Program Schedule

334
Emergence of OXA-23-possessing Acinetobacter baumannii in Hospitals in New York City

Session: Poster Abstract Session: Multidrug-resistant Organisms: Epidemiology and Prevention
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Acinetobacter baumannii is an established nosocomial pathogen in many medical centers worldwide. The spread of multidrug resistant strains of A. baumannii has been especially problematic.

Methods: During a three month surveillance study conducted November 2013 – January 2014, all unique patient isolates of A. baumannii were gathered from 11 hospitals in New York City. Susceptibility testing was performed by CLSI methods; isolates with a meropenem MIC of ≤ 2 µg/ml were considered susceptible. All isolates were screened by PCR for the presence of carbapenemases. Select isolates underwent genetic fingerprinting using ERIC-2 primers. Findings were compared to a similar surveillance study conducted in 2009.

Results: A total of 158 isolates of A. baumannii were gathered from the 11 hospitals. Overall susceptibility rates include: 72% to amikacin, 30% to ciprofloxacin, 94% to polymyxin B, 34 % to ceftazidime, and 31% to meropenem. 58 isolates possessed blaOXA23, two blaOXA24, and one blaKPC.

Nine hospitals participated in a similar surveillance study conducted in 2009. For these 9 hospitals, there was a marked decline in the total number of isolates reported (from 252 in 2009 to 122 in 2013-2014; Table). However, there was a marked increase in the number of isolates carrying blaOXA-23 (from 8 to 48). For these 8 hospitals, the percentage of meropenem-resistant isolates that possessed blaOXA23 increased from 5% in 2009 to 58% in 2013-2014.

 

Total number of isolates (number with blaOXA23)

 

2009

2013-2014

Hospital A

72 (4)

32 (19)

Hospital B

18 (2)

7 (2)

Hospital C

5 (2)

4 (0)

Hospital D

21 (0)

4 (0)

Hospital E

15 (0)

7 (2)

Hospital F

24 (1)

16 (1)

Hospital G

51 (0)

32 (18)

Hospital H

37 (1)

14 (6)

Hospital I

9 (0)

6 (0)

Total

252 (8)

122 (48)

Genetic fingerprinting of 15 OXA-23-carrying isolates from 8 hospitals revealed that 9 belonged to a single strain.

Conclusion: Since 2009, there has been a reduction in the prevalence of carbapenem-resistant A. baumannii at hospitals in New York City. However, dissemination of strains carrying blaOXA23 has clearly increased in several medical centers.

Marie Abdallah, MD1, Olawole Olafisoye, MD1, Christopher Cortes, MD2, Carl Urban, PhD3, Clayton Charles, MD4, David Landman, MD4 and John Quale, MD4, (1)Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, NY, (2)Infectious Diseases, New York Hospital Queens, Flushing, NY, (3)Infectious Disease, New York Hospital Queens, Flushing, NY, (4)Medicine, SUNY Downstate Medical Center, Brooklyn, NY

Disclosures:

M. Abdallah, None

O. Olafisoye, None

C. Cortes, None

C. Urban, Pfizer: Speaker's Bureau, Speaker honorarium
Cubist: Speaker's Bureau, Speaker honorarium

C. Charles, None

D. Landman, Tetraphase: Research Contractor, Research grant
Achaogen: Research Contractor, Research grant

J. Quale, Tetraphase: Research Contractor, Research grant
Achaogen: Research Contractor, Research grant

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