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Santajit S, Bhoopong P, Kong-Ngoen T, Tunyong W, Horpet D, Paehoh-ele W, Zahedeng T, Pumirat P, Sookrung N, Hinthong W, Indrawattana N. Phenotypic and Genotypic Investigation of Carbapenem-Resistant Acinetobacter baumannii in Maharaj Nakhon Si Thammarat Hospital, Thailand. Antibiotics (Basel) 2023; 12:antibiotics12030580. [PMID: 36978447 PMCID: PMC10044629 DOI: 10.3390/antibiotics12030580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Background: Acinetobacter baumannii is well known as a causative agent of severe hospital-acquired infections, especially in intensive care units. The present study characterised the genetic traits of biofilm-forming carbapenem-resistant A. baumannii (CRAB) clinical isolates. Additionally, this study determined the prevalence of biofilm-producing A. baumannii isolates from a tertiary care hospital and investigated the association of biofilms with the distribution of biofilm-related and antibiotic resistance-associated genotypes. (2) Methods: The 995 non-duplicate A. baumannii isolates were identified, and their susceptibilities to different antibiotics were determined using the disk diffusion method. Using the modified microtiter plate assay, the CRAB isolates were investigated for their biofilm formation ability. Hemolysin and protease activities were determined. CRABs were subjected to polymerase chain reaction (PCR) assays targeting blaVIM, blaNDM, blaIMP, blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, csuE and pgaB genes. Individual CRAB isolates were identified for their DNA fingerprint by repetitive element sequence-based (REP)-PCR. (3) Results: Among all A. baumannii isolates, 172 CRABs were identified. The major antibiotic resistance gene among the CRAB isolates was blaOXA-51-like (100%). Ninety-nine isolates (57.56%) were biofilm producers. The most prevalent biofilm gene was pgaB (79.65%), followed by csuE (76.74%). Evidence of virulence phenotypes revealed that all CRAB exhibited proteolytic activity; however, only four isolates (2.33%) were positive for the hemolytic-producing phenotype. REP-PCR showed that 172 CRAB isolates can be divided into 36-DNA fingerprint patterns. (4) Conclusions: The predominance of biofilm-producing CRAB isolates identified in this study is concerning. The characterisation of risk factors could aid in controlling the continual selection and spreading of the A. baumannii phenotype in hospitals, thereby improving patient care quality.
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Affiliation(s)
- Sirijan Santajit
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
- Research Center in Tropical Pathobiology, Walailak University, Nakhon Si Thammarat 80160, Thailand
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Phuangthip Bhoopong
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Thida Kong-Ngoen
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Witawat Tunyong
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Dararat Horpet
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Wanfudhla Paehoh-ele
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Tasneem Zahedeng
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Pornpan Pumirat
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Nitat Sookrung
- Siriraj Center of Research Excellence in Allergy and Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
- Biomedical Research Incubator Unit, Department of Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Woranich Hinthong
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Nitaya Indrawattana
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Correspondence: ; Tel.: +66-2-354-9100 (ext. 1598)
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Girija SA, Priyadharsini JV, Paramasivam A. Prevalence of carbapenem-hydrolyzing OXA-type β-lactamases among Acinetobacter baumannii in patients with severe urinary tract infection. Acta Microbiol Immunol Hung 2019; 67:49-55. [PMID: 31813258 DOI: 10.1556/030.66.2019.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/02/2019] [Indexed: 11/19/2022]
Abstract
Acinetobacter baumannii produces carbapenemase-hydrolyzing class D β-lactamases (CHDLs) as one of the major drug resistance mechanisms. This investigation is thus aimed to assess the prevalence and to characterize the CHDL-producing strains of A. baumannii by both phenotypic assays and genotypic characterization. A total of 73 isolates of A. baumannii were phenotypically and genotypically characterized from patients (N = 1,000) with severe urinary tract infection. Tested strains were subjected to double disk synergy testing by Kirby-Bauer disk diffusion method with modified Hodge test (MHT) for carbapenemase production. Plasmid DNA was molecularly screened for CHDL-encoding blaoxa-51, blaoxa-23, and blaoxa-143 genes by polymerase chain reaction. Carbapenem-resistant profile showed 100%, 61.64%, and 67.12% resistance by Kirby-Bauer disk diffusion method that correlated with MHT positivity for 100% (n = 73), 80% (n = 36), and 78% (n = 38) of the isolates against imipenem, doripenem, and meropenem, respectively. The blaoxa-51 and blaoxa-23 were observed in 41.09% (n = 30) and 35.61% (n = 26) with co-occurrence in 4.10% (n = 3) of the isolates. MHT-positive isolates showed 100%, 91.66%, and 71.4% for blaoxa-51 and 91.78%, 51.11%, and 34.69% for blaoxa-23 with imipenem, doripenem, and meropenem resistance, respectively. None of the strains yielded blaoxa-143 gene. The findings of this study showed prevalence of carbapenem resistance and high frequency of blaoxa-51 and blaoxa-23 among A. baumannii.
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Affiliation(s)
- Smiline As Girija
- Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | | | - Arumugam Paramasivam
- BRULAC-DRC, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
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3
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Molecular investigation of integron types and imipenem-resistance encoded genes in Acinetobacter baumannii strains isolated from burns patients in Iran. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kim YA, Kim JJ, Won DJ, Lee K. Seasonal and Temperature-Associated Increase in Community-Onset Acinetobacter baumannii Complex Colonization or Infection. Ann Lab Med 2018; 38:266-270. [PMID: 29401563 PMCID: PMC5820073 DOI: 10.3343/alm.2018.38.3.266] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/17/2017] [Accepted: 01/05/2018] [Indexed: 12/03/2022] Open
Abstract
Identifying the trends in community-onset Acinetobacter baumannii complex isolation and diversity according to temperature could help provide insight into the behavior of the A. baumannii complex. We performed a retrospective analysis of A. baumannii complex (Acinetobacter baumannii, Acinetobacter nosocomialis, Acinetobacter pittii, and Acinetobacter calcoaceticus) isolates obtained from patients at a Korean community hospital from 2006 to 2015 with reference to seasonal temperatures. The incidence rates were compared between warm (June–September) and cold (November–March) months, defined as an average mean temperature ≥20℃ and ≤5℃, respectively. Incidence rate was calculated as the number of cases per month, converted to cases/105 admissions for healthcare-acquired isolates and cases/103 outpatients for community-onset isolates. Approximately 3,500 A. baumannii complex cases were identified, and 26.2% of them were community-onset cases. The median (interquartile range) number of community-onset A. baumannii complex cases was significantly higher (P=0.0002) in warm months at 13.8 (9.5–17.6) than in cold months at 10.1 (6.3–13.2). There was a strong correlation between community-onset A. baumannii complex cases and temperature (Pearson's r=0.6805, P=0.0149). Thus, we identified a seasonality pattern for community-onset A. baumannii complex colonization or infection, but not for healthcare-acquired cases.
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Affiliation(s)
- Young Ah Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jin Ju Kim
- Department of Laboratory Medicine, Inha University College of Medicine, Incheon, Korea
| | - Dong Ju Won
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyungwon Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.,Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.
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6
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Raible KM, Sen B, Law N, Bias TE, Emery CL, Ehrlich GD, Joshi SG. Molecular characterization of β-lactamase genes in clinical isolates of carbapenem-resistant Acinetobacter baumannii. Ann Clin Microbiol Antimicrob 2017; 16:75. [PMID: 29145853 PMCID: PMC5691885 DOI: 10.1186/s12941-017-0248-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/08/2017] [Indexed: 01/26/2023] Open
Abstract
Background Acinetobacter baumannii is a nosocomial pathogen which is establishing as a major cause of morbidity and mortality within the healthcare community. The success of this pathogen is largely due to its ability to rapidly gain resistance to antimicrobial therapies and its capability to persist in an abiotic environment through the production of a biofilm. Our tertiary-care hospital has showed high incidence of carbapenem-resistant Acinetobacter baumannii (CRAB) isolates. Methods In this study we explore both genotypic and phenotypic properties of 26 CRAB isolates: 16 isolates were collected from January 2010 to March 2011, and 10 were collected between February and May 2015. Results We determined that all 26 CRAB isolates possessed multiple β-lactamase genes, including genes from Groups A, C, and D. Specifically, 42% of the isolates possesses the potentially plasmid-borne genes of OXA-23-like or OXA-40-like β-lactamase. The presence of mobile gene element integron cassettes and/or integrases in 88% of the isolates suggests a possible mechanism of dissemination of antibiotic resistance genes. Additionally, the location of insertion sequence (IS) ISAba1 in promotor region of of the OXA-51-like, ADC-7, and ampC genes was confirmed. Multilocus sequence typing (MLST) demonstrated that all 26 CRAB isolates were either sequence type (ST)-229 or ST-2. Interestingly, ST-2 went from being the minority CRAB strain in the 2010–2011 isolates to the predominant strain in the 2015 isolates (from 32 to 90%). We show that the ST-2 strains have an enhanced ability to produce biofilms in comparison to the ST-229 strains, and this fact has potentially led to more successful colonization of the clinical environment over time. Conclusions This study provides a longitudinal genetic and phenotypic survey of two CRAB sequence types, and suggests how their differing phenotypes may interact with the selective pressures of a hospital setting effecting strain dominance over a 5-year period. Electronic supplementary material The online version of this article (10.1186/s12941-017-0248-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kevin M Raible
- Center for Surgical Infections & Biofilms, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.,Center for Genomic Sciences, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA
| | - Bhaswati Sen
- Center for Surgical Infections & Biofilms, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.,Center for Genomic Sciences, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA
| | - Nancy Law
- Center for Surgical Infections & Biofilms, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA
| | - Tiffany E Bias
- Center for Surgical Infections & Biofilms, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA
| | - Christopher L Emery
- Center for Surgical Infections & Biofilms, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.,Department of Pathology and Lab Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Garth D Ehrlich
- Center for Surgical Infections & Biofilms, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.,Center for Genomic Sciences, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.,Center for Advanced Microbial Processing, Institute of Molecular Medicine and Infectious Diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.,Department of Microbiology and Immunology, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.,Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA
| | - Suresh G Joshi
- Center for Surgical Infections & Biofilms, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA. .,Center for Genomic Sciences, Institute of Molecular Medicine and Infectious diseases, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA. .,Department of Microbiology and Immunology, Drexel University College of Medicine, 245 N. 15th Street, Philadelphia, PA, 19102, USA.
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Rahman M, Prasad KN, Gupta S, Singh S, Singh A, Pathak A, Gupta KK, Ahmad S, Gonzalez-Zorn B. Prevalence and Molecular Characterization of New Delhi Metallo-Beta-Lactamases in Multidrug-Resistant Pseudomonas aeruginosa and Acinetobacter baumannii from India. Microb Drug Resist 2017; 24:792-798. [PMID: 29058515 DOI: 10.1089/mdr.2017.0078] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
New Delhi metallo-beta-lactamase (NDM)-mediated carbapenem resistance in Pseudomonas aeruginosa and Acinetobacter baumannii is a major concern. We investigated the presence of NDM and its variants in P. aeruginosa and A. baumannii at a tertiary hospital in North India. A total of 236 isolates (130 P. aeruginosa and 106 A. baumannii) were included; 38 (29.23%) P. aeruginosa and 20 A. baumannii isolates (18.8%) were resistant to carbapenems and all of them were blaNDM positive. All 38 carbapenem-resistant P. aeruginosa harbored blaNDM-1, while 12 (60%) of 20 A. baumannii harbored blaNDM-2. Pulsed-field gel electrophoresis showed that all 58 isolates were clonally unrelated. By Southern blot analysis, blaNDM-2 was located on chromosome. The blaNDM-2-positive isolates were more frequently recovered from tracheal aspirate (67% vs.16%; p = 0.02) and intensive care unit (67% vs. 20%; p = 0.001) than blaNDM-1. Among other carbapenemases, VIM was significantly associated with blaNDM-1 than blaNDM-2 (61% vs. 17%; p = 0.006). Mortality between blaNDM-1- and blaNDM-2-infected patients was comparable. When expressed in Escherichia coli, blaNDM-2 transformant conferred one doubling dilution higher MIC value for cefotaxime, piperacillin/tazobactam than blaNDM-1. The study shows the emergence of blaNDM-mediated resistance among P. aeruginosa and A. baumannii and rapid evolution of blaNDM-2 in A. baumannii with its chromosomal localization.
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Affiliation(s)
- Mohibur Rahman
- 1 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
| | - Kashi Nath Prasad
- 1 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
| | - Shefali Gupta
- 1 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
| | - Sanjay Singh
- 1 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
| | - Avinash Singh
- 1 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
| | - Ashutosh Pathak
- 1 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
| | - Kamlesh Kumar Gupta
- 1 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
| | - Saheem Ahmad
- 2 Department of Biosciences, Integral University , Lucknow, India
| | - Bruno Gonzalez-Zorn
- 3 Department of Sanidad Animal, Universidad Complutense de Madrid , Madrid, Spain
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Hammami S, Dahdeh C, Mamlouk K, Ferjeni S, Maamar E, Hamzaoui Z, Saidani M, Ghedira S, Houissa M, Slim A, Boutiba-Ben Boubaker I. Rectal Carriage of Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Gram-Negative Bacilli in Intensive Care Units in Tunisia. Microb Drug Resist 2017; 23:695-702. [DOI: 10.1089/mdr.2016.0205] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Samia Hammami
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
- Faculté des Sciences de Bizerte, Université de Carthage, Bizerte, Tunisie
| | - Chaima Dahdeh
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
| | - Kelthoum Mamlouk
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
| | - Sana Ferjeni
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
| | - Elaa Maamar
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
| | - Zeineb Hamzaoui
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
| | - Mabrouka Saidani
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
- Laboratoire de Microbiologie, Hôpital Charles Nicolle de Tunis, Tunis, Tunisie
| | - Salma Ghedira
- Service de Reanimation Medico-chirurgicale–Hôpital, Charles Nicolle de Tunis, Tunis, Tunisie
| | - Mohamed Houissa
- Service de Reanimation Medico-chirurgicale–Hôpital, Charles Nicolle de Tunis, Tunis, Tunisie
| | - Amin Slim
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
- Laboratoire de Microbiologie, Hôpital Charles Nicolle de Tunis, Tunis, Tunisie
| | - Ilhem Boutiba-Ben Boubaker
- LR99ES09 Laboratoire de Recherche “Résistance aux Antimicrobiens,” Faculté de Médecine de Tunis, Université de Tunis El Manar, Tunis, Tunisie
- Laboratoire de Microbiologie, Hôpital Charles Nicolle de Tunis, Tunis, Tunisie
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Dias VC, Resende JA, Bastos AN, De Andrade Bastos LQ, De Andrade Bastos VQ, Bastos RV, Diniz CG, Da Silva VL. Epidemiological, Physiological, and Molecular Characteristics of a Brazilian Collection of Carbapenem-Resistant Acinetobacter baumannii and Pseudomonas aeruginosa. Microb Drug Resist 2017; 23:852-863. [PMID: 28437232 DOI: 10.1089/mdr.2016.0219] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Nonfermenting Gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii are widespread in the environment and are increasingly associated with nosocomial infections, often associated with multidrug-resistance phenotypes. This study aimed to evaluate epidemiological, physiological, and molecular characteristics of carbapenem resistance in P. aeruginosa and A. baumannii. In total, 63 nonreplicated strains (44 A. baumannii and 19 P. aeruginosa) were isolated from hospitalized patients. Antimicrobial resistance patterns, biocide tolerance, oxidative stress, hemolytic activity, and biofilm formation were assessed. Genetic markers related to β-lactamase synthesis, efflux systems, and porin loss were screened by PCR. Epidemiological data of patients were analyzed. Advanced age, intensive care unit admission, invasive medical devices, treatment with fluoroquinolones or β-lactams/β-lactamase inhibitor combinations, and prolonged hospital stay were predisposing factors for infection. Colistin showed to be active in vitro against these bacteria. Carbapenem-resistant P. aeruginosa strains did not show hemolytic activity and were less tolerant to oxidative stress and biocides. However, increased ability of biofilm formation was observed, comparing to the carbapenem-susceptible isolates. Genetic markers related to oxacillinases synthesis (OXA-23 and OXA-143), oprD absence, and efflux pump (adeB) were detected in carbapenem-resistant A. baumannii. Screening for OXA-51-like gene was performed as confirmatory test for A. baumannii identification. In P. aeruginosa genes encoding efflux pumps (MexAB-OprM, MexCD-OprJ, MexEF-OprN, and MexXY-OprM) and SPM-1 were found; besides, oprD absence was also observed. Our results suggest that these organisms are well adapted to different environments and confirm the difficulty of therapeutic management of patients with infections associated with multidrug-resistant microorganisms, with direct impact on mortality and epidemiological control of these strains in health centers.
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Affiliation(s)
- Vanessa Cordeiro Dias
- 1 Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora , Juiz de Fora, Brazil .,2 Cortes Villela Clinical Laboratory , Juiz de Fora, Brazil
| | - Juliana Alves Resende
- 1 Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora , Juiz de Fora, Brazil
| | | | | | | | | | - Cláudio Galuppo Diniz
- 1 Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora , Juiz de Fora, Brazil
| | - Vânia Lúcia Da Silva
- 1 Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora , Juiz de Fora, Brazil
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Chen CH, Tu CC, Kuo HY, Zeng RF, Yu CS, Lu HHS, Liou ML. Dynamic change of surface microbiota with different environmental cleaning methods between two wards in a hospital. Appl Microbiol Biotechnol 2016; 101:771-781. [PMID: 27771740 DOI: 10.1007/s00253-016-7846-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/23/2016] [Accepted: 09/08/2016] [Indexed: 01/04/2023]
Abstract
Terminal disinfection and daily cleaning have been performed in hospitals in Taiwan for many years to reduce the risks of healthcare-associated infections. However, the effectiveness of these cleaning approaches and dynamic changes of surface microbiota upon cleaning remain unclear. Here, we report the surface changes of bacterial communities with terminal disinfection and daily cleaning in a medical intensive care unit (MICU) and only terminal disinfection in a respiratory care center (RCC) using 16s ribosomal RNA (rRNA) metagenomics. A total of 36 samples, including 9 samples per sampling time, from each ward were analysed. The clinical isolates were recorded during the sampling time. A large amount of microbial diversity was detected, and human skin microbiota (HSM) was predominant in both wards. In addition, the colonization rate of the HSM in the MICU was higher than that in the RCC, especially for Moraxellaceae. A higher alpha-diversity (p = 0.005519) and a lower UniFrac distance was shown in the RCC due to the lack of daily cleaning. Moreover, a significantly higher abundance among Acinetobacter sp., Streptococcus sp. and Pseudomonas sp. was shown in the RCC compared to the MICU using the paired t test. We concluded that cleaning changes might contribute to the difference in diversity between two wards.
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Affiliation(s)
- Chang-Hua Chen
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan.,Center for Infectious Diseases Research, Changhua Christian Hospital, Changhua City, Taiwan.,Department of Nursing, College of Medicine & Nursing, Hung Kuang University, Taichung County, Taiwan
| | - Chi-Chao Tu
- Department of Laboratory Medicine, Keelung Hospital, Minister of Health and Welfare, Keelung City, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Yuanpei University, No. 306, Yuanpei Street, Hsin-Chu, 30015, Taiwan
| | - Han-Yueh Kuo
- Department of Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Rong-Fong Zeng
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University, No. 306, Yuanpei Street, Hsin-Chu, 30015, Taiwan
| | - Cheng-Sheng Yu
- Institute of Statistics, National Chiao Tung University, Hsinchu, Taiwan
| | | | - Ming-Li Liou
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University, No. 306, Yuanpei Street, Hsin-Chu, 30015, Taiwan.
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Ahmed SS, Alp E, Ulu-Kilic A, Dinc G, Aktas Z, Ada B, Bagirova F, Baran I, Ersoy Y, Esen S, Guven TG, Hopman J, Hosoglu S, Koksal F, Parlak E, Yalcin AN, Yilmaz G, Voss A, Melchers W. Spread of carbapenem-resistant international clones of Acinetobacter baumannii in Turkey and Azerbaijan: a collaborative study. Eur J Clin Microbiol Infect Dis 2016; 35:1463-8. [PMID: 27259712 DOI: 10.1007/s10096-016-2685-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 05/16/2016] [Indexed: 02/02/2023]
Abstract
Epidemic clones of Acinetobacter baumannii, described as European clones I, II, and III, are associated with hospital epidemics throughout the world. We aimed to determine the molecular characteristics and genetic diversity between European clones I, II, and III from Turkey and Azerbaijan. In this study, a total of 112 bloodstream isolates of carbapenem-resistant Acinetobacter spp. were collected from 11 hospitals across Turkey and Azerbaijan. The identification of Acinetobacter spp. using conventional and sensitivity tests was performed by standard criteria. Multiplex polymerase chain reaction (PCR) was used to detect OXA carbapenemase-encoding genes (bla OXA-23-like, bla OXA-24-like, bla OXA-51-like, and bla OXA-58-like). Pulsed-field gel electrophoresis (PFGE) typing was used to investigate genetic diversity. The bla OXA-51-like gene was present in all 112 isolates, 75 (67 %) carried bla OXA-23-like, 7 (6.2 %) carried bla OXA-58-like genes, and 5 (4.5 %) carried bla OXA-24-like genes. With a 90 % similarity cut-off value, 15 clones and eight unique isolates were identified. The largest clone was cluster D, with six subtypes. Isolates from clusters D and I were widely spread in seven different geographical regions throughout Turkey. However, F cluster was found in the northern and eastern regions of Turkey. EU clone I was grouped within J cluster with three isolates found in Antalya, Istanbul, and Erzurum. EU clone II was grouped in the U cluster with 15 isolates and found in Kayseri and Diyarbakır. The bla OXA-24-like gene in carbapenemases was identified rarely in Turkey and has been reported for the first time from Azerbaijan. Furthermore, this is the first multicenter study in Turkey and Azerbaijan to identify several major clusters belonging to European clones I and II of A. baumannii.
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Affiliation(s)
- S S Ahmed
- Faculty of Infectious Diseases, Erciyes University, Kayseri, Turkey.
- Genome and Stem Cell Center, Erciyes University, Kayseri, Turkey.
| | - E Alp
- Faculty of Infectious Diseases, Erciyes University, Kayseri, Turkey
| | - A Ulu-Kilic
- Faculty of Infectious Diseases, Erciyes University, Kayseri, Turkey
| | - G Dinc
- Faculty of Infectious Diseases, Erciyes University, Kayseri, Turkey
- Dep. of Medical Microbiology, Erciyes University, Kayseri, Turkey
| | - Z Aktas
- Dep. of Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - B Ada
- Dep. Infectious Diseases, Faculty of Medicine, Ege Univerisity, Izmir, Turkey
| | - F Bagirova
- Dep. of Infectious Diseases, Faculty of Medicine, Azerbaijan Medical University, Baku, Azerbaijan
| | - I Baran
- Dep. of Infectious Diseases, Faculty of Medicine, Ankara teaching hospital, Ankara, Turkey
| | - Y Ersoy
- Dep. of Infectious Diseases, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - S Esen
- Dep. of Infectious Diseases, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - T G Guven
- Dep. of Infectious Diseases, Faculty of Medicine, Cokurva University, Adana, Turkey
| | - J Hopman
- Dep. of Medical Microbiology, Radboud UMC, Nijmegen, Netherlands
| | - S Hosoglu
- Dep. of Infectious Diseases, Faculty of Medicine, Trabzon Teaching hospital, Trabzon, Turkey
| | - F Koksal
- Dep. of Infectious Diseases, Faculty of Medicine, Cokurva University, Adana, Turkey
| | - E Parlak
- Dep. of Infectious Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - A N Yalcin
- Dep. of Infectious Diseases, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - G Yilmaz
- Dep. of Infectious Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - A Voss
- Dep. of Medical Microbiology, Radboud UMC, Nijmegen, Netherlands
| | - W Melchers
- Dep. of Medical Microbiology, Radboud UMC, Nijmegen, Netherlands
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Zanganeh Z, Eftekhar F. Correlation of Oxacillinase Gene Carriage With the Genetic Fingerprints of Imipenem-Resistant Clinical Isolates of Acinetobacter baumannii. Jundishapur J Microbiol 2015; 8:e26545. [PMID: 26495112 PMCID: PMC4609178 DOI: 10.5812/jjm.26545] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/03/2015] [Accepted: 05/15/2015] [Indexed: 02/06/2023] Open
Abstract
Background: Emergence of multidrug-resistant Acinetobacter baumannii has resulted in the treatment failure of related infections and an increase in patient mortality. The presence of class D β-lactamases (oxacillinases) in this organism is an important mechanism underlying resistance to beta-lactam antibiotics. Objectives: The aim of this work was to investigate the correlation between oxacillinase gene carriage and genetic fingerprints in imipenem-resistant burn and non-burn isolates of A. baumannii. Materials and Methods: Fifty-eight A. baumannii isolates were collected from October 2011 to April 2012, which included 28 burn isolates from Shahid Motahari Hospital and 30 non-burn isolates from Imam Hossein Hospital. The minimum inhibitory and minimum bactericidal concentrations (MIC and MBC) of imipenem were measured by the broth microdilution method. The presence of oxacillinase genes (OXA-23-, OXA-24-, OXA-51-, and OXA-58-like genes) was shown using type-specific primers and PCR. Genetic profiles were generated by RAPD-PCR fingerprinting. Results: OXA-23 was observed in 81% of the isolates and its distribution was similar within the two groups. The presence of OXA-51 was shown in 58.6% of the isolates, of which most were burn isolates (67.6%). OXA-24 was present in 20.7% of the isolates, all belonging to the burn group; OXA-58 was not observed in any of the isolates. RAPD-PCR fingerprints revealed two clusters at a similarity level of 70% (A, B). At a similarity level of 85%, nine different groups were observed for burn and non-bun isolates. Conclusions: Our results showed that blaOXA-23 was the most prevalent gene, followed by blaOXA-51, among the burn and non-burn clinical isolates of A. baumannii. BlaOXA-24-like genes were detected at a lower level and were only found among the burn isolates, which also showed higher heterogeneity compared to the non-burn group.
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Affiliation(s)
- Zahra Zanganeh
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, Tehran, IR Iran
| | - Fereshteh Eftekhar
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, Tehran, IR Iran
- Corresponding author: Fereshteh Eftekhar, Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University G. C., Tehran, IR Iran. Tel: +98-2129903208, Fax: +98-2122431664, E-mail:
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Xu Y, Yan H, Zhang Y, Jiang K, Lu Y, Ren Y, Wang H, Wang S, Xing W. A fully sealed plastic chip for multiplex PCR and its application in bacteria identification. LAB ON A CHIP 2015; 15:2826-2834. [PMID: 26016439 DOI: 10.1039/c5lc00244c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Multiplex PCR is an effective tool for simultaneous multiple target detection but is limited by the intrinsic interference and competition among primer pairs when it is performed in one reaction tube. Dividing a multiplex PCR into many single PCRs is a simple strategy to overcome this issue. Here, we constructed a plastic, easy-to-use, fully sealed multiplex PCR chip based on reversible centrifugation for the simultaneous detection of 63 target DNA sequences. The structure of the chip is quite simple, which contains sine-shaped infusing channels and a number of reaction chambers connecting to one side of these channels. Primer pairs for multiplex PCR were sequentially preloaded in the different reaction chambers, and the chip was enclosed with PCR-compatible adhesive tape. For usage, the PCR master mix containing a DNA template is pipetted into the infusing channels and centrifuged into the reaction chambers, leaving the infusing channels filled with air to avoid cross-contamination of the different chambers. Then, the chip is sealed and placed on a flat thermal cycler for PCR. Finally, amplification products can be detected in situ using a fluorescence scanner or recovered by reverse centrifugation for further analyses. Therefore, our chip possesses two functions: 1) it can be used for multi-target detection based on end-point in situ fluorescence detection; and 2) it can work as a sample preparation unit for analyses that need multiplex PCR such as hybridization and target sequencing. The performance of this chip was carefully examined and further illustrated in the identification of 8 pathogenic bacterial genomic DNA samples and 13 drug-resistance genes. Due to simplicity of its structure and operation, accuracy and generality, high-throughput capacity, and versatile functions (i.e., for in situ detection and sample preparation), our multiplex PCR chip has great potential in clinical diagnostics and nucleic acid-based point-of-care testing.
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Affiliation(s)
- Youchun Xu
- School of Medicine, Tsinghua University, Beijing 100084, China.
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A case of IMP-4-, OXA-421-, OXA-96-, and CARB-2-producing Acinetobacter pittii sequence type 119 in Australia. J Clin Microbiol 2014; 53:727-30. [PMID: 25428154 DOI: 10.1128/jcm.02726-14] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
An IMP-4-producing Acinetobacter pittii strain coproducing oxacillinases was isolated from a leg wound of a 67-year-old female patient. Identification to the species level by rpoB and gyrB sequencing and multiplex-PCR-based analysis revealed that the isolate was A. pittii. Whole-genome sequencing of this A. pittii isolate determined the presence of blaOXA-96, blaCARB-2, and a novel blaOXA-421 gene. The position of this novel blaOXA-421 gene was similar to that of blaOXA-51 in A. baumannii, downstream of the phosphinothricin N-acetyltransferase gene and upstream of fxsA in the chromosome. This A. pittii isolate was found to belong to sequence type 119 (ST119). Here, we report the first isolation of IMP-4-producing A. pittii ST119 with a novel blaOXA-421 gene from a patient in Australia and characterize its draft genome.
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Merabishvili M, Vandenheuvel D, Kropinski AM, Mast J, De Vos D, Verbeken G, Noben JP, Lavigne R, Vaneechoutte M, Pirnay JP. Characterization of newly isolated lytic bacteriophages active against Acinetobacter baumannii. PLoS One 2014; 9:e104853. [PMID: 25111143 PMCID: PMC4128745 DOI: 10.1371/journal.pone.0104853] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/18/2014] [Indexed: 12/24/2022] Open
Abstract
Based on genotyping and host range, two newly isolated lytic bacteriophages, myovirus vB_AbaM_Acibel004 and podovirus vB_AbaP_Acibel007, active against Acinetobacter baumannii clinical strains, were selected from a new phage library for further characterization. The complete genomes of the two phages were analyzed. Both phages are characterized by broad host range and essential features of potential therapeutic phages, such as short latent period (27 and 21 min, respectively), high burst size (125 and 145, respectively), stability of activity in liquid culture and low frequency of occurrence of phage-resistant mutant bacterial cells. Genomic analysis showed that while Acibel004 represents a novel bacteriophage with resemblance to some unclassified Pseudomonas aeruginosa phages, Acibel007 belongs to the well-characterized genus of the Phikmvlikevirus. The newly isolated phages can serve as potential candidates for phage cocktails to control A. baumannii infections.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
- Laboratory for Bacteriology Research (LBR), Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Dieter Vandenheuvel
- Laboratory of Gene Technology, Faculty of Bioscience Engineering, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Andrew M. Kropinski
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Guelph, Ontario, Canada
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada
| | - Jan Mast
- Electron Microscopy Unit, Veterinary and Agrochemical Research Centre, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Noben
- Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, Faculty of Bioscience Engineering, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Mario Vaneechoutte
- Laboratory for Bacteriology Research (LBR), Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
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Todorova B, Velinov T, Ivanov I, Dobreva E, Kantardjiev T. First detection of OXA-24 carbapenemase-producing Acinetobacter baumannii isolates in Bulgaria. World J Microbiol Biotechnol 2013; 30:1427-30. [PMID: 24287943 DOI: 10.1007/s11274-013-1562-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
Abstract
This report describes the first identification of OXA-24 carbapenemase-producing Acinetobacter baumannii isolates from Bulgaria. According to national surveillance data A. baumannii along with Pseudomonas aeruginosa are the most troublesome microorganisms in hospital environment with high rates of acquired carbapenem resistance. In the present study real-time multiplex PCR was performed to identify the most common carbapenemase genes in 15 non-duplicate carbapenem-resistant A. baumannii isolates collected in 2012. The results showed lack of KPC, GES, VIM, IMP-type enzymes. Four A. baumannii isolates tested positive by PCR for the acquired OXA-24 together with the intrinsic OXA-51 carbapenemase. OXA-24 and OXA-23 were determined as co-existent in one isolate. Two isolates were identified with OXA-23 in addition to the OXA-51 carbapenemase.
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Affiliation(s)
- Bozhana Todorova
- National Center of Infectious and Parasitic Diseases (NCIPD), 26, Yanko Sakazov Blvd, 1504, Sofia, Bulgaria,
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Detection of blaOXA-23 in Acinetobacter spp. isolated from patients of a university hospital. Braz J Infect Dis 2012; 16:521-6. [DOI: 10.1016/j.bjid.2012.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022] Open
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18
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Schleicher X, Higgins PG, Wisplinghoff H, Körber-Irrgang B, Kresken M, Seifert H. Molecular epidemiology of Acinetobacter baumannii and Acinetobacter nosocomialis in Germany over a 5-year period (2005-2009). Clin Microbiol Infect 2012; 19:737-42. [PMID: 23034071 DOI: 10.1111/1469-0691.12026] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To investigate the species distribution within the Acinetobacter calcoaceticus-Acinetobacter baumannii complex and the molecular epidemiology of A. baumannii and Acinetobacter nosocomialis, 376 Acinetobacter isolates were collected prospectively from hospitalized patients at 15 medical centres in Germany during three surveillance studies conducted over a 5-year period. Species identification was performed by molecular methods. Imipenem minimum inhibitory concentrations (MIC) were determined by broth microdilution. The prevalence of the most common carbapenemase-encoding genes was investigated by oxacillinase (OXA) -multiplex polymerase chain reaction (PCR). The molecular epidemiology was investigated by repetitive sequence-based PCR (rep-PCR; DiversiLab™). Acinetobacter pittii was the most prevalent Acinetobacter species (n = 193), followed by A. baumannii (n = 140), A. calcoaceticus (n = 10) and A. nosocomialis (n = 8). The majority of A. baumannii was represented by sporadic isolates (n = 70, 50%) that showed unique rep-PCR patterns, 25 isolates (18%) clustered with one or two other isolates, and only 45 isolates (32%) belonged to one of the previously described international clonal lineages. The most prevalent clonal lineage was international clone (IC) 2 (n = 34) and IC 1 (n = 6). According to CLSI, 25 A. baumannii isolates were non-susceptible to imipenem (MIC ≥ 8 mg/L), all of which produced an OXA-58-like or OXA-23-like carbapenemase. The rate of imipenem susceptibility among A. baumannii isolates decreased from 96% in 2005 to 76% in 2009. All other Acinetobacter isolates were susceptible to imipenem. The population structure of carbapenem-susceptible A. baumannii in Germany is highly diverse. Imipenem non-susceptibility was strongly associated with the clonal lineages IC 2 and IC 1. These data underscore the high clonality of carbapenem-resistant A. baumannii isolates.
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Affiliation(s)
- X Schleicher
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
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19
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Tiwari V, Kapil A, Moganty RR. Carbapenem-hydrolyzing oxacillinase in high resistant strains of Acinetobacter baumannii isolated from India. Microb Pathog 2012; 53:81-6. [DOI: 10.1016/j.micpath.2012.05.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 05/02/2012] [Accepted: 05/10/2012] [Indexed: 10/28/2022]
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Kempf M, Rolain JM, Azza S, Diene S, Joly-Guillou ML, Dubourg G, Colson P, Papazian L, Richet H, Fournier PE, Ribeiro A, Raoult D. Investigation of Acinetobacter baumannii resistance to carbapenems in Marseille hospitals, south of France: a transition from an epidemic to an endemic situation. APMIS 2012; 121:64-71. [PMID: 23030740 DOI: 10.1111/j.1600-0463.2012.02935.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 05/18/2012] [Indexed: 11/30/2022]
Abstract
Carbapenem-resistant Acinetobacter baumannii infections are a worldwide endemic nosocomial threat. Between December 2010 and April 2011, an increase of carbapenem-resistant A. baumannii infections occurred in several Marseille University Hospitals. The aim of this study was to investigate the increase of carbapenem-resistant A. baumannii infections and to characterize the mechanisms of carbapenem resistance. The increase was detected by a homemade computer surveillance program, known as EPIMIC, that monitors antibiotic resistance profiles on a weekly basis. During this period, positive samples of carbapenem-resistant A. baumannii were retrieved from patients hospitalized in different units. Genotyping of the isolates was performed using pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), and carbapenemase gene analyses were performed to detect the presence of carbapenemases and to determine the relationships of the isolates. Carbapenem-resistant A. baumannii were isolated in a total of 11 patients who were hospitalized in different hospitals units. We identified the presence of the bla(OXA23-like) carbapenemase-encoding gene in all of the isolates and found four major PFGE groups and different MLST groups. These results demonstrate a current evolution in the A. baumannii epidemiology in Marseille with a switch from an epidemic situation to an endemic situation and with several circulating clones.
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Affiliation(s)
- Marie Kempf
- Faculté de Médecine et de Pharmacie, URMITE CNRS-IRD, UMR, Aix-Marseille Univ, France
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Tiwari V, Nagpal I, Subbarao N, Moganty RR. In-silico modeling of a novel OXA-51 from β-lactam-resistant Acinetobacter baumannii and its interaction with various antibiotics. J Mol Model 2012; 18:3351-61. [PMID: 22271096 DOI: 10.1007/s00894-011-1346-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 12/20/2011] [Indexed: 01/09/2023]
Abstract
Acinetobacter baumannii, one of the major Gram negative bacteria, causes nosocomial infections such as pneumonia, urinary tract infection, meningitis, etc. β-lactam-based antibiotics like penicillin are used conventionally to treat infections of A. baumannii; however, they are becoming progressively less effective as the bacterium produces diverse types of β-lactamases to inactivate the antibiotics. We have recently identified a novel β-lactamase, OXA-51 from clinical strains of A. baumannii from our hospital. In the present study, we generated the structure of OXA-51 using MODELLER9v7 and studied the interaction of OXA-51 with a number of β-lactams (penicillin, oxacillin, ceftazidime, aztreonam and imipenem) using two independent programs: GLIDE and GOLD. Based on the results of different binding parameters and number of hydrogen bonds, interaction of OXA-51 was found to be maximum with ceftazidime and lowest with imipenem. Further, molecular dynamics simulation results also support this fact. The lowest binding affinity of imipenem to OXA-51 indicates clearly that it is not efficiently cleaved by OXA-51, thus explaining its high potency against resistant A. baumannii. This finding is supported by experimental results from minimum inhibitory concentration analysis and transmission electron microscopy. It can be concluded that carbapenems (imipenem) are presently effective β-lactam antibiotics against resistant strains of A. baumannii harbouring OXA-51. The results presented here could be useful in designing more effective derivatives of carbapenem.
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Affiliation(s)
- Vishvanath Tiwari
- Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Amudhan SM, Sekar U, Arunagiri K, Sekar B. OXA beta-lactamase-mediated carbapenem resistance in Acinetobacter baumannii. Indian J Med Microbiol 2011; 29:269-74. [PMID: 21860108 DOI: 10.4103/0255-0857.83911] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Acinetobacter baumannii is a significant pathogen in health care settings. In recent years, an increase in carbapenem resistance among A. baumannii due to Ambler class B metallo-beta-lactamases or class D OXA carbapenamases has been reported. In this study we detected the presence of OXA carbapenamases and coproduction of metallo-beta-lactamases (blaVIM and blaIMP ) by phenotypic and genotypic methods in carbapenem resistant clinical isolates of Acinetobacter baumannii. MATERIALS AND METHODS A total of 116 consecutive, non-duplicate carbapenem resistant A. baumannii isolated from various clinical specimens were included in the study. The modified Hodge test and inhibitor potentiated disk diffusion tests were done for the screening of carbapenamase and metallo-beta-lactamase production, respectively. Polymerase chain reaction (PCR) was performed for the detection of OXA (blaOXA 23 like, blaOXA 24 like, blaOXA-51 like and blaOXA-58 like genes) and metallo-beta-lactamases (blaVIM and blaIMP ) genes. Gene sequencing was performed for representative isolates. RESULTS Among 116 A. baumannii, OXA genes were detected in 106 isolates. BlaOXA 51 like (n = 99) and blaOXA -23 like (n = 95) were the most common and they coexisted in 89 isolates. blaOXA-24 like gene was detected in two isolates of which one also carried blaOXA-51 like and blaOXA-58 like genes. The modified Hodge test was positive in 113 isolates. The metallo-beta-lactamase screening test was positive in 92 isolates. blavim was detected in 54 isolates of which 1 also carried the blaIMP gene. CONCLUSIONS blaOXA-23 like and bla OXA 51 like genes are the most common types of OXA carbapenamases while the blaVIM type is the most common type of metallo-beta-lactamase contributing to carbapenem resistance in clinical isolates of A. baumannii. The coproduction of OXA and metallo-beta-lactamases is not an uncommon phenomenon in A. baumannii.
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Affiliation(s)
- S M Amudhan
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, India
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Abstract
Pathogenic bacteria have increasingly been resisting to antimicrobial therapy. Recently, resistance problem has been relatively much worsened in Gram-negative bacilli. Acinetobacter spp. are typical nosocomial pathogens causing infections and high mortality, almost exclusively in compromised hospital patients. Acinetobacter spp. are intrinsically less susceptible to antibiotics than Enterobacteriaceae, and have propensity to acquire resistance. A surveillance study in Korea in 2009 showed that resistance rates of Acinetobacter spp. were very high: to fluoroquinolone 67%, to amikacin 48%, to ceftazidime 66% and to imipenem 51%. Carbapenem resistance was mostly due to OXA type carbapenemase production in A. baumannii isolates, whereas it was due to metallo-β-lactamase production in non-baumannii Acinetobacter isolates. Colistin-resistant isolates were rare but started to be isolated in Korea. Currently, the infection caused by multidrug-resistant A. baumannii is among the most difficult ones to treat. Analysis at tertiary care hospital in 2010 showed that among the 1,085 isolates of Acinetobacter spp., 14.9% and 41.8% were resistant to seven, and to all eight antimicrobial agents tested, respectively. It is known to be difficult to prevent Acinetobacter spp. infection in hospitalized patients, because the organisms are ubiquitous in hospital environment. Efforts to control resistant bacteria in Korea by hospitals, relevant scientific societies and government agencies have only partially been successful. We need concerted multidisciplinary efforts to preserve the efficacy of currently available antimicrobial agents, by following the principles of antimicrobial stewardship.
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Affiliation(s)
- Kyungwon Lee
- Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Dongeun Yong
- Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Yunsop Chong
- Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
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Jean SS, Hsueh PR. High burden of antimicrobial resistance in Asia. Int J Antimicrob Agents 2011; 37:291-5. [PMID: 21382699 DOI: 10.1016/j.ijantimicag.2011.01.009] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 01/07/2011] [Indexed: 01/29/2023]
Abstract
Antimicrobial resistance is associated with high mortality rates and high medical costs. Marked variations in the resistance profiles of bacterial and fungal pathogens as well as the quality of public hygiene have had a considerable impact on the effectiveness of antimicrobial agents in Asian countries. In Asia, one of the epicentres of antimicrobial drug resistance, there is an alarming number of antibiotic-resistant species, including penicillin- and erythromycin-resistant Streptococcus pneumoniae, ampicillin-resistant Haemophilus influenzae, multidrug-resistant (MDR) Acinetobacter baumannii, extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (particularly mediated by CTX-M-9, CTX-M-14 and CTX-M-15), New Delhi metallo-β-lactamase 1 (NDM-1)-producing Enterobacteriaceae, MDR Salmonella enterica serotypes Choleraesuis and Typhi, carbapenem-resistant A. baumannii (OXA-58 and OXA-23 carbapenemases) and azole-resistant Candida glabrata. A few clones of MDR A. baumannii and hospital-acquired meticillin-resistant Staphylococcus aureus (MRSA) have been widely disseminated in hospital settings in Asia, and K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae strains have been widely distributed in China. In addition, the emergence of extensively drug-resistant Mycobacterium tuberculosis (XDR-TB) has illustrated the need for regular monitoring of resistance profiles of clinical isolates as well as the deliberative use of fluoroquinolones. Continuous surveillance of resistance data from clinical isolates as well as implementation of strict infection control policies in healthcare settings are required to mitigate the progression of antimicrobial resistance.
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Affiliation(s)
- Shio-Shin Jean
- Departments of Intensive Care and Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
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Lee K, Lee MA, Lee CH, Lee J, Roh KH, Kim S, Kim JJ, Koh E, Yong D, Chong Y. Increase of ceftazidime- and fluoroquinolone-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter spp. in Korea: analysis of KONSAR study data from 2005 and 2007. Yonsei Med J 2010; 51:901-11. [PMID: 20879058 PMCID: PMC2995968 DOI: 10.3349/ymj.2010.51.6.901] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Antimicrobial resistance monitoring could be a useful source of information for treating and controlling nosocomial infections. We analyzed antimicrobial resistance data generated by Korean Hospitals and by a commercial laboratory in 2005 and 2007. MATERIALS AND METHODS Susceptibility data for 2005 and 2007 were collected from 37 and 41 hospitals, respectively, and from one commercial laboratory. Intermediate susceptibility was not included in the calculation of resistance rates. RESULTS Methicillin-resistant Staphylococcus aureus (MRSA) (64%), third-generation cephalosporin-resistant Klebsiella pneumoniae (29%), fluoroquinolone-resistant Escherichia coli (27%), Pseudomonas aeruginosa (33%), and Acinetobacter spp. (48%), and amikacin-resistant P. aeruginosa (19%) and Acinetobacter spp. (37%) were prevalent in hospitals in 2007. A gradual increase of vancomycin-resistant Enterococcus faecium and imipenem-resistant Acinetobacter spp. was observed. Higher incidences of thirdgeneration cephalosporin-resistant E. coli and K. pneumoniae and imipenemresistant P. aeruginosa were found in the commercial laboratory than in the hospitals. CONCLUSION Methicillin-resistant S. aureus, third-generation cephalosporin- resistant K. pneumoniae, and fluoroquinolone-resistant E. coli, P. aeruginosa and Acinetobacter spp. remain prevalent in Korea, while the incidence of vancomycin-resistant E. faecium and imipenem-resistant Acinetobacter spp. has increased gradually. The higher prevalences of third-generation cephalosporinresistant E. coli and K. pneumoniae, and imipenem-resistant P. aeruginosa in the commercial laboratory are a new concern.
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Affiliation(s)
- Kyungwon Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ae Lee
- Department of Laboratory Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Chae Hoon Lee
- Department of Laboratory Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Jongwook Lee
- Department of Laboratory Medicine, Konyang University Hospital, Daejeon, Korea
| | - Kyoung Ho Roh
- Department of Laboratory Medicine, Konyang University Hospital, Daejeon, Korea
| | - Sunjoo Kim
- Department of Laboratory Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Jin Ju Kim
- Department of Laboratory Medicine, Inha University Hospital, Incheon, Korea
| | - Eunmi Koh
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dongeun Yong
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yunsop Chong
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
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Andriamanantena TS, Ratsima E, Rakotonirina HC, Randrianirina F, Ramparany L, Carod JF, Richard V, Talarmin A. Dissemination of multidrug resistant Acinetobacter baumannii in various hospitals of Antananarivo Madagascar. Ann Clin Microbiol Antimicrob 2010; 9:17. [PMID: 20591154 PMCID: PMC2910008 DOI: 10.1186/1476-0711-9-17] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 06/30/2010] [Indexed: 11/10/2022] Open
Abstract
This study reports the dissemination of multidrug-resistant (MDR) OXA-23-producing Acinetobacter baumannii clones in hospitals in Antananarivo, Madagascar. A total of 53 carbapenem-resistant A. baumannii isolates were obtained from September 2006 to March 2009 in five hospitals. These resistant strains represent 44% of all A. baumannii isolates. The double disk synergy test was performed to screen for production of metallo-beta-lactamases. Polymerase chain reaction (PCR) and DNA sequencing were performed for the detection of bla(AmpC), bla(OXA-51),bla(OXA-23), bla(OXA-24), bla(IMP), bla(VIM). The presence of the insertion sequence ISAba1 relative to blaOXA-23 and blaOXA-51 was assessed by PCR. Isolates were typed by Rep-PCR. All the isolates were MDR and produced the OXA-23 carbapenemase, which was confirmed by sequencing. PCR analysis for AmpC and OXA-51 gave positive results for all strains studied. No isolates produced metallo-beta-lactamases. In all isolates ISAba1 laid upstream of blaOXA-23. The A. baumannii isolates were separated into two genotypes; genotype A had a higher prevalence (41 strains) than genotype B (12 strains). Genotype A was present in four hospitals, whilst genotype B had spread in two hospitals. The high frequency of MDR OXA-23-producing A. baumannii in various hospitals in Antananarivo is curious since carbapenems are not available in Madagascar, but it emphasises the need for infection control procedures and strict adherence to them to prevent the spread of these resistant organisms in Antananarivo and also the need to control the use of carbapenems in the future.
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