Investigation of Acinetobacter baumannii resistance to carbapenems in Marseille hospitals, south of France: a transition from an epidemic to an endemic situation.

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Kempf, Marie | Rolain, Jean-Marc | Azza, Saïd | Diene, Seydina M. | Joly-Guillou, Marie-Laure | Dubourg, Gregory | Colson, Philippe | Papazian, Laurent | Richet, Hervé | Fournier, Pierre-Edouard | Ribeiro, Amandina | Raoult, Didier

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Carbapenem-resistant Acinetobacter baumannii infections are a worldwide endemic nosocomial threat. Between December 2010 and April 2011, an increase of carbapenem-resistant A. baumannii infections occurred in several Marseille University Hospitals. The aim of this study was to investigate the increase of carbapenem-resistant A. baumannii infections and to characterize the mechanisms of carbapenem resistance. The increase was detected by a homemade computer surveillance program, known as EPIMIC, that monitors antibiotic resistance profiles on a weekly basis. During this period, positive samples of carbapenem-resistant A. baumannii were retrieved from patients hospitalized in different units. Genotyping of the isolates was performed using pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), and carbapenemase gene analyses were performed to detect the presence of carbapenemases and to determine the relationships of the isolates. Carbapenem-resistant A. baumannii were isolated in a total of 11 patients who were hospitalized in different hospitals units. We identified the presence of the bla(OXA23-like) carbapenemase-encoding gene in all of the isolates and found four major PFGE groups and different MLST groups. These results demonstrate a current evolution in the A. baumannii epidemiology in Marseille with a switch from an epidemic situation to an endemic situation and with several circulating clones.

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