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Zhang HL, Nizamani MM, Wang Y, Cui X, Xiu H, Qayyum M, Sun Q. Analysis of antimicrobial resistance and genetic diversity of Acinetobacter baumannii in a tertiary care hospital in Haikou City. Sci Rep 2024; 14:22068. [PMID: 39333332 PMCID: PMC11437051 DOI: 10.1038/s41598-024-73258-2] [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: 01/12/2024] [Accepted: 09/16/2024] [Indexed: 09/29/2024] Open
Abstract
This study addresses the distribution and antimicrobial resistance of Acinetobacter baumannii (A. baumannii) in a medical facility in Haikou City, aiming to provide essential insights for enhancing in-hospital treatment and prevention strategies. We conducted a retrospective analysis of 513 A. baumannii isolates collected from a tertiary care hospital in Haikou between January 2018 and December 2020, focusing on their antimicrobial resistance patterns. Random Amplified Polymorphic DNA (RAPD) analysis was performed on 48 randomly selected A. baumannii strains. Using Gel-pro4.0 and NTSYSspc2.10 software, we constructed dendrograms to assess the genetic diversity of these strains. Our results indicate that males between 60 and 70 years old are particularly vulnerable to A. baumannii infections, which are most frequently detected in sputum samples, with a detection rate exceeding 70%. Alarmingly, over 50% of the isolates were identified as multi-drug resistant. The RAPD-PCR fingerprinting cluster analysis demonstrated substantial genetic diversity among the strains. Using primer OPA-02 at a 45% similarity coefficient, the strains were categorized into four groups (A-D), with group A being predominant (39 strains). high-prevalence areas like the Neurosurgery and Intensive Care Medicine Wards require enhanced surveillance and targeted interventions to manage Group C infections effectively. Additionally, the varied presence of other groups necessitates customized strategies to address the specific risks in each ward. Similarly, primer 270 at a 52% similarity coefficient classified the strains into five groups (E-I), with group E being most common (36 strains). The study highlights a concerning prevalence of antimicrobial resistance, particularly multi-drug resistance, among A. baumannii strains in the Haikou hospital. The significant genetic diversity, especially within groups A and E, underscores the need for tailored hospital treatment protocols and prevention measures. These findings contribute to the growing body of research on antimicrobial resistance, emphasizing the urgent need for effective management strategies in healthcare settings.
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Affiliation(s)
- Hai-Li Zhang
- School of Tropical Medicine, Hainan Medical University, Haikou, 571199, Hainan, China
- Hainan Yazhou Bay Seed Laboratory, Sanya Nanfan Research Institute of Hainan University, Sanya, 572025, China
| | - Mir Muhammad Nizamani
- School of Tropical Medicine, Hainan Medical University, Haikou, 571199, Hainan, China
- Institute of Marine Sciences, Guangdong Provincial Key Laboratory of Marine Disaster Prediction and Prevention, Shantou University, Shantou, 515063, China
| | - Yanjing Wang
- School of Tropical Medicine, Hainan Medical University, Haikou, 571199, Hainan, China
- The First Affiliated Hospital of Hainan Medical College, Hainan Medical University, Hai Kou, 571199, Hainan, China
| | - Xiaoli Cui
- Autobio Diagnostics Co., Ltd, Zhengzhou, 450000, China
| | - Hao Xiu
- School of Tropical Medicine, Hainan Medical University, Haikou, 571199, Hainan, China
- The First Affiliated Hospital of Hainan Medical College, Hainan Medical University, Hai Kou, 571199, Hainan, China
| | - Muhammad Qayyum
- School of Economics and Statistics, Guangzhou University, Guangzhou, China
| | - Qinghui Sun
- School of Tropical Medicine, Hainan Medical University, Haikou, 571199, Hainan, China.
- The First Affiliated Hospital of Hainan Medical College, Hainan Medical University, Hai Kou, 571199, Hainan, China.
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Boral J, Vatansever C, Ozcan G, Keske S, Menekse S, Gonen M, Can F. Resensitization to colistin results in rapid and stable recovery of adherence, serum resistance and ompW in Acinetobacter baumannii. PLoS One 2024; 19:e0309307. [PMID: 39196973 PMCID: PMC11356438 DOI: 10.1371/journal.pone.0309307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/08/2024] [Indexed: 08/30/2024] Open
Abstract
BACKGROUND Colistin resistance in Acinetobacter baumannii is an emerging problem that limits antimicrobial therapy options. MATERIALS & METHODS We isolated two pairs of colistin susceptible and colistin-resistant A. baumannii (K1007/K1006 and K408/K409) from two patients diagnosed with carbapenem-resistant A. baumannii infection. Colistin susceptible isolates were exposed to in vitro colistin induction for 50 generations. The selected cell populations were subjected to DNA and RNA sequencing and phenotypic assays. RESULTS In the in vitro induction assay, K408 gained colistin resistance on the corresponding day of clinical resistance (K408-G25) and got resensitized to colistin in the consecutive generation (K408-G26). A significant upregulation of ompW, ata, adeFGH genes on K408-G25 was followed by a downregulation upon resensitization to colistin (G26). Despite the upregulation of the ompW gene in transcriptomic analysis, the ompW protein disappeared on K408-G25 and recovered in the resensitized generation (G26). In parallel, disrupted cell membrane integrity recovered in K408-G26. In the K408-G25, downregulation of pbpG and upregulation of pbp1a/pbp3 genes decreased serum-resistance which was reversed in the resensitized generation (G26). The K1007 did not gain colistin resistance amongst 50-generations, however, the generation corresponding to clinical resistance day (K1007-G9) had a similar trend with K408-G25. The clinical colistin-resistant K409 and K1006 had SNPs on pmrA and pmrB genes. CONCLUSION In this study, we observed that A. baumannii regulates adhesion, efflux pumps and serum-resistance associated genes as an early response to colistin stress. Besides, the ompW protein disappears in the cell membrane of colistin resistant cells which recovers after resensitization to colistin. The lack of ompW protein in colistin-resistant cells should be taken into consideration for escape mutants in development of antivirulence vaccination or treatment options.
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Affiliation(s)
- Jale Boral
- Graduate School of Health Sciences, Koç University, Istanbul, Türkiye
- Koç University İşBank Center for Infectious Diseases (KUISCID), Koç University Hospital, Istanbul, Türkiye
| | - Cansel Vatansever
- Koç University İşBank Center for Infectious Diseases (KUISCID), Koç University Hospital, Istanbul, Türkiye
| | - Gulin Ozcan
- Graduate School of Health Sciences, Koç University, Istanbul, Türkiye
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Siran Keske
- Koç University İşBank Center for Infectious Diseases (KUISCID), Koç University Hospital, Istanbul, Türkiye
| | - Sirin Menekse
- Department of Infectious Diseases, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Türkiye
| | - Mehmet Gonen
- Koç University İşBank Center for Infectious Diseases (KUISCID), Koç University Hospital, Istanbul, Türkiye
- Department of Industrial Engineering, College of Engineering, Koç University, Istanbul, Türkiye
| | - Fusun Can
- Graduate School of Health Sciences, Koç University, Istanbul, Türkiye
- Koç University İşBank Center for Infectious Diseases (KUISCID), Koç University Hospital, Istanbul, Türkiye
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Garaizar J, Laorden L. Bacterial Genomics and Epidemiology. Microorganisms 2023; 11:1428. [PMID: 37374930 DOI: 10.3390/microorganisms11061428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Innovative technologies for Whole-Genome Sequencing (WGS) help to improve our understanding of the epidemiology and pathogenesis of bacterial infectious diseases and are becoming affordable for most microbiological laboratories [...].
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Affiliation(s)
- Javier Garaizar
- MikroIker Research Group, Department of Immunology, Microbiology, and Parasitology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain
| | - Lorena Laorden
- MikroIker Research Group, Department of Immunology, Microbiology, and Parasitology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain
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Colistin Resistance in Acinetobacter baumannii: Molecular Mechanisms and Epidemiology. Antibiotics (Basel) 2023; 12:antibiotics12030516. [PMID: 36978383 PMCID: PMC10044110 DOI: 10.3390/antibiotics12030516] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/17/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Acinetobacter baumannii is recognized as a clinically significant pathogen causing a wide spectrum of nosocomial infections. Colistin was considered a last-resort antibiotic for the treatment of infections caused by multidrug-resistant A. baumannii. Since the reintroduction of colistin, a number of mechanisms of colistin resistance in A. baumannii have been reported, including complete loss of LPS by inactivation of the biosynthetic pathway, modifications of target LPS driven by the addition of phosphoethanolamine (PEtN) moieties to lipid A mediated by the chromosomal pmrCAB operon and eptA gene-encoded enzymes or plasmid-encoded mcr genes and efflux of colistin from the cell. In addition to resistance to colistin, widespread heteroresistance is another feature of A. baumannii that leads to colistin treatment failure. This review aims to present a critical assessment of relevant published (>50 experimental papers) up-to-date knowledge on the molecular mechanisms of colistin resistance in A. baumannii with a detailed review of implicated mutations and the global distribution of colistin-resistant strains.
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Goic-Barisic I, Music MS, Drcelic M, Tuncbilek S, Akca G, Jakovac S, Tonkić M, Hrenovic J. Molecular characterisation of colistin and carbapenem-resistant clinical isolates of Acinetobacter baumannii from Southeast Europe. J Glob Antimicrob Resist 2023; 33:26-30. [PMID: 36878462 DOI: 10.1016/j.jgar.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVES To characterise 11 colistin- and carbapenem-resistant Acinetobacter baumannii isolates recently emerging in hospital settings. METHODS A. baumannii isolates were collected from hospitalised patients under colistin treatment in three countries of Southeast Europe: Turkey, Croatia, and Bosnia and Herzegovina. Isolates were identified using molecular methods. RESULTS Isolates from Turkey and Croatia belong to the sequence types ST195 or ST281 of the clone lineage 2, while the single isolate from Bosnia and Herzegovina belongs to the ST231 of clone lineage 1. All isolates turned out to be highly resistant to colistin (MIC ≥ 16 mg/L) and have point mutations in pmrCAB operon genes. The colistin-resistant isolate from Bosnia and Herzegovina had a unique P170L point mutation in the pmrB gene and the R125H point mutation in the pmrC gene. The L20S mutation in the pmrA gene was detected only in isolates from Croatia and has never been reported before in isolates from this country. CONCLUSION Colistin resistance in A. baumannii in hospitalised patients receiving colistin treatment is a result of chromosomal mutations. The pattern of point mutations in pmrCAB genes suggests a spread of specific colistin-resistant isolates within the hospital.
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Affiliation(s)
- Ivana Goic-Barisic
- University Hospital of Split, Department of Clinical Microbiology, Split, Croatia; University of Split School of Medicine, Split, Croatia.
| | | | - Marina Drcelic
- University of Zagreb Faculty of Science, Department of Biology, Zagreb, Croatia
| | - Semra Tuncbilek
- Ufuk University Medical School, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Gulcin Akca
- Gazi University Faculty of Dentistry, Department of Medical Microbiology, Ankara, Turkey
| | - Sanja Jakovac
- University Clinical Hospital Mostar, Department of Microbiology and Molecular Diagnostics, Mostar, Bosnia and Herzegovina; University of Mostar School of Medicine, Mostar, Bosnia and Herzegovina
| | - Marija Tonkić
- University Hospital of Split, Department of Clinical Microbiology, Split, Croatia; University of Split School of Medicine, Split, Croatia
| | - Jasna Hrenovic
- University of Zagreb Faculty of Science, Department of Biology, Zagreb, Croatia
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Kabic J, Novovic K, Kekic D, Trudic A, Opavski N, Dimkic I, Jovcic B, Gajic I. Comparative genomics and molecular epidemiology of colistin-resistant Acinetobacter baumannii. Comput Struct Biotechnol J 2022; 21:574-585. [PMID: 36659926 PMCID: PMC9816908 DOI: 10.1016/j.csbj.2022.12.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
This study aimed to investigate the prevalence and resistance mechanisms of colistin-resistant Acinetobacter baumannii (ColRAB) isolates in Serbia, assess their genetic relatedness to other circulating A. baumannii isolates in the neighbouring European countries, and analyse the global genomic epidemiology of ColRAB isolates. A total of 784 isolates of A. baumannii were recovered from hospitalised patients in Serbia between 2018 and 2021. The antimicrobial susceptibility testing was performed using disk diffusion and broth microdilution. All ColRAB isolates were subjected to DNA isolation and whole-genome sequencing (WGS). Overall, 3.94 % (n = 30) isolates were confirmed as ColRAB. Results of mutational and transcriptional analysis of genes associated with colistin resistance indicate the central role of the two-component regulating system, PmrAB, and increased expression of the pmrC gene in ColRAB. Most of the isolates (n = 29, 96.6 %) belonged to international clone II, with the most common sequence type being STPas2 (n = 23, 76.6 %). Based on the WGS analysis, ColRAB isolates belonging to the same ST isolated in various countries were grouped into the same clusters, indicating the global dissemination of several high-risk clonal lineages. Phylogenomic analysis of ColRAB isolates, together with all previously published A. baumannii genomes from South-Eastern European countries, showed that colistin resistance arose independently in several clonal lineages. Comparative genomic analysis revealed multiple genes with various roles (transcriptional regulation, transmembrane transport, outer membrane assembly, etc.), which might be associated with colistin resistance in A. baumannii. The obtained findings serve as the basis for further studies, contributing to a better understanding of colistin resistance mechanisms in A. baumannii.
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Affiliation(s)
- Jovana Kabic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia
| | - Katarina Novovic
- Laboratory for Molecular Microbiology, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000, Belgrade, Serbia
| | - Dusan Kekic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia
| | - Anika Trudic
- Department of Microbiology, Faculty of Medicine, University of Novi Sad, 21000, Novi Sad, Serbia
- Institute for Pulmonary Diseases of Vojvodina, 21204, Sremska Kamenica, Serbia
| | - Natasa Opavski
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia
| | - Ivica Dimkic
- Faculty of Biology, University of Belgrade, 11000, Belgrade, Serbia
| | - Branko Jovcic
- Laboratory for Molecular Microbiology, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000, Belgrade, Serbia
- Faculty of Biology, University of Belgrade, 11000, Belgrade, Serbia
- Correspondence to: Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Faculty of Biology, University of Belgrade Studentski trg 16, 11000 Belgrade, Serbia.
| | - Ina Gajic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia
- Correspondence to: Institute of Microbiology and Immunology, Medical Faculty, University of Belgrade Dr Subotica 1, 11000 Belgrade, Serbia.
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Performance Evaluation of the VITEK2 and Sensititre Systems to Determine Colistin Resistance and MIC for Acinetobacter baumannii. Diagnostics (Basel) 2022; 12:diagnostics12061487. [PMID: 35741297 PMCID: PMC9221671 DOI: 10.3390/diagnostics12061487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 11/26/2022] Open
Abstract
Performances of the colistin antimicrobial susceptibility testing (AST) systems of Acinetobacter baumannii vary depending on the manufacturer, and data on colistin-resistant A. baumannii are limited. We evaluated the VITEK2 and Sensititre systems to determine colistin resistance and minimum inhibitory concentration (MIC) for A. baumannii isolated from a clinical microbiology laboratory. A total of 213 clinical A. baumannii isolates were tested, including 81 colistin-resistant A. baumannii. ASTs were performed using the VITEK2 and Sensititre systems according to the manufacturer’s instructions. Reference MICs for colistin were determined using the manual broth microdilution method (BMD). The results of the two AST methods were compared with the BMD results. VITEK2 and Sensititre systems showed category agreements of 95.3% and 99.1%, respectively. VITEK2 had a relatively high very major error (VME) rate (9.9%). Sensititre reported higher MICs than the reference method for the susceptible isolates and showed low essential agreement. In conclusion, the automated systems investigated in this study showed good category agreements for colistin AST of A. baumannii. However, VITEK2 had a high VME rate, and Sensititre had differences in MIC results. Colistin AST remains a challenging task in the clinical laboratory.
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The Distribution Characteristics of Aerosol Bacteria in Different Types of Pig Houses. Animals (Basel) 2022; 12:ani12121540. [PMID: 35739876 PMCID: PMC9219456 DOI: 10.3390/ani12121540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Microbial aerosols from pig houses can be released into the environment, posing a serious threat to biosafety and public health. At present, there are few studies on the structural characteristics of aerosol bacteria in piggeries at different growth stages. It is important to understand the characteristics of aerosol bacteria in pig houses to solve the problems of air pollution and disease control in pig houses at different growth stages. In this study, bacterial aerosol concentrations and bacterial communities were compared in pig houses at different growth stages in Hebei Province, China. It was found that bacterial concentrations, community richness, and diversity in the air increased with the age of pigs. There are many pathogenic bacteria in the microbial aerosols of piggery. Our study highlights the importance of more comprehensive research and analysis of microbial aerosols in pig houses. Precautions for air pollution should be instituted in pig houses, including wearing masks, rigorous disinfection, and hygiene procedures. Abstract With the development of modern pig raising technology, the increasing density of animals in pig houses leads to the accumulation of microbial aerosols in pig houses. It is an important prerequisite to grasp the characteristics of bacteria in aerosols in different pig houses to solve the problems of air pollution and disease prevention and control in different pig houses. This work investigated the effects of growth stages on bacterial aerosol concentrations and bacterial communities in pig houses. Three traditional types of closed pig houses were studied: farrowing (FAR) houses, weaning (WEA) houses, and fattening (FAT) houses. The Andersen six-stage sampler and high-volume air sampler were used to assess the concentrations and size distribution of airborne bacteria, and 16S rRNA gene sequencing was used to identify the bacterial communities. We found that the airborne bacterial concentration, community richness, and diversity index increased with pig age. We found that Acinetobacter, Erysipelothrix, Streptococcus, Moraxella, and Aerococcus in the microbial aerosols of pig houses have the potential risk of causing disease. These differences lead us to believe that disinfection strategies for pig houses should involve a situational focus on environmental aerosol composition on a case-by-case basis.
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