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Antimicrobial Resistance, Integron Carriage, and Fluoroquinolone Resistance Genes in Acinetobacte baumannii Isolates. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-120590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Acinetobacte is the leading cause of pneumonia and sepsis in the ICU ward. Accordingly, in the present study, the antibiotic susceptibility pattern, presence, and dissemination of different classes of integrons and fluoroquinolone resistance genes were investigated among A. baumannii isolates. Methods: In this descriptive, cross-sectional study, during a period of 24 months (2018-2020), 100 isolates of A. baumannii were isolated from different clinical specimens of patients admitted to the two teaching hospital in Ardabil province in the northwest of Iran. Kirby -Bauer disk diffusion, PCR, and sequencing methods were used for antimicrobial susceptibility testing and gene and mutation verification. Results: The resistance rates to all tested antibiotics were found to be between 78% and 100%. No isolate was resistant to polymyxin B. Multidrug-resistant (MDR) rate among tested clinical isolates was about 99%. The prevalence of class 1, 2, and 3 integrons was found to be 70%, 21%, and 0%, respectively. The aadA1 cassette gene was detected in all class 1 integron-carrying strains. Conclusions: High-level antibiotic resistance and a high prevalence of integrons were observed among these clinical isolates. Our findings highlighted the need for continuous monitoring of resistant isolates.
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Elham B, Fawzia A. Colistin resistance in Acinetobacter baumannii isolated from critically ill patients: clinical characteristics, antimicrobial susceptibility and outcome. Afr Health Sci 2019; 19:2400-2406. [PMID: 32127810 PMCID: PMC7040249 DOI: 10.4314/ahs.v19i3.13] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Acinetobacter baumannii (AB) is increasingly becoming a clinically relevant organism due to the rising number of associated nosocomial infections. The therapeutic options are extremely minimal because of its ability to develop resistance to all available antimicrobials, including colistin (CST). Data on the clinical and microbiological characteristics of colistin-resistant A. baumannii infections remain scarce to date. Methods In this prospective study, clinical isolates of colistin resistance among Acinetobacter strain was evaluated from the database of Microbiology Laboratory of King Khalid University Hospital, Saudi Arabia. Results In a total of 142 patients with 136 Acinetobacter isolates, Acintobacter baumannii was the predominant serotype 73% of the isolates and Acinetobacter lwoffii constituted 27% of the isolate . There was 8.5% colistin resistant isolates with colistin E-test MIC >4. The clinical characteristics were determined for colistin resistant Acinetobacter baumannii. All patients were critically ill and 64% of them were hositalized in the Intensive Care Unit (ICU). All patients have been previously given antibiotics. Other associated clinical characteristics included; morbid obesity and sleeve gastrectomy (21 %), mechanical ventilation and central venous catheter (50%). High mortality rate was found(28%). Conclusion There is an increase of colistin resistance among clinical isolates of Acinetobacter baumannii causing serious infections especially in critically ill patients.
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Affiliation(s)
- Bukhari Elham
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh 11442, Saudi Arabia
| | - Alotaibi Fawzia
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
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Hamidian M, Hall RM. The AbaR antibiotic resistance islands found in Acinetobacter baumannii global clone 1 - Structure, origin and evolution. Drug Resist Updat 2018; 41:26-39. [PMID: 30472242 DOI: 10.1016/j.drup.2018.10.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/15/2018] [Accepted: 10/30/2018] [Indexed: 11/28/2022]
Abstract
In multiply resistant Acinetobacter baumannii, complex transposons located in the chromosomal comM gene carry antibiotic and heavy metal resistance determinants. For one type, known collectively as AbaR, the ancestral form, AbaR0, entered a member of global clone 1 (GC1) in the mid 1970s and continued to evolve in situ forming many variants. In AbaR0, antibiotic and mercuric ion resistance genes are located between copies of a cadmium-zinc resistance transposon, Tn6018, and this composite transposon is in a class III transposon, Tn6019, carrying arsenate/arsenite resistance genes and five tni transposition genes. The antibiotic resistance genes in the AbaR0 and derived AbaR3 configurations are aphA1b, blaTEM, catA1, sul1, tetA(A), and cassette-associated aacC1 and aadA1 genes. These genes are in a specific arrangement of fragments from well-known transposons, e.g. Tn1, Tn1721, Tn1696 and Tn2670, that arose in an IncM1 plasmid. All known GC1 lineage 1 isolates carry AbaR0 or AbaR3, which arose around 1990, or a variant derived from one of them. Variants arose via deletions caused by one of three internal IS26s, by recombination between duplicate copies of sul1 or Tn6018, or by gene cassette addition or replacement. A few GC2 isolates also carry an AbaR island with different cassette-associated genes, aacA4 and oxa20.
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Affiliation(s)
- Mohammad Hamidian
- School of Molecular and Microbial Biosciences, The University of Sydney, NSW 2006, Australia; The ithree institute, University of Technology Sydney, Ultimo 2007, NSW, Australia
| | - Ruth M Hall
- School of Molecular and Microbial Biosciences, The University of Sydney, NSW 2006, Australia.
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Dissemination of Classes 1, 2, and 3 Integrons in Acinetobacter baumannii Strains Recovered from Intensive Care Units Using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.13100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Huang G, Peng Y, Yang Y, Tang C, Fu Y. Multilocus sequence typing and molecular characterization of β-lactamase genes among Acinetobacter baumannii isolates in a burn center. Burns 2017; 43:1473-1478. [PMID: 28461077 DOI: 10.1016/j.burns.2017.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/17/2017] [Accepted: 03/22/2017] [Indexed: 11/26/2022]
Abstract
Acinetobacter baumannii (A. baumannii) is one of the leading pathogens in hospital infections. To characterize the epidemiology of A. baumannii in a burn ward, we collected all A. baumannii isolates though 18 months. Antibiotic susceptibility and antibiotic resistant genes were tested. Multilocus sequence typing (MLST) was further used to molecularly subtype these isolates. These isolates showed a severe multidrug resistant phenotype with 85% resistance to imipenem and meropenem. Along with the resistant phenotype, antibiotic resistant genes were widely found among these isolates. The prevalences of OXA23, AmpC, PER and VIM were 65.1%, 84%, 37.7% and 53%, respectively. Fifteen reported STs and sixteen novel STs were found in this study. ST368 (35%) was the dominant type, followed by ST195 (15%), ST191 (12%), ST369 (10%) and ST208 (10%). Majority (82.8%) of these isolates belong to clonal group 92, indicating the nosocomial spreading of A. baumannii. Further monitoring and control measures for A. baumannii spreading are necessary.
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Affiliation(s)
- Guangtao Huang
- Institute of Burn Research, Southwest Hospital, The Third Military Medical University, Chongqing, China
| | - Yuan Peng
- The First Clinical College of Chongqing Medical University, Chongqing, China
| | - Yong Yang
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Chengyong Tang
- Department of Clinical Pharmacology, The First Clinical College of Chongqing Medical University, Chongqing, China.
| | - Yuexian Fu
- Department of Burn & Plastic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
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Mayanskiy N, Chebotar I, Alyabieva N, Kryzhanovskaya O, Savinova T, Turenok A, Bocharova Y, Lazareva A, Polikarpova S, Karaseva O. Emergence of the Uncommon Clone ST944/ST78 Carrying bla OXA-40-like and bla CTX-M-like Genes Among Carbapenem-Nonsusceptible Acinetobacter baumannii in Moscow, Russia. Microb Drug Resist 2017; 23:864-870. [PMID: 28437227 DOI: 10.1089/mdr.2016.0302] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Carbapenem-nonsusceptible (Carba-NS) Acinetobacter baumannii has emerged as an important cause of nosocomial infections. In the present study, we characterized 91 Carba-NS A. baumannii isolates collected from patients of surgical departments and intensive care units at three hospitals in Moscow in 2012-2015. Multilocus sequence typing (MLST) using the Oxford (Oxf) scheme identified 16 sequence types (STs) of three clonal complexes (CCs), including CC92Oxf (67%), CC109Oxf (1%), CC944Oxf (29%), and the singleton ST1100Oxf (3%). CC944Oxf was composed of ST944Oxf (n = 16) and two of its newly described single locus variants ST1103Oxf (n = 3) and ST1104Oxf (n = 7); all the three STs were identical to the Pasteur (Pas) MLST scheme ST78. All CC944Oxf/ST78Pas isolates were blaOXA-40-like positive and all but one isolate harbored a blaCTX-M-like gene. ST944Oxf was the only ST found in each of the three study hospitals. Biofilm growth capacity was similar among Carba-NS and nonclonal carbapenem-susceptible isolates. Our data demonstrate the predominance of two clonal lineages among Carba-NS A. baumannii. One of these, the uncommon blaOXA-40-like/blaCTX-M-like-positive clone of CC944Oxf/ST78Pas, seems to be endemic in Russia.
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Affiliation(s)
- Nikolay Mayanskiy
- 1 Scientific Center of Children's Health , Moscow, Russia .,2 I.M. Sechenov First Moscow State Medical University , Moscow, Russia
| | - Igor Chebotar
- 1 Scientific Center of Children's Health , Moscow, Russia
| | | | | | | | - Andrej Turenok
- 2 I.M. Sechenov First Moscow State Medical University , Moscow, Russia
| | | | - Anna Lazareva
- 1 Scientific Center of Children's Health , Moscow, Russia
| | | | - Olga Karaseva
- 4 Scientific Research Institute for Children's Surgery and Traumatology , Moscow, Russia
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Goudarzi H, Azad M, Seyedjavadi SS, Azimi H, Salimi Chirani A, Fallah Omrani V, Goudarzi M. Characterization of integrons and associated gene cassettes in Acinetobacter baumannii strains isolated from intensive care unit in Tehran, Iran. JOURNAL OF ACUTE DISEASE 2016. [DOI: 10.1016/j.joad.2016.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pfeifer Y, Trifonova A, Pietsch M, Brunner M, Todorova I, Gergova I, Wilharm G, Werner G, Savov E. Clonal Transmission of Gram-Negative Bacteria with Carbapenemases NDM-1, VIM-1, and OXA-23/72 in a Bulgarian Hospital. Microb Drug Resist 2016; 23:301-307. [PMID: 27459019 DOI: 10.1089/mdr.2016.0059] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We characterized 72 isolates with reduced susceptibility to carbapenems (50 Acinetobacter spp., 13 Proteus mirabilis, five Escherichia coli, one Morganella morganii, one Enterobacter cloacae, one Providencia rettgeri, and one Pseudomonas aeruginosa) from a hospital in Sofia, Bulgaria. Different β-lactamase genes were identified by polymerase chain reaction and sequencing. Bacterial strain typing was performed by enzymatic macrorestriction and pulsed-field gel electrophoresis (PFGE) typing as well as multilocus sequence typing for selected isolates. The majority of Acinetobacter baumannii (46/50) and one Acinetobacter pittii isolate harbored carbapenemase genes blaOXA-23 or blaOXA-72; two A. baumannii contained both genes. PFGE typing of all A. baumannii showed the presence of nine different clones belonging to eight sequence types ST350, ST208, ST436, ST437, ST449, ST231, ST502, and ST579. Molecular characterization of the remaining isolates confirmed the presence of one NDM-1-producing E. coli-ST101 clone (five isolates) and one P. mirabilis clone (13 isolates) with VIM-1 and CMY-99. Furthermore, NDM-1 was identified in P. rettgeri and M. morganii and VIM-2 in the P. aeruginosa isolate. The permanent introduction of OXA-23/72 carbapenemase-producing A. baumannii clones into the hospital and the repeated occurrence of one VIM-1-producing P. mirabilis and one NDM-1-producing E. coli-ST101 clone over a period of more than 1 year is of concern and requires intensified investigations.
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Affiliation(s)
- Yvonne Pfeifer
- 1 Robert Koch Institute , FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
| | | | - Michael Pietsch
- 1 Robert Koch Institute , FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
| | - Magdalena Brunner
- 1 Robert Koch Institute , FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
| | | | | | - Gottfried Wilharm
- 3 Robert Koch Institute , P2 Acinetobacter baumannii, Wernigerode, Germany
| | - Guido Werner
- 1 Robert Koch Institute , FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
| | - Encho Savov
- 2 Military Medical Academy , Sofia, Bulgaria
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Chmielarczyk A, Pilarczyk-Żurek M, Kamińska W, Pobiega M, Romaniszyn D, Ziółkowski G, Wójkowska-Mach J, Bulanda M. Molecular Epidemiology and Drug Resistance of Acinetobacter baumannii Isolated from Hospitals in Southern Poland: ICU as a Risk Factor for XDR Strains. Microb Drug Resist 2016; 22:328-35. [PMID: 26745326 DOI: 10.1089/mdr.2015.0224] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The objectives of the present study were to investigate the carbapenemase and metallo-beta-lactamase genes of Acinetobacter baumannii clinical isolates by polymerase chain reaction (PCR) and real time PCR and to determine the molecular epidemiology of the strains using the DiversiLab tool. From these data, correlations between drug resistance, resistance genes, and epidemiological clones may be revealed. The study was conducted on 125 A. baumannii collected over the 2013 year. The majority of the isolates from both intensive care unit (ICU) and non-ICU cases originated from pneumonia infections (79.2%), isolates from blood infections accounted for 17.6% and 3.2% were from meningitis infections. In the ICU cases compared with the non-ICU cases, bloodstream infections were more frequently diagnosed (19.2% vs. 11.5%). Sixty percent of A. baumannii strains were resistant to all the antimicrobials tested with the exception of colistin. All strains were susceptible to colistin and polymyxin B. Extensively drug-resistant (XDR) strains accounted for 80.8% of the isolates tested and these XDR strains were more frequently isolated from ICU cases than from non-ICU cases (93.9% vs. 30.8%). Among the 101 isolates of A. baumannii exhibiting the XDR pattern of resistance, 80 possessed the blaOXA-24 gene and 29 had the blaOXA-23 gene. Only two isolates possessed the blaVIM gene. The presence of the ISAba1element was confirmed among 10 strains from patients hospitalized in the ICU. Using repetitive extragenic palindromic sequence PCR (DiversiLab typing), six clones and 12 unique strains were identified, of which two clones dominated. Most isolates belonging to clone 1 (66.7%) and clone 2 (85.5%) were susceptible only to colistin. In summary, it is clear from our findings and those of other studies that carbapenem resistance among A. baumannii strains presents a serious clinical problem worldwide. Furthermore, the presence of XDR international clone II in ICUs poses a potential risk for future outbreaks of A. baumannii infection and controlling A. baumannii infections in hospitals presents a serious challenge.
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Affiliation(s)
| | | | - Wanda Kamińska
- 2 Department of Microbiology and Clinical Immunology, Microbiological Diagnostics Laboratory, The Children's Memorial Health Institute , Warsaw, Poland
| | - Monika Pobiega
- 1 Department of Microbiology, Jagiellonian University Medical College , Krakow, Poland
| | - Dorota Romaniszyn
- 1 Department of Microbiology, Jagiellonian University Medical College , Krakow, Poland
| | | | | | - Małgorzata Bulanda
- 1 Department of Microbiology, Jagiellonian University Medical College , Krakow, Poland
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Oikonomou O, Sarrou S, Papagiannitsis CC, Georgiadou S, Mantzarlis K, Zakynthinos E, Dalekos GN, Petinaki E. Rapid dissemination of colistin and carbapenem resistant Acinetobacter baumannii in Central Greece: mechanisms of resistance, molecular identification and epidemiological data. BMC Infect Dis 2015; 15:559. [PMID: 26653099 PMCID: PMC4675053 DOI: 10.1186/s12879-015-1297-x] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 11/27/2015] [Indexed: 12/17/2022] Open
Abstract
Background Colistin-resistant/carbapenem-resistant Acinetobacter baumannii is a significant challenge for antibiotic treatment and infection control policies. Since 2012, in Central Greece an increase of colistin/pan- resistant A. baumannii has occurred, indicating the need for further analysis. Methods A total of 86 colistin-resistant/carbapenem-resistant out of 1228 A. baumannii clinical isolates, consecutively collected between 2012 and 2014 in a tertiary Greek hospital of Central Greece, as well as one environmental isolate from surveillance cultures were studied. Molecular typing and mechanisms of resistance to colistin and to carbapenems were assessed, whereas, epidemiological and clinical data of the patients were reviewed. Results During the study period, the rate of colistin resistance gradually increased and reached 21.1 % in 2014. All colistin-resistant/carbapenem-resistant A. baumannii belonged to 3LST ST101 clone that corresponds to the international clonal lineage II. Carbapenem resistance was associated with the presence of blaoxa-23-like, while resistance to colistin probably correlated with G54E and R109H amino acid substitutions in PmrA and PmrC, respectively. Conclusions Epidemiological data of the patients indicated that the first detection of colistin-resistant/carbapenem-resistant ST101 clone in the University Hospital of Larissa (UHL) was associated with a patient who previously had received colistin, while, the movement of the infected patients into the hospital probably resulted to its spread.
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Affiliation(s)
- O Oikonomou
- Department of Microbiology, University Hospital of Larissa, Larissa, Greece
| | - S Sarrou
- Department of Microbiology, University Hospital of Larissa, Larissa, Greece
| | - C C Papagiannitsis
- Department of Microbiology, University Hospital of Larissa, Larissa, Greece.,Faculty of Medicine and University Hospital in Plzen, Charles University in Prague, Plzen, Czech Republic
| | - S Georgiadou
- Department of Medicine, Medical School, University of Thessaly, Larissa, Greece
| | - K Mantzarlis
- Department of Critical Care, Medical School, University of Thessaly, Larissa, Greece
| | - E Zakynthinos
- Department of Critical Care, Medical School, University of Thessaly, Larissa, Greece
| | - G N Dalekos
- Department of Medicine, Medical School, University of Thessaly, Larissa, Greece
| | - E Petinaki
- Department of Microbiology, University Hospital of Larissa, Larissa, Greece. .,Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece.
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