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Fatal outbreak of an emerging clone of extensively drug-resistant Acinetobacter baumannii with enhanced virulence
CL. Jones, M. Clancy, C. Honnold, S. Singh, E. Snesrud, F. Onmus-Leone, P. McGann, AC. Ong, Y. Kwak, P. Waterman, DV. Zurawski, RJ. Clifford, E. Lesho,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, Research Support, U.S. Gov't, Non-P.H.S.
PubMed
25824815
DOI
10.1093/cid/civ225
Knihovny.cz E-zdroje
- MeSH
- Acinetobacter baumannii klasifikace genetika izolace a purifikace patogenita MeSH
- centra terciární péče statistika a číselné údaje MeSH
- dospělí MeSH
- epidemický výskyt choroby * MeSH
- fylogeneze MeSH
- genomika MeSH
- imunokompetence MeSH
- infekce bakteriemi rodu Acinetobacter epidemiologie genetika mikrobiologie mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mnohočetná bakteriální léková rezistence * genetika MeSH
- modely nemocí na zvířatech MeSH
- multilokusová sekvenční typizace MeSH
- myši MeSH
- senioři nad 80 let MeSH
- virulence genetika MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- myši MeSH
- senioři nad 80 let MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
- Geografické názvy
- Česká republika MeSH
- Kalifornie MeSH
- Německo MeSH
- Spojené státy americké MeSH
BACKGROUND: Severe Acinetobacter baumannii infections in immunocompetent patients are uncommon, and the virulence mechanisms of this organism are not fully understood. METHODS: Following an outbreak of fatal A. baumannii infections in a cohort of relatively immunocompetent patients (low comorbidity and illness severity scores), isolates were investigated with comparative genomics and in animal models. RESULTS: Two unrelated A. baumannii clades were associated with the outbreak. The clone associated with the majority of patient deaths, clade B, is evolutionarily distinct from the 3 international clonal complexes, belongs to multilocus sequence type (MLST) 10, and is most closely related to strains isolated from the Czech Republic, California, and Germany in 1994, 1997, and 2003, respectively. In 2 different murine models, clade B isolates were more virulent than comparator strains, including the highly virulent reference strain AB5075. The most virulent clade B derivative, MRSN 16897, was isolated from the patient with the lowest combined comorbidity/illness severity score. Clade B isolates possess a unique combination of putative virulence genes involved in iron metabolism, protein secretion, and glycosylation, which was leveraged to develop a rapid and specific clinical assay to detect this clade that cannot be distinguished by MLST. CONCLUSIONS: Clade B warrants continued surveillance and investigation.
Citace poskytuje Crossref.org
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- $a BACKGROUND: Severe Acinetobacter baumannii infections in immunocompetent patients are uncommon, and the virulence mechanisms of this organism are not fully understood. METHODS: Following an outbreak of fatal A. baumannii infections in a cohort of relatively immunocompetent patients (low comorbidity and illness severity scores), isolates were investigated with comparative genomics and in animal models. RESULTS: Two unrelated A. baumannii clades were associated with the outbreak. The clone associated with the majority of patient deaths, clade B, is evolutionarily distinct from the 3 international clonal complexes, belongs to multilocus sequence type (MLST) 10, and is most closely related to strains isolated from the Czech Republic, California, and Germany in 1994, 1997, and 2003, respectively. In 2 different murine models, clade B isolates were more virulent than comparator strains, including the highly virulent reference strain AB5075. The most virulent clade B derivative, MRSN 16897, was isolated from the patient with the lowest combined comorbidity/illness severity score. Clade B isolates possess a unique combination of putative virulence genes involved in iron metabolism, protein secretion, and glycosylation, which was leveraged to develop a rapid and specific clinical assay to detect this clade that cannot be distinguished by MLST. CONCLUSIONS: Clade B warrants continued surveillance and investigation.
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