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Chávez Rodríguez M, Mascareñas De Los Santos AH, Vaquera Aparicio DN, Aguayo Samaniego R, García Pérez R, Siller-Rodríguez D, Rosales-González SP, Castillo-Morales PL, Castillo Bejarano JI. Molecular epidemiology of carbapenemase encoding genes in A. baumannii-calcoaceticus complex infections in children: a systematic review. JAC Antimicrob Resist 2024; 6:dlae098. [PMID: 39005591 PMCID: PMC11242458 DOI: 10.1093/jacamr/dlae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/29/2024] [Indexed: 07/16/2024] Open
Abstract
Background Acinetobacter baumannii-calcoaeticus complex is the leader pathogen for the World Health Organization's list due to the escalating prevalence of multidrug-resistant strains. Insights into the molecular characterization of carbapenemase genes in A. baumannii-calcoaceticus complex infections among children are scarce. To address this gap, we conducted a systematic review to describe the molecular epidemiology of the carbapenemase genes in A. baumannii-calcoaceticus complex infections in the pediatric population. Methods Adhering to the PRISMA 2020 guidelines for reporting systematic reviews, we conducted a review of in chore bibliographic databases published in English and Spanish, between January 2020 and December 2022. All studies conducted in patients ≤6 years with molecular characterization of carbapenemase-encoding genes in A. baumannii-calcoaceticus infections were included. Results In total, 1129 cases were reviewed, with an overall carbapenem-resistance rate of 60.3%. A. baumannii-calcoaceticus was isolated from blood cultures in 66.6% of cases. Regionally, the Eastern Mediterranean exhibited the highest prevalence of carbapenem resistance (88.3%). Regarding the carbapenemase genes, blaKPC displayed an overall prevalence of 1.2%, while class B blaNDM had a prevalence of 10.9%. Class D blaOXA-23-like reported a prevalence of 64%, blaOXA-48 and blaOXA-40 had a prevalence of 33% and 18.1%, respectively. Notably, the Americas region showed a prevalence of blaOXA-23-like at 91.6%. Conclusion Our work highlights the high prevalence of carbapenem-resistant A. baumannii-calcoaceticus and class D carbapenemase genes in children. Of note the distribution of different carbapenemase genes reveals considerable variations across WHO regions. To enhance epidemiological understanding, further extensive studies in children are imperative.
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Affiliation(s)
- Mariana Chávez Rodríguez
- Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
| | - Abiel Homero Mascareñas De Los Santos
- Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
| | - Denisse Natalie Vaquera Aparicio
- Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
| | - Rebeca Aguayo Samaniego
- Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
| | - Rodrigo García Pérez
- Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
| | - Daniel Siller-Rodríguez
- Hospital Epidemiology and Surveillance Unit, Christus Muguerza Hospital Alta Especialidad, Hidalgo Avenue, Obispado, ZC 64060 Monterrey, México
| | - Sara Paulina Rosales-González
- Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
| | - Patricia Lizeth Castillo-Morales
- Department of Endocrinology, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
| | - José Iván Castillo Bejarano
- Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Monterrey, México
- Hospital Epidemiology and Surveillance Unit, Christus Muguerza Hospital Alta Especialidad, Hidalgo Avenue, Obispado, ZC 64060 Monterrey, México
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Wang L, Chen QW, Qin YC, Yi XL, Zeng H. Analysis of carbapenem-resistant Acinetobacter baumannii carbapenemase gene distribution and biofilm formation. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2024; 15:1-11. [PMID: 38505565 PMCID: PMC10944714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/21/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE In recent years, Acinetobacter baumannii has been appearing in hospitals with high drug resistance and strong vitality, which brings many difficulties to clinical treatment. In this study, 255 strains of A. baumannii were isolated from Youjiang Medical University for Nationalities Affiliated Hospital clinical samples and found to be highly resistant to carbapenems. The drug resistance, biofilm-forming ability, and carbapenase gene distribution of 145 carbapenem-resistant A. baumannii (CRAB) strains were analyzed statistically. METHODS The clinically isolated strains were detected using Vitek mass spectrometry and Vitek2-compact for bacterial identification and susceptibility testing, respectively. The biofilms of clinical isolates were quantitatively detected by microplate crystal violet staining, and qualitatively observed by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). And the common carbapenemase genes were detected by polymerase chain reaction (PCR). RESULTS The 255 clinical isolates from the Youjiang District of western Guangxi Province had a high resistance rate to carbapenems antibiotics. The main specimens were from the intensive care unit (49%), and the most important specimens were sputum specimens (80%). All 145 strains of CRAB produced different degrees of biofilm, and six carbapenenase genes were detected. We found that there were significant differences in biofilm formation between resistant and sensitive strains of tobramycin, levofloxacin, ciprofloxacin, tigecycline, and doxycycline (P<0.05). The distribution of blaOXA-23 and blaOXA51 genes was significantly different from CRAB biofilm formation (P<0.05). In addition, AmpC, blaOXA-23, blaOXA-51, and TEM genes were more distributed in antibiotic-resistant strains. CONCLUSION The clinical strains have a high resistance rate to carbapenems, and the CRAB with blaOXA-51 and blaOXA-23 genes has a high resistance to antibiotics and a strong biofilm.
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Affiliation(s)
- Lin Wang
- School of Basic Medical Sciences, Youjiang Medical University for NationalitiesNo. 98 Chengxiang Road, Baise 533000, Guangxi, PR China
- Guangxi Technology Innovation Cooperation Base of Prevention and Control Pathogenic Microbes with Drug Resistance, Youjiang Medical University for NationalitiesBaise 533000, Guangxi, PR China
- Guangxi Zhuang Autonomous Region Engineering Research Center of Clinical Prevention and Control Technology and Leading Drug for Microorganisms with Drug Resistance in Border Ethnic AreasnBaise 533000, Guangxi, PR China
- Key Laboratory of The Prevention and Treatment of Drug-Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Education Department of Guangxi Zhuang Autonomous RegionBaise 533000, Guangxi, PR China
| | - Qi-Wei Chen
- The Affiliated Hospital of Youjiang Medical University for NationalitiesNo. 18 Zhongshan Second Road, Baise 533000, Guangxi, PR China
| | - Yan-Chun Qin
- School of Basic Medical Sciences, Youjiang Medical University for NationalitiesNo. 98 Chengxiang Road, Baise 533000, Guangxi, PR China
- Guangxi Technology Innovation Cooperation Base of Prevention and Control Pathogenic Microbes with Drug Resistance, Youjiang Medical University for NationalitiesBaise 533000, Guangxi, PR China
- Guangxi Zhuang Autonomous Region Engineering Research Center of Clinical Prevention and Control Technology and Leading Drug for Microorganisms with Drug Resistance in Border Ethnic AreasnBaise 533000, Guangxi, PR China
- Key Laboratory of The Prevention and Treatment of Drug-Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Education Department of Guangxi Zhuang Autonomous RegionBaise 533000, Guangxi, PR China
| | - Xue-Li Yi
- The Affiliated Hospital of Youjiang Medical University for NationalitiesNo. 18 Zhongshan Second Road, Baise 533000, Guangxi, PR China
| | - Hong Zeng
- School of Basic Medical Sciences, Youjiang Medical University for NationalitiesNo. 98 Chengxiang Road, Baise 533000, Guangxi, PR China
- Guangxi Technology Innovation Cooperation Base of Prevention and Control Pathogenic Microbes with Drug Resistance, Youjiang Medical University for NationalitiesBaise 533000, Guangxi, PR China
- Guangxi Zhuang Autonomous Region Engineering Research Center of Clinical Prevention and Control Technology and Leading Drug for Microorganisms with Drug Resistance in Border Ethnic AreasnBaise 533000, Guangxi, PR China
- Key Laboratory of The Prevention and Treatment of Drug-Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Education Department of Guangxi Zhuang Autonomous RegionBaise 533000, Guangxi, PR China
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Yousefi Nojookambari N, Eslami G, Sadredinamin M, Vaezjalali M, Nikmanesh B, Dehbanipour R, Yazdansetad S, Ghalavand Z. Sub-minimum inhibitory concentrations (sub-MICs) of colistin on Acinetobacter baumannii biofilm formation potency, adherence, and invasion to epithelial host cells: an experimental study in an Iranian children's referral hospital. Microbiol Spectr 2024; 12:e0252323. [PMID: 38230925 PMCID: PMC10846280 DOI: 10.1128/spectrum.02523-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/07/2023] [Indexed: 01/18/2024] Open
Abstract
Here, we described the efficacy of colistin sub-minimum inhibitory concentrations (sub-MICs) on biofilm-forming activity, host epithelial cell adherence, and invasion capacity of Acinetobacter baumannii strains collected from children admitted to the Children's Medical Center Hospital. Biofilm formation potency of A. baumannii clinical isolates was measured using a 96-well microtiter plate assay. Distribution of biofilm-related genes, including bap, abaI, ompA, csuE, and blaPER-1, was detected by PCR. The mRNA expression level of ompA and csuE was measured by qPCR in the presence of ¼ and ½ MICs of colistin. A. baumannii adhesion and invasion to eukaryotic host cells were phenotypically assayed at sub-MICs of colistin. Eighty percent (56/70) and 35.7% (25/70) of A. baumannii isolates were multidrug-resistant (MDR) and extensively drug-resistant (XDR) phenotypes, respectively. The strong, moderate, and weak biofilm producers of A. baumannii were 37.1% (26/70), 32.8%, (23/70), and 22.8% (16/70), respectively. The frequencies of biofilm-associated genes were 100% for abaI, ompA, and csuE, followed by 22.8% (16/70) and 24.3% (17/70) for bap and blaPER-1, respectively. The downregulation of csuE and ompA expression levels was observed in the sub-MIC of colistin. In vitro cell culture study showed a decreased capability of A. baumannii to adhere to the human epithelial cells at sub-inhibitory doses of colistin; however, none of the isolates could invade HEp-2 cells. Our study showed that the genes encoding biofilm-associated proteins undergo downregulation in expression levels after exposure to sub-MICs of colistin in A. baumannii. Longitudinal in vivo studies are needed to fully understand the clinical aspects of pathogenicity mechanisms and evolutionary dynamics of drug resistance.IMPORTANCESince the toxicity of colistin is dose dependent, there is a focus on strategies that reduce the dose while maintaining the therapeutic effect of the drug. Our findings about sub-inhibitory doses of colistin provide a novel insight into the logical use of colistin to treat and control Acinetobacter baumannii-related infections in clinical practice.
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Affiliation(s)
- Neda Yousefi Nojookambari
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrzad Sadredinamin
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Vaezjalali
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Dehbanipour
- Department of Microbiology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Sajjad Yazdansetad
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zohreh Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Boral J, Pınarlık F, Ekinci G, Can F, Ergönül Ö. Does Emerging Carbapenem Resistance in Acinetobacter baumannii Increase the Case Fatality Rate? Systematic Review and Meta-Analysis. Infect Dis Rep 2023; 15:564-575. [PMID: 37888136 PMCID: PMC10606343 DOI: 10.3390/idr15050055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND In the era of rising carbapenem resistance, we aimed to investigate the change in mortality rate and positivity of carbapenemase genes in Acinetobacter baumannii. METHODS Preferred Reporting Items for Systematic Review (PRISMA) guidelines were adopted in this systematic review. Our literature search included the Cochrane Library, Pubmed, Scopus, Web of Science, Medline, Tubitak TR Dizin, and Harman databases for studies dating back from 2003 to 2023 reporting bloodstream A. baumannii infections in Türkiye. A simple linear regression model was used to determine the association between resistance, mortality, and time. RESULTS A total of 1717 studies were identified through a literature search, and 21 articles were selected based on the availability of the data regarding mortality and resistance rate (four articles) or the molecular epidemiology of carbapenem-resistant A. baumannii (17 articles) in Türkiye. From 2007 to 2018, the carbapenem resistance rate increased (p = 0.025). The OXA-23 and OXA-58 positivities were inversely correlated (p = 0.025). CONCLUSIONS Despite the emergence of carbapenem resistance, mortality did not increase in parallel, which may be due to improved medical advancements or the fitness cost of bacteria upon prolonged antimicrobial exposure. Therefore, we suggest further global research with the foresight to assess clonal relatedness that might affect the carbapenem resistance rate.
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Affiliation(s)
- Jale Boral
- Graduate School of Health Sciences, Koç University, Istanbul 34010, Türkiye; (J.B.)
- Koç University İşBank Center for Infectious Diseases, Koç University Hospital (KUISCID), Istanbul 34010, Türkiye;
| | - Fatihan Pınarlık
- Graduate School of Health Sciences, Koç University, Istanbul 34010, Türkiye; (J.B.)
- Koç University İşBank Center for Infectious Diseases, Koç University Hospital (KUISCID), Istanbul 34010, Türkiye;
| | - Güz Ekinci
- Graduate School of Health Sciences, Koç University, Istanbul 34010, Türkiye; (J.B.)
- Koç University İşBank Center for Infectious Diseases, Koç University Hospital (KUISCID), Istanbul 34010, Türkiye;
| | - Füsun Can
- Koç University İşBank Center for Infectious Diseases, Koç University Hospital (KUISCID), Istanbul 34010, Türkiye;
- Department of Medical Microbiology, School of Medicine, Koç University, Istanbul 34010, Türkiye
| | - Önder Ergönül
- Koç University İşBank Center for Infectious Diseases, Koç University Hospital (KUISCID), Istanbul 34010, Türkiye;
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul 34010, Türkiye
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Rahimzadeh G, Rezai MS, Farshidi F. Genotypic Patterns of Multidrug-Resistant Acinetobacter baumannii: A Systematic Review. Adv Biomed Res 2023; 12:56. [PMID: 37200758 PMCID: PMC10186031 DOI: 10.4103/abr.abr_434_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 05/20/2023] Open
Abstract
Acinetobacter baumannii (A. baumannii) is one of the most common bacteria in nosocomial infections. Inappropriate usage of antibiotics has led to expanding emergence resistance to A. baumannii as a multidrug-resistant (MDR) strain. Empirical antibiotic therapy is necessary to evaluate the resistant gene pattern of MDR A. baumannii. For this purpose, the present study evaluated the resistance genes pattern of MDR A. baumannii collected from hospitalized patients using a genotypic diagnostic technique. To find evidence related to the study objectives, databases were searched such as Google Scholar, Web of Science, Science Direct, PubMed, and Scopus from 2000 to 2022, with specified keywords in the title and text of the articles. Articles were included based on inclusion and exclusion criteria. The mentioned database displayed 284 articles. After screening, 65 eligible articles were included. The results showed that various b-lactamases genes, aminoglycoside-modifying enzymes (AMEs) genes, and pump-expressing genes are resistance gene patterns in MDR A. baumannii isolates. MDR A. baumannii has significantly become resistant to b-lactams, carbapenems, and aminoglycosides.
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Affiliation(s)
- Golnar Rahimzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad S. Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Address for correspondence: Prof. Mohammad S. Rezai, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari - 4815838477, Iran. E-mail:
| | - Fereshteh Farshidi
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Yeganeh O, Shabani M, Pakzad P, Mosaffa N, Hashemi A. Evaluation the reactivity of a peptide-based monoclonal antibody derived from OmpA with drug resistant pulsotypes of Acinetobacter baumannii as a potential therapeutic approach. Ann Clin Microbiol Antimicrob 2022; 21:30. [PMID: 35773688 PMCID: PMC9245400 DOI: 10.1186/s12941-022-00523-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acinetobacter baumannii is an opportunistic and antibiotic-resistant pathogen that predominantly causes nosocomial infections. There is urgent need for development nonantibiotic-based treatment strategies. We developed a novel monoclonal antibody (mAb) against a peptide of conserved outer membrane protein A (OmpA) and evaluated its reactivity with different pulsotypes of A. baumannii. METHODS Peptide derived from A. baumannii OmpA was conjugated to keyhole limpet hemocyanin and injected into BALB/c mice. Splenocytes of immunized mice were fused with SP2/0 myeloma cells followed by selection of antibody-producing hybridoma cells. After screening of different hybridoma colonies by ELISA, one monoclone was selected as 3F10-C9 and the antibody was tested for reaction with five different Acinetobacter pulsotypes that were resistant to carbapenem antibiotics. The affinity constant was measured by ELISA. The ELISA, western blotting, indirect immunofluorescence (IFA), and in vitro opsonophagocytosis assays were used to evaluate the reactivity of generated mAb. RESULTS The anti-OmpA antibody reacted with the immunizing peptide and had a high affinity (1.94 × 10-9 M) for its antigen in the ELISA. Specific binding of mAb to OmpA was confirmed in Western blot. IFA assays revealed that mAb recognized specific OmpA on the pulsotypes. Opsonophagocytosis assays showed that the mAb increased the bactericidal activity of macrophage cells. The antibody function was higher in the presence of serum complement. CONCLUSIONS The peptide-based mAb demonstrated optimal performance in laboratory experiments which may be appropriate in investigation on OmpA in Acinetobacter pathogenesis and development of passive immunization as a novel therapeutic approach.
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Affiliation(s)
- Omid Yeganeh
- Department of Microbiology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mahdi Shabani
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parviz Pakzad
- Department of Microbiology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Nariman Mosaffa
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Hashemi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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