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April 05, 2006

Multidrug-resistant Acinetobacter On The Loose in Italian Hospitals

Will antibiotic-resistant Acinetobacter baumannii become the next MRSA? It's been killing hospital patients in the UK and France, and causing problems in US military hospitals. Now it's showing up in Italian hospitals.

A typically dry research paper, presented at the 16th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID)in France, discloses that "there is new and considerable concern in Italy over the first reports of nosocomial outbreaks of carbapenem-resistant A. baumannii in hospital intensive care units (ICUs) in Rome and southern Italy."

The paper discusses the study of about 100 cases of antibiotic-resistant, A. baumannii infections isolated from patients' respiratory tract, other parts of the body, and things like vein catheters, between 2003 and 2005. The Rome samples "were tested for susceptibility to a panel of 20 antimicrobial agents, and were found to be resistant to almost all of them; 52 of the isolates showed carbapenem resistance. All of the group of 16 samples taken from hospitals in southern Italy "showed resistance to cefotaxime, ceftazidime, aztreonam, cefepime, tazbacam and imipenem."

The high degree of antibiotic resistance found in these hospital samples produced an expression of "considerable concern" regarding the difficulty of treating such infections, according to the lead investigator, Laura Pagani, PhD, of the University of Pavia. "Above all, it is now very important to carry out careful surveillance of all of the at-risk hospital departments, particularly as A. baumannii is already a problem in all of the Italian hospitals."[my emphasis]

Another recent study found that A. baumannii has become "skilled" at picking up antibiotic resistance from other bacteria, through the swapping of plasmids. "It is like the A. baumannii genome is 'anticipating' any antibacterial challenge by setting up some kind of easily accessible 'shelves' to store the antibacterial resistances genes as they become needed and are available in the environment," said French researcher Jean-Michel Claverie.


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