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Azizi O, Shahcheraghi F, Salimizand H, Modarresi F, Shakibaie MR, Mansouri S, Ramazanzadeh R, Badmasti F, Nikbin V. Molecular Analysis and Expression of bap Gene in Biofilm-Forming Multi-Drug-Resistant Acinetobacter baumannii. Rep Biochem Mol Biol 2017; 5:62-72. [PMID: 28070537 DOI: pmid/28070537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Acinetobacter baumannii is commonly resistant to nearly all antibiotics due to presence of antibiotic resistance genes and biofilm formation. In this study we determined the presence of certain antibiotic-resistance genes associated with biofilm production and the influence of low iron concentration on expression of the biofilm-associated protein gene (bap) in development of biofilm among multi-drug-resistant A. baumannii (MDRAB). METHODS Sixty-five MDRAB isolates from clinical samples were collected. Molecular typing was carried out by random amplified polymorphism DNA polymerase chain reaction (RAPD-PCR). Biofilm formation was assayed by the microtiter method. RESULTS The sequence of bap was determined and deposited in the GenBank database (accession no. KR080550.1). Expression of bap in the presence of low iron was analyzed by relative quantitative real time PCR (rqRT-PCR). Nearly half of the isolates belonged to RAPD-types A and B remaining were either small clusters or singleton. The results of biofilm formation revealed that 23 (35.4%), 18 (27.7%), 13 (20%), and 11 (16.9%) of the isolates had strong, moderate, weak, and no biofilm activities, respectively. ompA and csuE genes were detected in all, while bap and blaPER-1 were detected in 43 (66%) and 42 (64%) of the isolates that showed strong and moderate biofilm activities (p ≤ 0.05), respectively. Analysis of bap expression by rqRT-PCR revealed five isolates with four-fold bap overexpression in the presence of low iron concentration (20 µM). CONCLUSION The results suggest that bap overexpression may influence biofilm formation in presence of low iron concentration.
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Affiliation(s)
- Omid Azizi
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Himen Salimizand
- Department of Microbiology and Virology, Kurdistan University of Medical Sciences, Kurdistan, Iran
| | - Farzan Modarresi
- Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mohammad Reza Shakibaie
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran; Environmental Health Sciences and Engineering Research Center; Kerman University of Medical Sciences, Kerman, Iran; Research Center for Infectious Diseases and Tropical Medicine, Kerman University of Medical Sciences
| | - Shahla Mansouri
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran
| | - Rashid Ramazanzadeh
- Cellular & Molecular Research Center and Microbiology Department, Faculty of Medicine, Kurdistan University of Medical Sciences, Iran
| | - Farzad Badmasti
- Department of Bacteriology, Pasteur institute of Iran, Tehran, Iran
| | - Vajihe Nikbin
- Department of Bacteriology, Pasteur institute of Iran, Tehran, Iran
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202
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Kobs VC, Ferreira JA, Bobrowicz TA, Ferreira LE, Deglmann RC, Westphal GA, França PHCD. The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting. Rev Soc Bras Med Trop 2017; 49:433-40. [PMID: 27598629 DOI: 10.1590/0037-8682-0002-2016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 07/12/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. METHODS Isolates identified over 6 consecutive years in a general hospital in Joinville, Southern Brazil, were evaluated. The investigation of 5 families of genes encoding oxacillinases and the ISAba1 sequence location relative to bla OXA genes was conducted using polymerase chain reaction. RESULTS All isolates presented the bla OXA-51-like gene (n = 78), and 91% tested positive for the bla OXA-23-like gene (n = 71). The presence of ISAba1 was exclusively detected in isolates carrying the bla OXA-23-like gene. All isolates in which ISAba1 was found upstream of the bla OXA-23-like gene (n = 69) showed resistance to carbapenems, whereas the only isolate in which ISAba1 was not located near the bla OXA-23-like gene was susceptible to carbapenems. The ISAba1 sequence position of another bla OXA-23-like-positive isolate was inconclusive. The isolates exclusively carrying the bla OXA-51-like gene (n = 7) showed susceptibility to carbapenems. CONCLUSIONS The presence of the ISAba1 sequence upstream of the bla OXA-23-like gene was strongly associated with carbapenem resistance in isolates of the A. calcoaceticus-A. baumannii complex in the hospital center studied.
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Affiliation(s)
- Vanessa Cristine Kobs
- Laboratório de Análises Clínicas, Hospital Dona Helena, Joinville, Santa Catarina, Brazil
| | | | | | - Leslie Ecker Ferreira
- Departamento de Farmácia, Universidade da Região de Joinville, Joinville, Santa Catarina, Brazil.,Departamento de Medicina, Universidade da Região de Joinville, Joinville, Santa Catarina, Brazil
| | - Roseneide Campos Deglmann
- Departamento de Farmácia, Universidade da Região de Joinville, Joinville, Santa Catarina, Brazil.,Departamento de Medicina, Universidade da Região de Joinville, Joinville, Santa Catarina, Brazil
| | - Glauco Adrieno Westphal
- Departamento de Medicina, Universidade da Região de Joinville, Joinville, Santa Catarina, Brazil
| | - Paulo Henrique Condeixa de França
- Departamento de Farmácia, Universidade da Região de Joinville, Joinville, Santa Catarina, Brazil.,Departamento de Medicina, Universidade da Região de Joinville, Joinville, Santa Catarina, Brazil
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203
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Almani SA, Naseer A, Maheshwari SK, Maroof P, Naseer R, Khoharo HK. Current Trends of Drug Resistance Patterns of Acinetobacter baumannii Infection in Blood Transfusion-dependent Thalassemia Patients. J Glob Infect Dis 2017; 9:135-138. [PMID: 29302147 PMCID: PMC5750436 DOI: 10.4103/jgid.jgid_151_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective The present study aimed to evaluate the current trends of drug resistance patterns of Acinetobacter baumannii infection in blood transfusion-dependent thalassemia patients. Study Design This study was a cross sectional study, conducted at the Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad, Sindh, Pakistan from October 2014 to January 2016. Subjects and Methods Of 921 blood samples, A. baumannii strains were isolated from 100 blood samples. Blood samples were processed for the isolation, identification, and drugs sensitivity as per the Clinical and Laboratory Standards Institute. A. baumannii strains were identified by microbiological methods and Gram's staining. API 20 E kit (Biomeriuex, USA) was also used for identification. Data were analyzed on Statisti × 8.1 (USA). Results Mean ± standard deviation age was 11.5 ± 2.8 years. Nearly 70% were male and 30% were female (P = 0.0001). Of 921 blood transfusion-dependent thalassemia patients, 100 (10.8%) patients showed growth of A. baumannii. Drug resistance was observed against the ceftazidime, cefixime, cefepime, imipenem, meropenem, amikacin, minocycline, tigecycline, and tazocin except for the colistin. Conclusion The present study reports drug-resistant A. baumannii in blood transfusion-dependent thalassemia patients. National multicenter studies are recommended to estimate the size of the problem.
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Affiliation(s)
- Suhail Ahmed Almani
- Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Ali Naseer
- Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | | | - Pir Maroof
- Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Raza Naseer
- Department of Medicine, Abbasi Shaheed Hospital, Karachi, Pakistan
| | - Haji Khan Khoharo
- Department of Medicine, Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh, Pakistan
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204
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Multi-omics approach to study global changes in a triclosan-resistant mutant strain of Acinetobacter baumannii ATCC 17978. Int J Antimicrob Agents 2017; 49:74-80. [DOI: 10.1016/j.ijantimicag.2016.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/28/2016] [Accepted: 10/01/2016] [Indexed: 11/23/2022]
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205
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Gholami M, Haghshenas M, Moshiri M, Razavi S, Pournajaf A, Irajian G, Heidary M. Frequency of 16S rRNA Methylase and Aminoglycoside-Modifying Enzyme Genes among Clinical Isolates of Acinetobacter baumannii in Iran. IRANIAN JOURNAL OF PATHOLOGY 2017; 12:329-338. [PMID: 29563928 PMCID: PMC5844677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 04/26/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND & OBJECTIVE Multidrug-resistant Acinetobacter baumannii (MDR-AB) is an important nosocomial pathogen which is associated with significant morbidity and mortality, particularly in high-risk populations. Aminoglycoside-modifying enzymes (AMEs) and 16S ribosomal RNA (16S rRNA) methylation are two important mechanisms of resistance to aminoglycosides. The aim of this study was to determine the prevalence of 16S rRNA methylase (armA, rmtA, rmtB, rmtC, and rmtD), and the AME genes [aac(6')-Ib, aac(3)-I, ant(3'')-I, aph(3')-I and aac(6')-Id], among clinical isolates of A. baumannii in Tehran, Iran. METHODS Between November 2015 to July 2016, a total of 110 clinical strains of A. baumannii were isolated from patients in two teaching hospitals in Tehran, Iran. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute guidelines. The presence of genes encoding the AMEs and 16S rRNA methylases responsible for resistance was investigated by multiplex polymerase chain reaction. RESULTS The results showed that colistin was an effective antibiotic and could be used as a last-resort treatment of infections caused by MDR-AB. The resistance rate to aminoglycosides were 100%, 96.36% and 90.9% for tobramycin, gentamicin and amikacin, respectively. In this study, AME genes of aac(6')-Ib, aac(3)-I and ant(3'')-I were most prevalent among the isolated strains. CONCLUSION Markedly high resistance to tobramycin, gentamicin and amikacin was noted in current study. Our results suggested that modifying enzyme genes in conjunction with methylation of 16S rRNA might contribute to aminoglycoside resistance induced in vivo in A. baumannii. Further studies are required to determine the prevalence of the aminoglycoside resistance genes in other hospitals of Iran.
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Affiliation(s)
- Mehrdad Gholami
- Dept. of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran,Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Haghshenas
- Dept. of Microbiology, Molecular and Cell-Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mona Moshiri
- Dept. of Pathobiology, Division of Microbiology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shabnam Razavi
- Dept. of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran,Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abazar Pournajaf
- Dept. of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Irajian
- Dept. of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran,Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran,Corresponding information: Gholamreza Irajian, Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran, E-mail: ,
| | - Mohsen Heidary
- Dept. of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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206
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Al-Agamy MH, Jeannot K, El-Mahdy TS, Shibl AM, Kattan W, Plésiat P, Courvalin P. First Detection of GES-5 Carbapenemase-Producing Acinetobacter baumannii Isolate. Microb Drug Resist 2016; 23:556-562. [PMID: 27854148 DOI: 10.1089/mdr.2016.0152] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study was conducted to investigate the molecular epidemiology of resistance in Acinetobacter baumannii isolates collected at a hospital in Riyadh, Saudi Arabia, from January through December 2010. Twenty-seven A. baumannii were highly resistant (MIC90 > 256 μg/ml) to ceftazidime, cefepime, and aztreonam. Imipenem resistance was seen in 24 isolates, of which 18 had an minimum inhibitory concentration (MIC) >32 μg/mL. Ciprofloxacin, gentamicin, and amikacin resistance was found in 93%, 52%, and 37% of all the isolates, respectively. Moreover, 8 (30%) isolates showed colistin resistance, and 15 (56%) were found to have MICs ≥4 μg/mL for tigecycline. The frequency of ADC, GES-1, GES-11, and GES-5 were 96.3% (n = 26), 18.5% (n = 5), 11% (n = 3), and 3.7% (n = 1), respectively. OXA-23 was found in 63% (n = 17) of the isolates; ISAba1 was found upstream of OXA-23 in 16. OXA-24/40 was detected in only one strain. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) analysis revealed that the 27 strains were distributed in 8 sequence types (STs) and 16 clonal pulsotypes (A-P). Five singleton STs were identified, including ST15 and ST113-ST116. The emergence of multidrug-resistant A. baumannii is becoming a major concern in Saudi Arabia. Metallo-β-lactamases have no role in carbapenem resistance in this collection. The spread of OXA-23 in our strains occurred across different STs and pulsotypes, unlike what has been observed in many other countries. PFGE typing was more discriminatory than MLST. The high frequency of colistin and tigecycline resistance found in the isolates calls for continuous monitoring. This study describes the first identification of GES-5 conferring carbapenem resistance in A. baumannii.
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Affiliation(s)
- Mohamed H Al-Agamy
- 1 Department of Pharmaceutics, College of Pharmacy, King Saud University , Riyadh, Saudi Arabia .,2 Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University , Cairo, Egypt
| | - Katy Jeannot
- 3 Centre National de Référence "Résistance aux Antibiotiques," Institut Pasteur , Paris, France
| | - Taghrid S El-Mahdy
- 4 Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University , Cairo, Egypt
| | - Atef M Shibl
- 5 College of Medicine, Alfaisal University , Riyadh, Saudi Arabia
| | - Wael Kattan
- 5 College of Medicine, Alfaisal University , Riyadh, Saudi Arabia
| | - Patrick Plésiat
- 3 Centre National de Référence "Résistance aux Antibiotiques," Institut Pasteur , Paris, France
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207
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Li PH, Cheng VCC, Yip T, Yap DYH, Lui SL, Lo WK. Epidemiology and Clinical Characteristics of Acinetobacter Peritoneal Dialysis-Related Peritonitis in Hong Kong-With a Perspective on Multi-Drug and Carbapenem Resistance. Perit Dial Int 2016; 37:177-182. [PMID: 27680764 DOI: 10.3747/pdi.2016.00123] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/09/2016] [Indexed: 11/15/2022] Open
Abstract
♦ BACKGROUND: Acinetobacter spp. is an important cause of peritoneal dialysis (PD)-related peritonitis, but studies on Acinetobacter peritonitis have been scarce. In view of the rising concern of carbapenem-resistant Acinetobacter (CRA) and multidrug-resistant Acinetobacter (MDRA) infections, we conducted this study on the incidence of Acinetobacter peritonitis and the impact of CRA and MDRA on its outcome. ♦ METHODS: We retrospectively evaluated the clinical characteristics, prevalence, antibiotic sensitivity patterns, outcomes, and factors associated with treatment failure over the past 16 years in our patients with Acinetobacter PD-related peritonitis. ♦ RESULTS: Out of 2,389 episodes of peritonitis, there were 66 episodes (3%) of Acinetobacter peritonitis occurring in 59 patients. Twelve episodes were caused by MDRA (18%), of which 5 were CRA (8%). There was a progressive increase in the incidence of MDRA and CRA infections over the study period. Most isolates were sensitive to sulbactam combinations (ampicillin-sulbactam [95.4%] and cefoperazone-sulbactam [93.9%]), aminoglycosides (amikacin [92.4%], tobramycin [90.9%], and gentamicin [89.4%]), and carbapenems (imipenem [92.2%]). There was 1 case of relapse. Fifteen episodes resulted in catheter removal (23%), and 7 patients died (11%). Hypoalbuminemia (odds ratio [OR] = 0.85, p = 0.006) and carbapenem resistance (OR = 18.2, p = 0.049) were significantly associated with higher rates of treatment failure. ♦ CONCLUSION: Both carbapenem resistance and hypoalbuminemia were significantly associated with treatment failure. Up to 80% of peritonitis episodes by CRA resulted in catheter loss or mortality. Sulbactam combinations and/or aminoglycosides remained effective for the majority of Acinetobacter isolates. There seemed to be an increasing relative incidence of MDRA and CRA infections over the past 16 years.
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Affiliation(s)
- Philip Hei Li
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | - Vincent C C Cheng
- Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | - Terence Yip
- Department of Medicine, Tung Wah Hospital, Hong Kong
| | - Desmond Y H Yap
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | | | - Wai-Kei Lo
- Department of Medicine, Tung Wah Hospital, Hong Kong
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208
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Johnson JK, Robinson GL, Zhao L, Harris AD, Stine OC, Thom KA. Comparison of molecular typing methods for the analyses of Acinetobacter baumannii from ICU patients. Diagn Microbiol Infect Dis 2016; 86:345-350. [PMID: 27640081 DOI: 10.1016/j.diagmicrobio.2016.08.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/18/2016] [Accepted: 08/24/2016] [Indexed: 01/23/2023]
Abstract
Acinetobacter baumannii has emerged as an important cause of healthcare-associated infections causing great morbidity and mortality. Despite its clinical importance, it is still unknown which molecular typing method is the best to determine or confirm institutional outbreaks as well as to identify epidemiologically related isolates from different geographical areas. To determine the most discriminatory molecular typing method, we isolated A. baumannii from perianal swabs collected from intensive care unit (ICU) patients in a cohort study during 2002 and 2008. Strains from each year were analyzed by pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST), and multi-locus variable-number tandem repeat analysis (MLVA). Genetic relatedness of the isolates was consistent between PFGE and MLST as well as between analyses of loci containing MLVA and MLST. Our data show that PFGE and MLVA are similar when discriminating between isolates and are both good methods to use when questioning whether two isolates are indistinguishable.
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Affiliation(s)
- J Kristie Johnson
- Department of Pathology, University of Maryland School of Medicine Baltimore, MD; Epidemiology and Public Health, University of Maryland School of Medicine Baltimore, MD.
| | - Gwen L Robinson
- Department of Pathology, University of Maryland School of Medicine Baltimore, MD
| | - LiCheng Zhao
- Department of Pathology, University of Maryland School of Medicine Baltimore, MD
| | - Anthony D Harris
- Epidemiology and Public Health, University of Maryland School of Medicine Baltimore, MD
| | - O Colin Stine
- Epidemiology and Public Health, University of Maryland School of Medicine Baltimore, MD
| | - Kerri A Thom
- Epidemiology and Public Health, University of Maryland School of Medicine Baltimore, MD
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209
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Aliramezani A, Douraghi M, Hajihasani A, Mohammadzadeh M, Rahbar M. Clonal relatedness and biofilm formation of OXA-23-producing carbapenem resistant Acinetobacter baumannii isolates from hospital environment. Microb Pathog 2016; 99:204-208. [PMID: 27569533 DOI: 10.1016/j.micpath.2016.08.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/05/2016] [Accepted: 08/24/2016] [Indexed: 11/16/2022]
Abstract
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a serious threat for hospitalized patients and it can survive for long periods in hospital settings, particularly on inanimate surfaces. The environment occupied by these resistant and resilient isolates may act as a reservoir for cross-colonization and outbreaks. Here, we aimed to determine the distribution of CRAB in the hospital environment and to characterize their clonal relatedness, susceptibility profile, carriage of blaOXA genes, and biofilm formation. A total of 1080 samples were collected from various environmental surfaces and equipment of two referral hospitals in Tehran, Iran. The A. baumannii isolates were subjected to gyrB multiplex PCR, antibiotic susceptibility testing, biofilm formation assay, pulsed field gel electrophoresis (PFGE), and multiplex PCR for blaOXA-58, blaOXA-24, and blaOXA-23 genes. Eighteen Acinetobacter spp. were isolated; 8 were identified as A. baumannii and 10 as A. lwoffii. Five of A. baumannii isolates were CRAB and exhibited the multidrug-resistant (MDR) phenotype as well. All CRAB isolates produced biofilm, albeit with different levels. Four of CRAB isolates harbored the blaOXA-23. The CRAB isolates were clustered into 3 distinct pulsotypes (PTs). The CRAB isolates belonging to PT1 were detected in two geographically distinct hospitals whereas those belonging to PT3 were found in two different units of same hospital. This study revealed the presence of clonally related OXA-23-producing CRAB in high risk units of referral hospitals as inter- or intra-hospital dissemination. The distribution of multiresistant A. baumannii on several surfaces and areas may increase the risk of transmission of resistant isolates to vulnerable patients.
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Affiliation(s)
- Amir Aliramezani
- Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Douraghi
- Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Azade Hajihasani
- Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Mohammadzadeh
- Pediatrics Infectious Diseases Research Center, Department of Infectious Diseases, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rahbar
- Department of Microbiology, Reference Health Laboratories, Ministry of Health, Tehran, Iran
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210
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Azizi O, Shakibaie MR, Badmasti F, Modarresi F, Ramazanzadeh R, Mansouri S, Shahcheraghi F. Class 1 integrons in non-clonal multidrug-resistant Acinetobacter baumannii from Iran, description of the new blaIMP-55 allele in In1243. J Med Microbiol 2016; 65:928-936. [PMID: 27430533 DOI: 10.1099/jmm.0.000315] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Infections and outbreaks caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) are prevalent and have been reported worldwide over the past 20 or more years. Class 1 integron in MDR-AB plays an important role in the spread of antibiotic resistance in clinical settings. This study has been conducted to evaluate the detection of metallo-β-lactamase, characterization of class 1 integron and determination of clonal relatedness among A. baumannii hospital isolates. Sixty-five clinical isolates of MDR-AB were recovered from two Iranian hospital's intensive care units from February to August 2013. Integrase (intI1) and blaIMP genes were detected in 70.8 % (n=46/65) and 9.23 % (n=6/65) of the isolates using PCR assay, respectively. No other metallo-β-lactamase genes (blaVIM, blaSIM and blaNDM) were detected. PCR sequencing of integron gene cassette revealed the following arrays: blaOXA10-aacA4-blaIMP-55-cmlA5 (as a novel array was designated In1243), aacC1 and aadA1. Analysis of blaIMP gene revealed a new allele designated as blaIMP-55. Gene transfer experiment by conjugation showed the 36 kb conjugative plasmid harbouring In1243. The clonal assessment by repetitive extragenic palindromic PCR demonstrated a high-degree relatedness among the strains, but strains harbouring In1243 displayed a different repetitive extragenic palindromic PCR profile. In this study, we found that a novel class 1 integron (In1243) that encoded a new blaIMP allele resided on a transferable plasmid in non-clonal strains of MDR-AB.
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Affiliation(s)
- Omid Azizi
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Shakibaie
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran.,Kerman Research Center for Infectious Diseases and Tropical Medicine, Kerman, Iran.,Environmental Health Sciences and Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Farzad Badmasti
- Department of Bacteriology, Microbiology Center, Pasteur Institute of Iran, Tehran, Iran
| | - Farzan Modarresi
- Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Rashid Ramazanzadeh
- Cellular & Molecular Research Center and Microbiology Department, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Shahla Mansouri
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran
| | - Fereshteh Shahcheraghi
- Department of Bacteriology, Microbiology Center, Pasteur Institute of Iran, Tehran, Iran
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211
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El-Mahdy TS, Al-Agamy MH, Al-Qahtani AA, Shibl AM. Detection of bla OXA-23-like and bla NDM-1 in Acinetobacter baumannii from the Eastern Region, Saudi Arabia. Microb Drug Resist 2016; 23:115-121. [PMID: 27183378 DOI: 10.1089/mdr.2015.0304] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Acinetobacter baumannii is currently considered as one of the most common successful pathogens in the healthcare system due to its ability to quickly develop resistance. Ten carbapenem-resistant A. calcoaceticus-baumannii complex were isolated from the eastern region, Saudi Arabia in 2014. All isolates were resistant to ciprofloxacin, however, 8 of 10 isolates were tigecycline resistant. Susceptibility test was also carried out for three aminoglycosides, resistance to gentamicin was 80%, amikacin was 90%, and tobramycin was 50%. Colistin susceptibility was seen in all isolates. The 10 isolates harbored blaOXA-23-like and ISAba1 and 9 of them also carried blaADC. Three isolates of 10 harbored blaNDM-1 coding for NDM metallo-β-lactamase (MBL) with coexistence of blaADC together with either blaGES or blaTEM or both. Those three isolates exhibited negative Etest MBL screening test. Pulsed-field gel electrophoresis revealed the high clonal variability of the isolates, although two isolates were indistinguishable. The risk of dissemination of carbapenem resistance through presence of ISAba1 upstream of OXA-23-like in all isolates raises the concern about emergence of higher carbapenem prevalence rates in the future in our region. This study also demonstrated the importance of molecular surveillance to provide accurate and reliable data about the resistance rates of A. baumannii. Finally, the high incidence of NDM-1 among our isolates requires a routine surveillance to monitor the future prevalence of this enzyme in the region.
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Affiliation(s)
- Taghrid S El-Mahdy
- 1 Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University , Hofuf, Al-Ahsa, Saudi Arabia .,2 Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University , Cairo, Egypt
| | - Mohamed H Al-Agamy
- 3 Department of Pharmaceutics and Microbiology, College of Pharmacy, King Saud University , Riyadh, Saudi Arabia .,4 Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University , Cairo, Egypt
| | - Ahmed A Al-Qahtani
- 5 Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia
| | - Atef M Shibl
- 3 Department of Pharmaceutics and Microbiology, College of Pharmacy, King Saud University , Riyadh, Saudi Arabia
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212
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Greene C, Vadlamudi G, Newton D, Foxman B, Xi C. The influence of biofilm formation and multidrug resistance on environmental survival of clinical and environmental isolates of Acinetobacter baumannii. Am J Infect Control 2016; 44:e65-71. [PMID: 26851196 PMCID: PMC6993530 DOI: 10.1016/j.ajic.2015.12.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 12/06/2015] [Accepted: 12/08/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Acinetobacter baumannii is a gram-negative, opportunistic pathogen. Its ability to form biofilm and increasing resistance to antibiotic agents present challenges for infection control. A better understanding of the influence of biofilm formation and antibiotic resistance on environmental persistence of A baumannii in hospital settings is needed for more effective infection control. METHODS A baumannii strains isolated from patients and the hospital environment were identified via Matrix Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) mass spectrometry (Bruker Daltonics, Bellerica, MA), repetitive extragenic palindromic polymerase chain reaction genotyped, and antibiotic resistance was determined using Vitek 2 (bioMérieux, Inc, Durham NC). Biofilm mass was quantified via microtiter plate method and desiccation tolerance determined up to 56 days. RESULTS High biofilm forming, clinical, multidrug-resistant- (MDR) positive strains were 50% less likely to die of desiccation than low biofilm, non-MDR strains. In contrast, environmental, MDR-positive, low biofilm forming strains had a 2.7 times increase in risk of cell death due to desiccation compared with their MDR-negative counterparts. MDR-negative, high biofilm forming environmental strains had a 60% decrease in risk compared with their low biofilm forming counterparts. CONCLUSION The MDR-positive phenotype was deleterious for environmental strains and the high biofilm phenotype was critical for survival. This study provides evidence of the trade-off between antibiotic resistance and desiccation tolerance, driven by condition-dependent adaptation, and establishes rationale for research into the genetic basis of the variation in fitness cost between clinical and environmental isolates.
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Affiliation(s)
- Christine Greene
- Department of Environmental Health and Science, University of Michigan, Ann Arbor, MI
| | - Gayathri Vadlamudi
- Department of Environmental Health and Science, University of Michigan, Ann Arbor, MI
| | - Duane Newton
- Department of Epidemiology, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Betsy Foxman
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | - Chuanwu Xi
- Department of Environmental Health and Science, University of Michigan, Ann Arbor, MI.
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213
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Çöl A, Dedeić-Ljubović A, Salimović-Bešić I, Hukic M. Antibiotic Resistance Profiles and Genetic Similarities Within a New Generation of Carbapenem-Resistant Acinetobacter calcoaceticus-A. baumannii Complex Resistotypes in Bosnia and Herzegovina. Microb Drug Resist 2016; 22:655-661. [PMID: 27082787 DOI: 10.1089/mdr.2015.0257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Acinetobacter calcoaceticus-A. baumannii complex (ACB complex) is a nosocomial pathogen. Due to its high ability to develop antibiotic resistance, it has become a problematic challenge in the modern healthcare system. The molecular and genetic mechanisms of gaining multidrug resistance in ACB complex are well known. This study focuses on providing an overview of the antibiotic resistance profiles, genetic similarities and resistotypes, and general characteristics of carbapenem-resistant ACB complex (CRACB) in Bosnia and Herzegovina (BiH). In light of the data collected in this study, together with the already known information concerning antibiotic resistance of ACB complex, we intend to further elucidate the antibiotic therapy for CRACB strain resistotypes in BiH.
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Affiliation(s)
- Aydin Çöl
- 1 Biology Education, Ishik University , Erbil, Iraq
| | - Amela Dedeić-Ljubović
- 2 Clinical Microbiology, Clinical Center University of Sarajevo , Sarajevo, Bosnia and Herzegovina
| | - Irma Salimović-Bešić
- 2 Clinical Microbiology, Clinical Center University of Sarajevo , Sarajevo, Bosnia and Herzegovina
| | - Mirsada Hukic
- 3 Genetics and Bioengineering, International Burch University , Sarajevo, Bosnia and Herzegovina
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214
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Alaei N, Aziemzadeh M, Bahador A. Antimicrobial resistance profiles and genetic elements involved in carbapenem resistance in Acinetobacter baumannii isolates from a referral hospital in Southern Iran. J Glob Antimicrob Resist 2016; 5:75-9. [PMID: 27436472 DOI: 10.1016/j.jgar.2015.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 11/18/2015] [Accepted: 12/22/2015] [Indexed: 11/19/2022] Open
Abstract
In this study, antimicrobial resistance patterns, carbapenemase production, carbapenem-hydrolysing class D OXA-type β-lactamase (CHDL)-encoding genes and ISAba insertion elements were characterised in Acinetobacter baumannii isolates from Southern Iran. A total of 85 A. baumannii isolates from patients in a tertiary care hospital were isolated. Antibiotic susceptibility profiles to 14 antimicrobials were determined by disc diffusion assay. Minimum inhibitory concentrations (MICs) to colistin and tigecycline were determined by the broth microdilution method. Isolates were analysed for OXA-type carbapenemase-encoding genes, ISAba elements upstream of blaOXA genes, and carbapenemase production by the CarbAcineto NP test. Of the 85 A. baumannii isolates, 73 (86%) were non-susceptible to imipenem. The MIC50 and MIC90 values for imipenem were 16mg/L and 64mg/L, respectively. Fourteen isolates (16%) were resistant to colistin. Among the 79 carbapenem-non-susceptible A. baumannii isolates, 77 (97%) were carbapenemase-producers as determined by the CarbAcineto NP test. The most frequently identified OXA-type carbapenemase gene was blaOXA-23-like, which was identified in 44 isolates (52%), followed by blaOXA-24-like with 13 isolates (15%). Statistical analysis showed that ISAba elements upstream of the blaOXA gene were significantly related to imipenem-non-susceptible isolates. The presence of blaOXA genes and ISAba1 and ISAba4 elements can explain the resistance of the isolates to carbapenems. The concerns raised following the emergence of colistin-resistant A. baumannii isolates highlight the need for a comprehensive national programme to collect and examine A. baumannii isolates from different parts of Iran.
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Affiliation(s)
- Najmeh Alaei
- Department of Microbiology, Faculty of Basic Sciences, Islamic Azad University, Karaj Branch, Karaj, Iran
| | - Masoud Aziemzadeh
- Department of Microbiology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Keshavarz Blvd., 100 Poursina Ave., Tehran 14167-53955, Iran.
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215
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In Vitro Activity of Tigecycline Against Acinetobacter baumannii: Global Epidemiology and Resistance Mechanisms. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 897:1-14. [DOI: 10.1007/5584_2015_5001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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216
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Lin MF, Tsai PW, Chen JY, Lin YY, Lan CY. OmpA Binding Mediates the Effect of Antimicrobial Peptide LL-37 on Acinetobacter baumannii. PLoS One 2015; 10:e0141107. [PMID: 26484669 PMCID: PMC4618850 DOI: 10.1371/journal.pone.0141107] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 10/05/2015] [Indexed: 02/06/2023] Open
Abstract
Multidrug-resistant Acinetobacter baumannii has recently emerged as an important pathogen in nosocomial infection; thus, effective antimicrobial regimens are urgently needed. Human antimicrobial peptides (AMPs) exhibit multiple functions and antimicrobial activities against bacteria and fungi and are proposed to be potential adjuvant therapeutic agents. This study examined the effect of the human cathelicidin-derived AMP LL-37 on A. baumannii and revealed the underlying mode of action. We found that LL-37 killed A. baumannii efficiently and reduced cell motility and adhesion. The bacteria-killing effect of LL-37 on A. baumannii was more efficient compared to other AMPs, including human ß–defensin 3 (hBD3) and histatin 5 (Hst5). Both flow cytometric analysis and immunofluorescence staining showed that LL-37 bound to A. baumannii cells. Moreover, far-western analysis demonstrated that LL-37 could bind to the A. baumannii OmpA (AbOmpA) protein. An ELISA assay indicated that biotin-labelled LL-37 (BA-LL37) bound to the AbOmpA74-84 peptide in a dose-dependent manner. Using BA-LL37 as a probe, the ~38 kDa OmpA signal was detected in the wild type but the ompA deletion strain did not show the protein, thereby validating the interaction. Finally, we found that the ompA deletion mutant was more sensitive to LL-37 and decreased cell adhesion by 32% compared to the wild type. However, ompA deletion mutant showed a greatly reduced adhesion defect after LL-37 treatment compared to the wild strain. Taken together, this study provides evidence that LL-37 affects A. baumannii through OmpA binding.
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Affiliation(s)
- Ming-Feng Lin
- Department of Medicine, National Taiwan University Hospital Chu-Tung Branch, Hsin-Chu County, Taiwan
| | - Pei-Wen Tsai
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsin-Chu City, Taiwan
| | - Jeng-Yi Chen
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsin-Chu City, Taiwan
| | - Yun-You Lin
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsin-Chu City, Taiwan
| | - Chung-Yu Lan
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsin-Chu City, Taiwan
- Department of Life Science, National Tsing Hua University, Hsin-Chu City, Taiwan
- * E-mail:
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217
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Chernysh S, Gordya N, Suborova T. Insect Antimicrobial Peptide Complexes Prevent Resistance Development in Bacteria. PLoS One 2015; 10:e0130788. [PMID: 26177023 PMCID: PMC4503414 DOI: 10.1371/journal.pone.0130788] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 05/26/2015] [Indexed: 12/15/2022] Open
Abstract
In recent decades much attention has been paid to antimicrobial peptides (AMPs) as natural antibiotics, which are presumably protected from resistance development in bacteria. However, experimental evolution studies have revealed prompt resistance increase in bacteria to any individual AMP tested. Here we demonstrate that naturally occurring compounds containing insect AMP complexes have clear advantage over individual peptide and small molecule antibiotics in respect of drug resistance development. As a model we have used the compounds isolated from bacteria challenged maggots of Calliphoridae flies. The compound isolated from blow fly Calliphora vicina was found to contain three distinct families of cell membrane disrupting/permeabilizing peptides (defensins, cecropins and diptericins), one family of proline rich peptides and several unknown antimicrobial substances. Resistance changes under long term selective pressure of the compound and reference antibiotics cefotaxime, meropenem and polymyxin B were tested using Escherichia coli, Klebsiella pneumonia and Acinetobacter baumannii clinical strains. All the strains readily developed resistance to the reference antibiotics, while no signs of resistance growth to the compound were registered. Similar results were obtained with the compounds isolated from 3 other fly species. The experiments revealed that natural compounds containing insect AMP complexes, in contrast to individual AMP and small molecule antibiotics, are well protected from resistance development in bacteria. Further progress in the research of natural AMP complexes may provide novel solutions to the drug resistance problem.
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Affiliation(s)
- Sergey Chernysh
- Laboratory of Insect Biopharmacology and Immunology, Faculty of Biology, St. Petersburg State University, St. Petersburg, Russia
- * E-mail:
| | - Natalia Gordya
- Laboratory of Insect Biopharmacology and Immunology, Faculty of Biology, St. Petersburg State University, St. Petersburg, Russia
| | - Tatyana Suborova
- Research Center of Kirov Military Medical Academy, St. Petersburg, Russia
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218
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Quiñones D, Carvajal I, Perez Y, Hart M, Perez J, Garcia S, Salazar D, Ghosh S, Kawaguchiya M, Aung MS, Kobayashi N. High prevalence of bla OXA-23 in Acinetobacter spp. and detection of bla NDM-1 in A. soli in Cuba: report from National Surveillance Program (2010-2012). New Microbes New Infect 2015; 7:52-6. [PMID: 26236494 PMCID: PMC4511621 DOI: 10.1016/j.nmni.2015.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/13/2015] [Accepted: 06/04/2015] [Indexed: 11/29/2022] Open
Abstract
As a first national surveillance of Acinetobacter in Cuba, a total of 500 Acinetobacter spp. isolates recovered from 30 hospitals between 2010 and 2012 were studied. Acinetobacter baumannii–calcoaceticus complex accounted for 96.4% of all the Acinetobacter isolates, while other species were detected at low frequency (A. junii 1.6%, A. lwoffii 1%, A. haemolyticus 0.8%, A. soli 0.2%). Resistance rates of isolates were 34–61% to third-generation cephalosporins, 49–50% to β-lactams/inhibitor combinations, 42–47% to aminoglycosides, 42–44% to carbapenems and 55% to ciprofloxacin. However, resistance rates to colistin, doxycycline, tetracycline and rifampin were less than 5%. Among carbapenem-resistant isolates, 75% harboured different blaOXA genes (OXA-23, 73%; OXA-24, 18%; OXA-58, 3%). The blaNDM-1 gene was identified in an A. soli strain, of which the species was confirmed by sequence analysis of 16S rRNA gene, rpoB, rpoB–rpoC and rpoL–rpoB intergenic spacer regions and gyrB. The sequences of blaNDM-1 and its surrounding genes were identical to those reported for plasmids of A. baumannii and A. lwoffi strains. This is the first report of blaNDM-1 in A. soli, together with a high prevalence of OXA-23 carbapenemase for carbapenem resistance in Acinetobacter spp. in Cuba.
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Affiliation(s)
- D Quiñones
- Tropical Medicine Institute 'Pedro Kourí', Havana City, Cuba
| | - I Carvajal
- Tropical Medicine Institute 'Pedro Kourí', Havana City, Cuba
| | - Y Perez
- Tropical Medicine Institute 'Pedro Kourí', Havana City, Cuba
| | - M Hart
- 'Hermanos Ameijeiras' Hospital, Havana City, Cuba
| | - J Perez
- Pediátrico 'J. M. Márquez' Hospital, Havana City, Cuba
| | - S Garcia
- 'V. I. Lenin' Hospital, Holguín, Holguín, Cuba
| | - D Salazar
- Tropical Medicine Institute 'Pedro Kourí', Havana City, Cuba
| | - S Ghosh
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan ; Department of Biomedical Science, Ross University School of Medicine, St Kitts, West Indies
| | - M Kawaguchiya
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - M S Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - N Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
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219
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Falagas ME, Vardakas KZ, Roussos NS. Trimethoprim/sulfamethoxazole for Acinetobacter spp.: A review of current microbiological and clinical evidence. Int J Antimicrob Agents 2015; 46:231-41. [PMID: 26070662 DOI: 10.1016/j.ijantimicag.2015.04.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/08/2015] [Indexed: 11/30/2022]
Abstract
Clinicians nowadays are confronted with an epidemic of multidrug-resistant (MDR) Acinetobacter infections and are forced to consider every treatment alternative, including older antibiotic agents, not conventionally used. This review aimed to evaluate the published evidence on the antimicrobial activity and clinical effectiveness of trimethoprim/sulfamethoxazole (TMP-SMX) against Acinetobacter spp. Selected in vitro studies included antimicrobial surveillance reports, microbiological studies regarding the activity of TMP-SMX against MDR Acinetobacter isolates, and clinical studies published after the year 2000. Non-susceptibility rates for Acinetobacter spp. in surveillance studies ranged from 4% to 98.2%; in 23 of 28 studies, non-susceptibility to TMP-SMX was >50% and in a subset of 15 studies non-susceptibility was >70%. In studies regarding MDR Acinetobacter spp., non-susceptibility rates ranged from 5.9% to 100%; however, 19 of 21 studies reported >70% non-susceptibility. Extensively drug-resistant Acinetobacter baumannii complex had total (100%) resistance in five of six studies. Carbapenem-resistant Acinetobacter spp. had non-susceptibility rates to TMP-SMX of >80% in 22 of 26 studies. One study on polymyxin-resistant A. baumannii showed a susceptibility rate of 54.2% (13/24). Only seven case reports evaluated TMP-SMX for Acinetobacter spp. infections, mainly in combination with other agents; all cases were deemed therapeutic successes. Although TMP-SMX is not usually active against Acinetobacter spp., it might be considered in cases where there are no other options.
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Affiliation(s)
- Matthew E Falagas
- Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece; Department of Medicine-Infectious Diseases, IASO General Hospital, Athens, Greece; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.
| | - Konstantinos Z Vardakas
- Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece; Department of Medicine-Infectious Diseases, IASO General Hospital, Athens, Greece
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220
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Gade M, Paul A, Alex C, Choudhury D, Thulasiram HV, Kikkeri R. Supramolecular scaffolds on glass slides as sugar based rewritable sensors for bacteria. Chem Commun (Camb) 2015; 51:6346-9. [DOI: 10.1039/c5cc01019e] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We describe here the sugar functionalized β-cyclodextrin–ferrocene glass slides as fully reversible bacterial biosensors under the influence of external adamantane carboxylic acid.
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Affiliation(s)
- Madhuri Gade
- Indian Institute of Science Education and Research
- Pune 411008
- India
| | - Ajay Paul
- Chemical Biology Unit
- Division of Organic chemistry
- CSIR-National Chemical Laboratory
- Pune-411008
- India
| | - Catherine Alex
- Indian Institute of Science Education and Research
- Pune 411008
- India
| | - Devika Choudhury
- Department of Energy Science and Engineering
- IIT Bombay
- Mumbai-400076
- India
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