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Clonal Relatedness and Resistance Characteristics of Oxa-24 and -58 Producing Carbapenem-Resistant Acinetobacter Baumannii Isolates in Tehran, Iran Publisher Pubmed



Salehi B1 ; Ghalavand Z2 ; Mohammadzadeh M3 ; Maleki DT2 ; Kodori M2 ; Kadkhoda H2
Authors
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Authors Affiliations
  1. 1. Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Applied Microbiology Published:2019


Abstract

Aims: The present study was conducted to investigate the mechanism of carbapenem resistance and the molecular epidemiology of carbapenem-resistant Acinetobacter baumannii (CRAB) isolates collected from two nearby hospitals in Tehran, Iran. Methods and Results: A total of 180 CRAB isolates were studied. Antimicrobial susceptibility testing was performed using disk diffusion and Epsilometer tests. The detection of OXA-23, -24 and -58 was implemented for all isolates using polymerase chain reaction. Subsequently, isolates harbouring OXA-24 and -58 were investigated for the presence of resistance determinants of Ambler class A, metallo-β-lactamases (MBLs), and carbapenem-hydrolysing class D β-lactamases, ISAba1, and the genetic relatedness between them was analysed using pulsed-field gel electrophoresis (PFGE). All isolates were found to be resistant to imipenem with a MIC of ≥8 µg ml−1 and were susceptible to colistin with a MIC of ≤1·5 µg ml−1. Sixty percent of the isolates had OXA-23. OXA-24 and -58 were detected in 31 of 180 CRAB isolates. These chosen isolates were devoid of MBLs and blaSHV, blaC TX-M, blaVEBESBL genes. The PER determinant was detected in 38% of isolates as the most common extended spectrum β-lactamases (ESBLs). Of these isolates, 51·6% had OXA-23, and ISAba1 was found to be upstream of OXA-23 and OXA-51 in 16 and 8 isolates, respectively. The band patterns produced by PFGE showed nine clonal pulsotypes distributed between the two hospitals. Conclusion: The findings showed that the refractory CRAB isolates were transmitted intra- and inter-hospital, particularly in the ICU due to shortcomings in infection control surveillance. Significance and Impact of the Study: Carbapenem resistance is a substantial threat in the treatment of infections caused by A. baumannii due to limitations in the therapeutic options. © 2019 The Society for Applied Microbiology
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