbial Drug Resistance
Genes
Military Facilities
Interspersed Repetitive Sequences
Anti-Bacterial Agents
Phenotype
Afghanistan
Molecular Typing
Acinetobacter baumannii
Iraq
Infection
Patient Care
Clone Cells
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Hujer, Kristine M. ; Hujer, Andrea M. ; Hulten, Edward A. ; Bajaksouzian, Saralee ; Adams, Jennifer M. ; Donskey, Curtis J. ; Ecker, David J. ; Massire, Christian ; Eshoo, Mark W. ; Sampath, Rangarajan ; Thomson, Jodi M. ; Rather, Philip N. ; Craft, David W. ; Fishbain, Joel T. ; Ewell, Allesa J. ; Jacobs, Michael R. ; Paterson, David L. ; Bonomo, Robert A. / Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. In: Antimicrobial agents and chemotherapy. 2006 ; Vol. 50, No. 12. pp. 4114-4123.
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abstract = "Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multidrug-resistant (MDR) Acinetobacter baumannii isolates. In order to anticipate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter sp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC). Susceptibility testing, PCR amplification of the genetic determinants of resistance, and clonality were determined. Seventy-five unique patient isolates were included in this study: 53{\%} were from bloodstream infections, 89{\%} were resistant to at least three classes of antibiotics, and 15{\%} were resistant to all nine antibiotics tested. Thirty-seven percent of the isolates were recovered from patients nosocomially infected or colonized at the WRAMC. Sixteen unique resistance genes or gene families and four mobile genetic elements were detected. In addition, this is the first report of blaOXA-58-like and blaPER-like genes in the U.S. MDRA baumannii isolates with at least eight identified resistance determinants were recovered from 49 of the 75 patients. Molecular typing revealed multiple clones, with eight major clonal types being nosocomially acquired and with more than 60{\%} of the isolates being related to three pan-European types. This report gives a {"}snapshot{"} of the complex genetic background responsible for antimicrobial resistance in Acinetobacter spp. from the WRAMC. Identifying genes associated with the MDR phenotype and defining patterns of transmission serve as a starting point for devising strategies to limit the clinical impact of these serious infections.",
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Hujer, KM, Hujer, AM, Hulten, EA, Bajaksouzian, S, Adams, JM, Donskey, CJ, Ecker, DJ, Massire, C, Eshoo, MW, Sampath, R, Thomson, JM, Rather, PN, Craft, DW, Fishbain, JT, Ewell, AJ, Jacobs, MR, Paterson, DL & Bonomo, RA 2006, 'Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center', Antimicrobial agents and chemotherapy, vol. 50, no. 12, pp. 4114-4123. https://doi.org/10.1128/AAC.00778-06

Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. / Hujer, Kristine M.; Hujer, Andrea M.; Hulten, Edward A.; Bajaksouzian, Saralee; Adams, Jennifer M.; Donskey, Curtis J.; Ecker, David J.; Massire, Christian; Eshoo, Mark W.; Sampath, Rangarajan; Thomson, Jodi M.; Rather, Philip N.; Craft, David W.; Fishbain, Joel T.; Ewell, Allesa J.; Jacobs, Michael R.; Paterson, David L.; Bonomo, Robert A.

In: Antimicrobial agents and chemotherapy, Vol. 50, No. 12, 01.12.2006, p. 4114-4123.

Research output: Contribution to journalArticle

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T1 - Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center

AU - Hujer, Kristine M.

AU - Hujer, Andrea M.

AU - Hulten, Edward A.

AU - Bajaksouzian, Saralee

AU - Adams, Jennifer M.

AU - Donskey, Curtis J.

AU - Ecker, David J.

AU - Massire, Christian

AU - Eshoo, Mark W.

AU - Sampath, Rangarajan

AU - Thomson, Jodi M.

AU - Rather, Philip N.

AU - Craft, David W.

AU - Fishbain, Joel T.

AU - Ewell, Allesa J.

AU - Jacobs, Michael R.

AU - Paterson, David L.

AU - Bonomo, Robert A.

PY - 2006/12/1

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N2 - Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multidrug-resistant (MDR) Acinetobacter baumannii isolates. In order to anticipate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter sp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC). Susceptibility testing, PCR amplification of the genetic determinants of resistance, and clonality were determined. Seventy-five unique patient isolates were included in this study: 53% were from bloodstream infections, 89% were resistant to at least three classes of antibiotics, and 15% were resistant to all nine antibiotics tested. Thirty-seven percent of the isolates were recovered from patients nosocomially infected or colonized at the WRAMC. Sixteen unique resistance genes or gene families and four mobile genetic elements were detected. In addition, this is the first report of blaOXA-58-like and blaPER-like genes in the U.S. MDRA baumannii isolates with at least eight identified resistance determinants were recovered from 49 of the 75 patients. Molecular typing revealed multiple clones, with eight major clonal types being nosocomially acquired and with more than 60% of the isolates being related to three pan-European types. This report gives a "snapshot" of the complex genetic background responsible for antimicrobial resistance in Acinetobacter spp. from the WRAMC. Identifying genes associated with the MDR phenotype and defining patterns of transmission serve as a starting point for devising strategies to limit the clinical impact of these serious infections.

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