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High Frequency of Class I and II Integrons and the Presence of aadA2 and dfrA12 Gene Cassettes in the Clinical Isolates of Acinetobacter baumannii from Shiraz, Southwest of Iran. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm.119436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Acinetobacter baumannii is a global concern that causes healthcare-associated infections due to multidrug resistance against commercially available antimicrobial agents. Objectives: The present study was conducted to determine the antimicrobial susceptibility of A. baumannii isolates from clinical specimens in Shiraz, Iran. In addition, the possible relationship of susceptibility patterns with the presence of integrons and related gene cassettes is investigated. Methods: A. baumannii isolates were collected, and their susceptibility to various antibiotics was tested using the Kirby-Bauer disk diffusion method. Moreover, molecular analyses were performed to detect the presence of the OXA-51-like gene, as well as class I, II, and III integrons, and associated gene cassettes. Results: The majority of isolates were resistant to imipenem (99.4%), piperacillin (98.2%), gentamycin (98.2%), meropenem (97.7%), ceftazidime (95.4%), amikacin (95.4%), and trimethoprim-sulfamethoxazole (90.8%). All strains showed multidrug resistance to the tested antibiotics. The distribution analysis of integrons genes revealed that 90.2, 72.4, and 12.1% of the isolates carried intI1, intI2, and intI3 genes, respectively. Moreover, two types of prevalent gene cassettes, including aad and dfr, were detected in class 1 integron-carrying strains. Conclusions: The current study showed the high prevalence of A. baumannii isolates harboring integrons in our investigated medical center, which may indicate the distribution of multidrug resistance events. The different gene cassette arrays in the present study highlight the remarkable role of geographical issues in disseminating multidrug-resistant isolates. This could be attributed to distinct therapeutic interventions in different areas. The results demonstrate the necessity of continuous surveillance to prevent the distribution of multidrug resistance among A. baumannii strains in Iran.
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Al Bshabshe A, Joseph MRP, Assiri A, Omer HA, Hamid ME. A multimodality approach to decreasing ICU infections by hydrogen peroxide, silver cations, and compartmentalization. J Infect Public Health 2020; 13:1172-1175. [PMID: 32192905 DOI: 10.1016/j.jiph.2020.01.312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Hospital-acquired infections in the Intensive Care Unit (ICU) account for an increase in morbidity and mortality leading to serious health complications. This study aims to determine the effect of a multimodality approach including disinfection and physical separation on the infections prevailing in ICU. METHODS The study employed prospective cross-over analysis to assess the 738 individuals (560 males and 178 females) at the ICU, Aseer Central Hospital, Saudi Arabia. The intervention programs were carried out for 3 years (2013-2015). It included the application of hydrogen peroxide and silver cations, physical separation, and compartmentalization of ICU. Acinetobacter spp., E. coli, and staphylococci were isolated, identified, and used to evaluate the efficacy of the intervention program. RESULTS The results provide endotracheal tube as the main specimen type (34.7%) followed by blood (29.1%), tracheal secretion (7.7%), wound (6%), urine (5.7%), throat swab (5.4%), sputum (3.7%), and other specimens (7.7%). It also showed the infection rate decreased from 14.3% to 4% in the last three months after continuous interventions (R2 = 0.44). There was a decrease in the occurrence of bacteria after an intervention (p = 0.036). CONCLUSION The outcome of the study revealed that mist and separation measures offered a significant decrease in infections at the ICU as per the measurement of the most hazardous nosocomial pathogens.
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Atik TK, Atik B, Kilinç O, Bektöre B, Duran H, Selek BM, Ceken N, Baylan O, Özyurt M. Epidemiological evaluation of an Acinetobacter baumannii outbreak observed at an intensive care unit. Saudi Med J 2018; 39:767-772. [PMID: 30106413 PMCID: PMC6194996 DOI: 10.15537/smj.2018.8.22431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives: To reveal the relationship between clinical and environmental isolates, analyzing both phenotypic and molecular aspects, in an Acinetobacter baumannii (A. baumannii) epidemic, and to use the epidemiological data to determine the source of the epidemic, to identify potential risk factors, and inform the effort to prevent and manage future epidemics. Methods: Acinetobacter baumannii was isolated from 5 clinical samples in Sultan Abdulhamid Han Training and Research hospital, Istanbul, Turkey, for a week period. To determine potential sources of infection we established cultures surveillance. Microbiological identification and antibiotic susceptibility testing of A. baumannii were performed using conventional methods and automated identification system. Multiplex polymerase chain reaction (PCR) and pulsed-field gel electrophoresis (PFGE) were used for carbapenemase gene screening and clonal relationship evaluation. Results: Among the environmental samples, bacterial growth was observed in 3 of the sample cultures. Clinical and environmental samples collected from patients X and Y had phenotypically similar antibiotic susceptibility patterns. The clinical and environmental isolates from patients X and Y comprised the first cluster (6 isolates), the isolates from patient Z formed the second cluster (2 isolates). Conclusion: We detected that all outbreak-related isolates contained the same OXA-type carbapenemase genes. Phenotypic similarity, based on the analysis of antimicrobial susceptibility patterns, was correlated with genotypic similarity. These results suggest that monitoring antimicrobial resistance patterns with daily culture surveillance follow-ups, coupled with the use of amplification based methods to detect that clonal relationships are important for the early identification of outbreaks and rapid deployment of proper countermeasures to halt the spread of the causative agent.
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Affiliation(s)
- Tuğba K. Atik
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
| | - Bülent Atik
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
- Address correspondence and reprint request to: Dr. Tuğba K. Atik, Department of Microbiology, Balıkesir Atatürk City hospital, Balıkesir, Turkey. E-mail: ORCID ID: orcid.org/0000-0002-2433-1977
| | - Osman Kilinç
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
| | - Bayhan Bektöre
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
| | - Hülya Duran
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
| | - Burak M. Selek
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
| | - Nihan Ceken
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
| | - Orhan Baylan
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
| | - Mustafa Özyurt
- From the Department of Microbiology (K. Atik, Kilinç), and from the Department of Anesthesiology and Reanimation clinic (Atik), Balıkesir Atatürk City hospital, from the Department of Microbiology (Duran, çeken), Balıkesir Public hospital, Balıkesir, from the Department of Microbiology (Bektöre), Kars Harakani Public hospital, Kars, and from the Department of Microbiology (selek, Baylan, özyurt), Sultan Abdulhamid Han Training and Research hospital, Health Sciences University, İstanbul, Turkey
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Zhang YY, Liang ZX, Li CS, Chang Y, Ma XQ, Yu L, Chen LA. Whole-Genome Analysis of an Extensively Drug-Resistant Acinetobacter baumannii Strain XDR-BJ83: Insights into the Mechanisms of Resistance of an ST368 Strain from a Tertiary Care Hospital in China. Microb Drug Resist 2018; 24:1259-1270. [PMID: 29489445 DOI: 10.1089/mdr.2017.0246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acinetobacter baumannii is an important pathogen of nosocomial infections. Nosocomial outbreaks caused by antibiotic-resistant A. baumannii remain a significant challenge. Understanding the antibiotic resistance mechanism of A. baumannii is critical for clinical treatment. The purpose of this study was to determine the whole-genome sequence (WGS) of an extensively drug-resistant (XDR) A. baumannii strain, XDR-BJ83, which was associated with a nosocomial outbreak in a tertiary care hospital of China, and to investigate the antibiotic resistance mechanism of this strain. The WGS of XDR-BJ83 was performed using single-molecule real-time sequencing. The complete genome of XDR-BJ83 consisted of a 4,011,552-bp chromosome and a 69,069-bp plasmid. The sequence type of XDR-BJ83 was ST368, which belongs to clonal complex 92 (CC92). The chromosome of XDR-BJ83 carried multiple antibiotic resistance genes, antibiotic efflux pump genes, and mobile genetic elements, including insertion sequences, transposons, integrons, and resistance islands. The plasmid of XDR-BJ83 (pBJ83) was a conjugative plasmid carrying type IV secretion system. These results indicate that the presence of multiple antibiotic resistance genes, efflux pumps, and mobile genetic elements is likely associated with resistance to various antibiotics in XDR-BJ83.
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Affiliation(s)
- Yang-Yang Zhang
- 1 Department of Respiratory Medicine, Chinese PLA General Hospital , Beijing, China .,2 Department of Respiratory Medicine, Affiliated Hospital of Chengde Medical University , Chengde, China
| | - Zhi-Xin Liang
- 1 Department of Respiratory Medicine, Chinese PLA General Hospital , Beijing, China
| | - Chun-Sun Li
- 1 Department of Respiratory Medicine, Chinese PLA General Hospital , Beijing, China
| | - Yan Chang
- 3 Department of Respiratory Medicine, The General Hospital of the PLA Rocket Force , Beijing, China
| | - Xiu-Qing Ma
- 1 Department of Respiratory Medicine, Chinese PLA General Hospital , Beijing, China
| | - Ling Yu
- 1 Department of Respiratory Medicine, Chinese PLA General Hospital , Beijing, China
| | - Liang-An Chen
- 1 Department of Respiratory Medicine, Chinese PLA General Hospital , Beijing, China
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Al Bshabshe A, Joseph MRP, Al Hussein A, Haimour W, Hamid ME. Multidrug resistance Acinetobacter species at the intensive care unit, Aseer Central Hospital, Saudi Arabia: A one year analysis. ASIAN PAC J TROP MED 2016; 9:903-908. [PMID: 27633307 DOI: 10.1016/j.apjtm.2016.07.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/16/2016] [Accepted: 07/01/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To identify and to determine the antimicrobial susceptibility of Acinetobacter baumannii (A. baumannii) clinical isolates from ICU at Aseer Central Hospital. METHODS The study was conducted in the Intensive Care Unit, Aseer Central Hospital, Saudi Arabia over 13 months period (2014-2015). Acinetobacter species (n = 105) were isolated from various clinical samples. Isolates were identified using selected phenotypic criteria and confirmed using the Vitek 2 automated system. This system was used to determine the susceptibilities of 21 antimicrobial agents. Patients, isolates and drug data were analyzed using the SPSS statistical software package to determine some epidemiological and microbiological patterns. RESULTS Of the 105 stains, A. baumannii accounted for 49 (46.67%), A. baumannii complex, 19 (18.09%), A. baumannii/haemolyticus 32 (30.47), Acinetobacter haemolyticus 4 (3.81%), Acinetobater lwoffii 1 (0.95%) and unidentified Acinetobater species 2 (1.3%). Of the 105 Acinetobacter strains, 103 (98.1%) were found multidrug resistant (MDR). A. baumannii strain were 100% sensitive to colistin and 74.5% to trimethoprim + sulfamethoxazole. The remaining 19 antimicrobial agents revealed low or no sensitivities: amikacin 16.3%; ampicillin 7.7%; ceftazidime, 7.3%. Distribution of similar sensitivities was shown by other Acinetobacter species. Mean number of isolates from males and females indicates no statistical variation (P = 0.867) whereas age groups showed significant differences (P = 0.008) as it is clear from the high percentage of infected individuals more than 60 years followed by those aged 20-29 years old (19.05%). Upper respiratory tract (30.48%), lower respiratory tract (47.65%) and subcutaneous tissue (9.5%) were the main sources of Acinetobacter spp. but mean numbers of isolates from these specimens indicate no discrepancy between specimens (P = 0.731). CONCLUSIONS Acinetobacter species including A. baumannii were found MDR (98.1%) according to the current Acinetobacter spp. antimicrobial categorization. Approximately half of these strains were A. baumannii. All Acinetobacter species were 100% sensitive to colistin and to some extent to trimethoprim + sulfamethoxazole (74.5%). ICU-acquired pneumonia among patients over 60 years of age who spend prolong times at artificial ventilations made up the majority of the cases.
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Affiliation(s)
- Ali Al Bshabshe
- Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Martin R P Joseph
- Department of Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ali Al Hussein
- Intensive Care Unit, Aseer Central Hospital, Abha, Saudi Arabia
| | - Waleed Haimour
- Microbiology Laboratories, Aseer Central Hospital, Abha, Saudi Arabia
| | - Mohamed E Hamid
- Department of Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia.
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Qian Y, Dong X, Wang Z, Yang G, Liu Q. Distributions and Types of Multidrug-Resistant Acinetobacter baumannii in Different Departments of a General Hospital. Jundishapur J Microbiol 2015; 8:e22935. [PMID: 26487921 PMCID: PMC4609033 DOI: 10.5812/jjm.22935] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/31/2014] [Accepted: 11/04/2014] [Indexed: 11/18/2022] Open
Abstract
Background: Acinetobacter baumannii is the most prevalent strain in hospitals and different clinical departments. Objectives: The current study aimed to investigate the genetic characteristics and resistance mechanisms of A. baumannii isolated from clinical samples in Shaoxing people’s hospital affiliated to Zhejiang University, Shaoxing, China. Patients and Methods: Acinetobacter baumannii strains were isolated from blood, phlegm and skin of the patients hospitalized in different departments as respiratory medicine, plastic surgery and intensive care unit (ICU). Multilocus sequence typing (MLST) was used to characterize the isolates. Kirby-Bauer test was used to evaluate antibiotic resistance of the bacteria. The expression of resistance inducing genes was detected by reverse transcription polymerase chain reaction (RT-PCR). The results were analyzed and compared. Results: Two bacterial types, ST208, and ST218, were identified in all 140 samples. The ST208 mainly came from ICU and department of respiratory medicine, while ST218 from department of plastic surgery; 70.21% of ST208 and 84.78% of ST218 were carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-susceptible Acinetobacter baumannii (CSAB), respectively. Multidrug-resistance genes in CRAB isolated from the hospital mainly included, oxa-23, oxa-5, intl 1 and qaceΔ1-sul 1. Besides, the highest and lowest antibiotic resistance was observed in the strains isolated from blood samples and wounds, respectively. Conclusions: The distribution of AB varies in different clinical departments and samples. In the hospital under study, the main types of AB were ST208 and ST218. The genes which affect the ability of antibiotic-resistance were oxa-23, oxa-51, intl 1 and qaceΔ1-sul 1.
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Affiliation(s)
- Yaner Qian
- The Center of Clinical Laboratory, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, 312000, China
| | - Xuejun Dong
- The Center of Clinical Laboratory, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, 312000, China
| | - Zongxin Wang
- The Center of Clinical Laboratory, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, 312000, China
| | - Guocan Yang
- The Center of Clinical Laboratory, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, 312000, China
| | - Qi Liu
- The Center of Clinical Laboratory, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, 312000, China
- Corresponding author: Qi Liu, The Center of Clinical Laboratory, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, 312000, China. Fax: +86-57588228566, E-mail:
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