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Bae IK, Hong JS. The Distribution of Carbapenem-Resistant Acinetobacter Species and High Prevalence of CC92 OXA-23-Producing Acinetobacter Baumannii in Community Hospitals in South Korea. Infect Drug Resist 2024; 17:1633-1641. [PMID: 38707988 PMCID: PMC11068040 DOI: 10.2147/idr.s459739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024] Open
Abstract
Background Clinical isolates of Acinetobacter species in South Korea are continuously exhibiting high rates of antimicrobial resistance to carbapenems, indicating that there are public health concerns among both healthcare-associated infections and community-associated infections. The aim of this study was to describe the prevalence and characteristics of carbapenem-resistant Acinetobacter isolates originating from community hospitals. Materials and Methods A total of 817 non-duplicated Acinetobacter species were isolated from December 2022 to July 2023 at long-term care facilities and general hospitals in 16 regions geographically distributed throughout South Korea. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK-2 system. The bacteria were identified as Acinetobacter baumannii by blaOXA-51 PCR and as non-baumannii Acinetobacter species by rpoB sequence analysis. The carbapenem resistance genes (OXA-23, OXA-48, OXA-58, IMP, VIM, NDM, GES, and KPC) were identified via PCR and sequencing. The genetic relatedness of carbapenem-resistant A. baumannii (CRAB) isolates was assessed by multilocus sequence typing. Results A total of 659 A. baumannii and 158 non-baumannii Acinetobacter isolates, comprising 19 different species, were identified in all 16 regions. The carbapenem resistance rate was 87.4% (n=576) for the A. baumannii isolates, and all the strains produced blaOXA-23. For non-baumannii Acinetobacter, the rate of carbapenem resistance was 8.9% (n=14); this resistance was primarily caused by blaOXA-23 (n=9), followed by blaNDM-1 (n=3) and blaVIM-2 (n=2). Of the 576 CRAB isolates, clonal complex 92 (CC92) was the predominant genotypes, followed by sequence type 229 (ST229), ST373, ST397, ST447, and ST620. Conclusion Our results showed the distribution of Acinetobacter species and showed that CC92 CRAB clinical isolates with widespread production of blaOXA-23 were predominant in community hospitals. Our findings suggest that there is a need for urgent and effective methods to reduce carbapenem resistance in A. baumannii in South Korea.
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Affiliation(s)
- Il Kwon Bae
- Department of Companion Animal Health and Science, Silla University, Busan, South Korea
| | - Jun Sung Hong
- Department of Companion Animal Health and Science, Silla University, Busan, South Korea
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2
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Odih EE, Sunmonu GT, Okeke IN, Dalsgaard A. NDM-1- and OXA-23-producing Acinetobacter baumannii in wastewater of a Nigerian hospital. Microbiol Spectr 2023; 11:e0238123. [PMID: 37796014 PMCID: PMC10714947 DOI: 10.1128/spectrum.02381-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/22/2023] [Indexed: 10/06/2023] Open
Abstract
IMPORTANCE Acinetobacter baumannii is a leading cause of hospital-associated infections globally. A. baumannii reservoirs outside hospital settings are still unknown, and their occurrence in the environment is linked to clinical and anthropogenic activities. Although the risk of transmission of A. baumannii from environmental sources to humans is not fully understood, these sources pose significant risks for the continued dissemination of A. baumannii and their resistance traits. This study provides evidence that diverse and clinically relevant A. baumannii strains, many of which are resistant to carbapenems, are constantly being discharged into the environment through inadequately treated hospital wastewater. We further elucidate potential transmission routes between the environment and clinical infections and demonstrate the high prevalence of carbapenem resistance genes on highly mobile transposons among these strains. Our findings highlight the pressing need to address hospital wastewater as a crucial factor in curtailing the spread of carbapenem-resistant A. baumannii.
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Affiliation(s)
- Erkison Ewomazino Odih
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Global Health Research Unit for the Genomic Surveillance of Antimicrobial Resistance, Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Gabriel Temitope Sunmonu
- Global Health Research Unit for the Genomic Surveillance of Antimicrobial Resistance, Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Iruka N. Okeke
- Global Health Research Unit for the Genomic Surveillance of Antimicrobial Resistance, Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Anders Dalsgaard
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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3
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Borges Duarte DF, Gonçalves Rodrigues A. Acinetobacter baumannii: insights towards a comprehensive approach for the prevention of outbreaks in health-care facilities. APMIS 2022; 130:330-337. [PMID: 35403751 DOI: 10.1111/apm.13227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/07/2022] [Indexed: 12/14/2022]
Abstract
Acinetobacter baumannii is known to be an opportunistic pathogen frequently responsible for outbreaks in health-care facilities, particularly in Intensive Care Units (ICU). It can easily survive in the hospital setting for long periods and can be transmitted throughout the hospital in a variety of ways, explored in this review. It can also easily acquire antibiotic resistance determinants rendering several antibiotic drugs useless. In 2019, the US Centre for Disease Control (CDC) considered the organism as an urgent threat. The aim of this review was to raise the awareness of the medical community about the relevance of this pathogen and discuss how it may impact seriously the healthcare institutions particularly in the aftermath of the recent COVID-19 pandemic. PubMed was searched, and articles that met inclusion criteria were reviewed. We conclude by the need to raise awareness to this pathogen's relevance and to encourage the implementation of preventive measures in order to mitigate its consequences namely the triage of specific high-risk patients.
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Affiliation(s)
- Diogo Filipe Borges Duarte
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Acácio Gonçalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal.,RISE - Health Research Network, Porto, Portugal.,Burn Unit, Department of Plastic and Reconstructive Surgery, S. Joao University Center Hospital, Porto, Portugal
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Lynch JP, Clark NM, Zhanel GG. Infections Due to Acinetobacter baumannii-calcoaceticus Complex: Escalation of Antimicrobial Resistance and Evolving Treatment Options. Semin Respir Crit Care Med 2022; 43:97-124. [PMID: 35172361 DOI: 10.1055/s-0041-1741019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Bacteria within the genus Acinetobacter (principally A. baumannii-calcoaceticus complex [ABC]) are gram-negative coccobacilli that most often cause infections in nosocomial settings. Community-acquired infections are rare, but may occur in patients with comorbidities, advanced age, diabetes mellitus, chronic lung or renal disease, malignancy, or impaired immunity. Most common sites of infections include blood stream, skin/soft-tissue/surgical wounds, ventilator-associated pneumonia, orthopaedic or neurosurgical procedures, and urinary tract. Acinetobacter species are intrinsically resistant to multiple antimicrobials, and have a remarkable ability to acquire new resistance determinants via plasmids, transposons, integrons, and resistance islands. Since the 1990s, antimicrobial resistance (AMR) has escalated dramatically among ABC. Global spread of multidrug-resistant (MDR)-ABC strains reflects dissemination of a few clones between hospitals, geographic regions, and continents; excessive antibiotic use amplifies this spread. Many isolates are resistant to all antimicrobials except colistimethate sodium and tetracyclines (minocycline or tigecycline); some infections are untreatable with existing antimicrobial agents. AMR poses a serious threat to effectively treat or prevent ABC infections. Strategies to curtail environmental colonization with MDR-ABC require aggressive infection-control efforts and cohorting of infected patients. Thoughtful antibiotic strategies are essential to limit the spread of MDR-ABC. Optimal therapy will likely require combination antimicrobial therapy with existing antibiotics as well as development of novel antibiotic classes.
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Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology; Department of Medicine; The David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Nina M Clark
- Division of Infectious Diseases, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - George G Zhanel
- Department of Medical Microbiology/Infectious Diseases, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada
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Liu B, Liu L. Molecular Epidemiology and Mechanisms of Carbapenem-Resistant Acinetobacter baumannii Isolates from ICU and Respiratory Department Patients of a Chinese University Hospital. Infect Drug Resist 2021; 14:743-755. [PMID: 33658811 PMCID: PMC7920613 DOI: 10.2147/idr.s299540] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background The objective of our study is to estimate the differences in molecular epidemiology and resistance mechanisms in carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from the ICU and respiratory department(RD) in Fourth Affiliated Hospital of Harbin Medical University. Methods Carbapenemase genes associated with carbapenem resistance were studied by polymerase chain reaction(PCR). Genotyping was analyzed using multi-locus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE). Results Sixty non-duplicate CRAB isolates from the ICU and RD (n=30, respectively) were collected. All of CRAB strains were not resistant to colistin (0%). The CRAB strains from the ICU were significantly more resistant to tigecycline and cefoperazone/sulbactam compared with the RD (23.3% vs 0%, P=0.03; 53.3% % vs 23.3%, P=0.01, respectively). PCR detection of genes associated with CRAB revealed that the ratio in both the ICU and the RD of blaVIM-2, blaIMP-4, blaNDM-1, blaOXA-23, ampC, and mutation of CarO were present in 23.3% vs 0% (P=0.01), 40% vs 10% (P=0.02), 20% vs 0% (P=0.02), 80% vs 56.7%, 16.7% vs 13.3% and 86.7% vs 60% (P=0.04), respectively. Seven genotypes were detected by the PFGE in the RD and the ICU, respectively. Genotype I was significantly more frequent in the ICU compared with the RD (63.3% vs 36.6%, P=0.03). MLST showed that there were 10 ST genotypes in the RD and four in the ICU, but ST92 in both groups was 33.3% vs 63.3% (P=0.03), respectively. Conclusion There are differences in molecular epidemiology and resistance mechanisms in the CRAB isolates between the ICU and RD.
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Affiliation(s)
- Bin Liu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Lei Liu
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
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Hamidian M, Nigro SJ. Emergence, molecular mechanisms and global spread of carbapenem-resistant Acinetobacter baumannii. Microb Genom 2020; 5. [PMID: 31599224 PMCID: PMC6861865 DOI: 10.1099/mgen.0.000306] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Acinetobacter baumannii is a nosocomial pathogen that has emerged as a global threat because of high levels of resistance to many antibiotics, particularly those considered to be last-resort antibiotics, such as carbapenems. Although alterations in the efflux pump and outer membrane proteins can cause carbapenem resistance, the main mechanism is the acquisition of carbapenem-hydrolyzing oxacillinase-encoding genes. Of these, oxa23 is by far the most widespread in most countries, while oxa24 and oxa58 appear to be dominant in specific regions. Historically, much of the global spread of carbapenem resistance has been due to the dissemination of two major clones, known as global clones 1 and 2, although new lineages are now common in some parts of the world. The analysis of all publicly available genome sequences performed here indicates that ST2, ST1, ST79 and ST25 account for over 71 % of all genomes sequenced to date, with ST2 by far the most dominant type and oxa23 the most widespread carbapenem resistance determinant globally, regardless of clonal type. Whilst this highlights the global spread of ST1 and ST2, and the dominance of oxa23 in both clones, it could also be a result of preferential selection of carbapenem-resistant strains, which mainly belong to the two major clones. Furthermore, ~70 % of the sequenced strains have been isolated from five countries, namely the USA, PR China, Australia, Thailand and Pakistan, with only a limited number from other countries. These genomes are a vital resource, but it is currently difficult to draw an accurate global picture of this important superbug, highlighting the need for more comprehensive genome sequence data and genomic analysis.
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Affiliation(s)
- Mohammad Hamidian
- The ithree institute, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Steven J Nigro
- Communicable Diseases Branch, Health Protection NSW, St Leonards, NSW 2065, Australia
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Co-existence of blaOXA-23 and blaVIM in carbapenem-resistant Acinetobacter baumannii isolates belonging to global complex 2 in a Chinese teaching hospital. Chin Med J (Engl) 2019; 132:1166-1172. [PMID: 30882466 PMCID: PMC6511418 DOI: 10.1097/cm9.0000000000000193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Carbapenem-resistant Acinetobacter baumannii (CRAB) have been a challenging concern of health-care associated infections. The aim of the current study was to investigate the molecular epidemiology and clonal dissemination of CRAB isolates in a Chinese teaching hospital. Methods Non-duplicate clinical A. baumannii isolates were collected from inpatients, and we measured the minimal inhibitory concentrations to determine antimicrobial susceptibility. Polymerase chain reaction (PCR) and sequencing were performed to detect carbapenem-resistance genes and occurrence of transposons among CRAB isolates. Moreover, the genetic diversity among isolates and clonal dissemination were determined by repetitive element PCR-mediated DNA fingerprinting (rep-PCR) and multilocus sequence typing (MLST). Results A total of 67 CRAB isolates displayed resistance to most of the antibiotics tested in this study, except tigecycline. We detected blaOXA-23, blaOXA-51, blaOXA-58, and blaVIM genes in 94.0%, 100.0%, 1.5%, and 80.6% of the CRAB isolates, respectively. Nevertheless, 74.6% of the CRAB isolates co-harbored the blaOXA-23 and blaVIM. Only one type of transposons was detected: Tn2008 (79.1%, 53/67). Although 12 distinctive types (A-L) were determined (primarily A type) ST195 was the most prevalent sequence type (ST). ST368, ST210, ST90, ST829, and ST136 were also detected, and all belonged to clonal complex 208 (CC208) and global complex 2 (GC2). Conclusion The blaOXA-23 and blaVIM genes contributed to the resistance among CRAB isolates collected in our study. Notably, most of the CRAB strains co-harbored blaOXA-23 and blaVIM genes, as well as Tn2008, which could contribute to clonal dissemination. The prevalence of such organisms may underlie hospital acquired infections.
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Askari N, Momtaz H, Tajbakhsh E. Acinetobacter baumannii in sheep, goat, and camel raw meat: virulence and antibiotic resistance pattern. AIMS Microbiol 2019; 5:272-284. [PMID: 31663061 PMCID: PMC6787353 DOI: 10.3934/microbiol.2019.3.272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/27/2019] [Indexed: 12/22/2022] Open
Abstract
Acinetobacter genus belongs to a group of Gram-negative coccobacillus. These bacteria are isolated from human and animal origins. Antimicrobial agents play a vital role in treating infectious diseases in both humans and animals, and Acinetobacter in this regard is defined as an organism of low virulence. The current study aimed to evaluate antibiotic resistance properties and virulence factor genes in Acinetobacterbaumannii strains isolated from raw animal meat samples. Fresh meat samples from 124 sheep, 162 goat, and 95 camels were randomly collected from Isfahan and Shahrekord cities in Iran. Most A. baumannii strains isolated from sheep meat samples represented fimH (82.35%), aac(3)-IV (78.43%), sul1 (78.43%) and Integron Class I (96.07%) genes. Moreover, more than 50% of A. baumannii strains isolated from sheep samples were resistant to streptomycin (54.90%), gentamycin (74.50%), co-trimoxazole (70.58%), tetracycline (82.35%), and trimethoprim (62.74%). Current findings revealed significant association between the presence of fimH, cnfI, afa/draBC, dfrA1, sulI, aac(3)-IV genes in sheep samples. Furthermore, significant association was observed between fimH, cnfI, sfa/focDE and dfrA1genes in goat meat samples. In sheep meat samples, significant differences were identified in resistance to gentamicin, tetracycline, and co-trimoxazole in comparison with other antibiotics. Finally, there were statistically significant differences between the incidences of resistance to gentamicin, tetracycline, and co-trimoxazole in comparison with other antibiotics in all strains. In conclusion, the presence of virulence factors and antibiotic resistance in A. baumannii strains isolated from animal meat samples showed that animals should be considered as a potential reservoir of multidrug-resistant A. baumannii.
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Affiliation(s)
- Neda Askari
- Ph.D Student of Microbiology, Department of Microbiology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Hassan Momtaz
- Department of Microbiology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Elahe Tajbakhsh
- Department of Microbiology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
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Yuhan Y, Ziyun Y, Yongbo Z, Fuqiang L, Qinghua Z. Over expression of AdeABC and AcrAB-TolC efflux systems confers tigecycline resistance in clinical isolates of Acinetobacter baumannii and Klebsiella pneumoniae. Rev Soc Bras Med Trop 2016; 49:165-71. [PMID: 27192584 DOI: 10.1590/0037-8682-0411-2015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/19/2016] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Due to the wide use of tigecycline in the treatment of severe infections caused by multidrug-resistant (MDR) bacteria, clinical resistance to tigecycline has increased in recent years. Here, we investigated the relationship between tigecycline resistance and the expression of efflux pumps. METHODS Clinical isolates of Acinetobacter baumannii and Klebsiella pneumoniae were consecutively collected from hospitalized patients in three hospitals. The minimum inhibitory concentration (MIC) of tigecycline was determined using the broth microdilution method. Expression levels of efflux pump genes and regulators were examined by quantitative real-time reverse transcription polymerase chain reaction. The correlations between tigecycline MICs and gene expression levels were analyzed. RESULTS Overall, 1,026 A. baumannii and 725 K. pneumoniae strains were collected. Most strains were isolated from sputum. The tigecycline resistance rate was 13.4% in A. baumannii isolates and 6.5% in K. pneumoniae isolates. Overexpression of AdeABC and AcrAB-TolC efflux systems was observed found in clinical tigecycline-resistant isolates. The tigecycline MIC had a linear relationship with the adeB expression level in A. baumannii isolates, but not with the acrB expression level in K. pneumoniae isolates. There were significant linear trends in the overexpression of ramA as the tigecycline MIC increased in K. pneumoniae isolates. CONCLUSIONS Tigecycline resistance in A. baumannii and K. pneumoniae was strongly associated with the overexpression of efflux systems. More studies are needed to elucidate whether there are other regulators that affect the expression of adeB in A. baumannii and how ramA affects the expression of acrB in K. pneumoniae.
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Affiliation(s)
- Yin Yuhan
- Department of Respiratory Medicine, An Qiu People's Hospital, An Qiu, China
| | - Yue Ziyun
- Department of Respiratory Medicine, An Qiu People's Hospital, An Qiu, China
| | - Zhang Yongbo
- Department of Respiratory Medicine, An Qiu People's Hospital, An Qiu, China
| | - Li Fuqiang
- Department of Clinical Laboratory, Liao Cheng Dong Chang Fu People's Hospital, Liao Cheng, China
| | - Zhang Qinghua
- Department of Clinical Laboratory, Yi Shui People's Hospital, Yi Shui, China
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Kamolvit W, Sidjabat HE, Paterson DL. Molecular Epidemiology and Mechanisms of Carbapenem Resistance ofAcinetobacterspp. in Asia and Oceania. Microb Drug Resist 2015; 21:424-34. [DOI: 10.1089/mdr.2014.0234] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Witchuda Kamolvit
- UQ Centre of Clinical Research, The University of Queensland, Brisbane, Australia
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Hanna E. Sidjabat
- UQ Centre of Clinical Research, The University of Queensland, Brisbane, Australia
| | - David L. Paterson
- UQ Centre of Clinical Research, The University of Queensland, Brisbane, Australia
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Zhou Y, Wu X, Zhang X, Hu Y, Yang X, Yang Z, Wang M. Genetic Characterization of ST195 and ST365 Carbapenem-Resistant Acinetobacter baumannii Harboring blaOXA-23 in Guangzhou, China. Microb Drug Resist 2015; 21:386-90. [PMID: 25602500 DOI: 10.1089/mdr.2014.0183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We investigated the distribution of resistance genes and the clonal relationships among carbapenem-resistant Acinetobacter baumannii isolates from the intensive care unit wards of two hospitals in Guangzhou, China. From 2012 to 2013, 57 A. baumannii isolates were obtained from blood cultures from two hospitals in Guangzhou. The antibiotic resistance profiles were determined by using the Vitek2 system and Etest strips. PCR was used to detect the genes encoding OXA-type carbapenemases and metallo-β-lactamases and the presence of ISAba1 upstream of the bla(OXA-51-like) gene and the bla(OXA-23-like) gene. Multilocus sequence typing (MLST) and sequence-based typing of bla(OXA-51-like) genes (SBT-bla(OXA-51-like )genes) were performed to analyze the genetic relationship of the isolates. Among the 57 isolates, 46 were carbapenem-resistant A. baumannii (CRAB) isolates. The bla(OXA-51-like) gene was identified in all 57 isolates, while the bla(OXA-23-like) gene was present in all 46 CRAB isolates. The MLST analysis grouped the A. baumannii isolates into five existing sequence types (STs) and five new STs. Fifty-two isolates belonged to the worldwide spread of clonal complex 92 (CC92), among which ST195 and ST365 were the most common STs. The MLST data and SBT-bla(OXA-51-like) genes showed that all isolates harboring the major bla(OXA-51-like) alleles, such as bla(OXA-66), belonged to CC92.
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Affiliation(s)
- Yong Zhou
- 1 Guangzhou Center for Disease Control and Prevention , Guangzhou, China
| | - Xinwei Wu
- 1 Guangzhou Center for Disease Control and Prevention , Guangzhou, China
| | - Xinqiang Zhang
- 1 Guangzhou Center for Disease Control and Prevention , Guangzhou, China
| | - Yushan Hu
- 1 Guangzhou Center for Disease Control and Prevention , Guangzhou, China
| | - Xia Yang
- 2 Department of Biochemistry, Zhongshan Medical School, Sun Yat-sen University , Guangzhou, China
| | - Zhicong Yang
- 1 Guangzhou Center for Disease Control and Prevention , Guangzhou, China
| | - Ming Wang
- 1 Guangzhou Center for Disease Control and Prevention , Guangzhou, China
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Dai XT, Sun FJ, Chen ZH, Luo GM, Feng W, Xiong W, Xia PY. The Epidemiology and Resistance Mechanisms of Acinetobacter baumannii Isolates from the Respiratory Department ICU of a Hospital in China. Microb Drug Resist 2014; 20:618-22. [PMID: 24991998 DOI: 10.1089/mdr.2014.0005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Xiao-Tian Dai
- Department of Pulmonology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Feng-Jun Sun
- Department of Pharmacy, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Zhen-Hong Chen
- Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing, China
| | - Guang-Ming Luo
- Department of Pulmonology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Wei Feng
- Department of Pharmacy, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Wei Xiong
- Department of Pulmonology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Pei-Yuan Xia
- Department of Pharmacy, Southwest Hospital, Third Military Medical University, Chongqing, China
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Molecular epidemiology and mechanisms of tigecycline resistance in clinical isolates of Acinetobacter baumannii from a Chinese university hospital. Antimicrob Agents Chemother 2013; 58:297-303. [PMID: 24165187 DOI: 10.1128/aac.01727-13] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Because of its remarkable ability to acquire antibiotic resistance and to survive in nosocomial environments, Acinetobacter baumannii has become a significant nosocomial infectious agent worldwide. Tigecycline is one of the few therapeutic options for treating infections caused by A. baumannii isolates. However, tigecycline resistance has increasingly been reported. Our aim was to assess the prevalence and characteristics of efflux-based tigecycline resistance in clinical isolates of A. baumannii collected from a hospital in China. A total of 74 A. baumannii isolates, including 64 tigecycline-nonsusceptible A. baumannii (TNAB) and 10 tigecycline-susceptible A. baumannii (TSAB) isolates, were analyzed. The majority of them were determined to be positive for adeABC, adeRS, adeIJK, and abeM, while the adeE gene was found in only one TSAB isolate. Compared with the levels in TSAB isolates, the mean expression levels of adeB, adeJ, adeG, and abeM in TNAB isolates were observed to increase 29-, 3-, 0.7-, and 1-fold, respectively. The efflux pump inhibitors (EPIs) phenyl-arginine-β-naphthylamide (PAβN) and carbonyl cyanide 3-chlorophenylhydrazone (CCCP) could partially reverse the resistance pattern of tigecycline. Moreover, the tetX1 gene was detected in 12 (18.8%) TNAB isolates. To our knowledge, this is the first report of the tetX1 gene being detected in A. baumannii isolates. ST208 and ST191, which both clustered into clonal complex 92 (CC92), were the predominant sequence types (STs). This study showed that the active efflux pump AdeABC appeared to play important roles in the tigecycline resistance of A. baumannii. The dissemination of TNAB isolates in our hospital is attributable mainly to the spread of CC92.
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