Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

Molecular Detection of Carbapenem Resistance in Acinetobacter Baumannii Isolated From Patients in Khorramabad City, Iran

Author(s): Zeinab Babaie, Somayeh Delfani*, Faranak Rezaei, Fatemeh Norolahi, Somayeh Mahdian and Pegah Shakib

Volume 20, Issue 4, 2020

Page: [543 - 549] Pages: 7

DOI: 10.2174/1871526519666190517124314

Price: $65

Abstract

Background: Acinetobacter baumannii is an opportunistic pathogen, which causes a wide range of infections in hospitals, especially in intensive care units. Nowadays, due to the high resistance of Acinetobacter bumanni to antibiotics, this study, in addition to the phenotypic and genotypic investigations of drug resistance, focused on determining the molecular types of Acinetobacter baumannii isolated from patients in Khorramabad city by the pulsed-field gel electrophoresis (PFGE) method.

Materials and Methods: In this cross-sectional study, 50 samples of Acinetobacter baumannii were collected from educational hospitals in Khorramabad city, Iran, from January to August 2015. They were identified in the laboratory using biochemical tests and culture methods. After determining the drug resistance pattern by the disc diffusion method and percentage of resistance genes to carbapenems, Acinetobacter baumannii isolates were analyzed using the PFGE method using the Apa1 enzyme.

Results: The highest antibiotic resistance observed for Acinetobacter baumannii strains was against ampicillin-sulbactam (100%) and aztreonam (98%). The highest sensitivity was to polymixin B (100%) and colistin (94%), and also to the OXA-51-like gene present in all samples. The OXA-23-like gene was positive in 44 (88%) samples. PFGE results showed that Acinetobacterbaumannii strains had 33 different pulsotype patterns, of which 27 patterns had more than one strain and 23 had only one strain.

Conclusion: Due to the high resistance of Acinetobacter baumannii and its ease of spread and its ability to transfer resistance genes, resistance control methods should be used in the disinfection of hospital areas. Hospital staff should observe hygiene standards and there should also be a reduction in antibiotic use.

Keywords: Acinetobacter baumannii, antibiotic resistance, pulsed-field gel electrophoresis (PFGE), ampicillin-sulbactam, aztreonam, coccobacillus.

[1]
Peleg, A.Y.; Seifert, H.; Paterson, D.L. Acinetobacter baumannii: emergence of a successful pathogen. Clin. Microbiol. Rev., 2008, 21(3), 538-582.
[http://dx.doi.org/10.1128/CMR.00058-07] [PMID: 18625687]
[2]
Baumann, P. Isolation of Acinetobacter from soil and water. J. Bacteriol., 1968, 96(1), 39-42.
[http://dx.doi.org/10.1128/JB.96.1.39-42.1968] [PMID: 4874313]
[3]
Gaynes, R.P.; Edwards, J.R.; Jarvis, W.R.; Culver, D.H.; Tolson, J.S.; Martone, W.J. National Nosocomial Infections Surveillance System. Nosocomial infections among neonates in high-risk nurseries in the United States. Pediatrics, 1996, 98(3 Pt 1), 357-361.
[PMID: 8784356]
[4]
Bergogne-Bérézin, E.; Towner, K.J. Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin. Microbiol. Rev., 1996, 9(2), 148-165.
[http://dx.doi.org/10.1128/CMR.9.2.148] [PMID: 8964033]
[5]
Mak, J.K.; Kim, M-J.; Pham, J.; Tapsall, J.; White, P.A. Antibiotic resistance determinants in nosocomial strains of multidrug-resistant Acinetobacter baumannii. J. Antimicrob. Chemother., 2009, 63(1), 47-54.
[http://dx.doi.org/10.1093/jac/dkn454] [PMID: 18988680]
[6]
Boroumand, M.; Akhyani, H.; Sheikhvatan, M.; Yazdi, S.H.; Saboo-rian, R.; Hashemi, S. Evaluation of antimicrobial re-sistance of Acinetobacter baumannii to Imipenem, Ciporofloxacin and Ceftazidime using E Test. Iran. J. Public Health, 2009, 38(2), 130-133.
[7]
Seifert, H.; Baginski, R.; Schulze, A.; Pulverer, G. Antimicrobial susceptibility of Acinetobacter species. Antimicrob. Agents Chemother., 1993, 37(4), 750-753.
[http://dx.doi.org/10.1128/AAC.37.4.750] [PMID: 8494371]
[8]
Shi, Z-Y.; Liu, P.Y-F.; Lau, Y.; Lin, Y.; Hu, B-S.; Shir, J-M. Antimicrobial susceptibility of clinical isolates of Acinetobacter baumannii. Diagn. Microbiol. Infect. Dis., 1996, 24(2), 81-85.
[http://dx.doi.org/10.1016/0732-8893(96)00017-X] [PMID: 9147913]
[9]
Karah, N.; Sundsfjord, A.; Towner, K.; Samuelsen, Ø. Insights into the global molecular epidemiology of carbapenem non-susceptible clones of Acinetobacter baumannii. Drug Resist. Updat., 2012, 15(4), 237-247.
[http://dx.doi.org/10.1016/j.drup.2012.06.001] [PMID: 22841809]
[10]
Mo, G.X.; She, D.Y.; Guan, X.Z.; Cui, J.C.; Wang, R.; Chen, L.A. [Antimicrobial resistance and genotyping of Acinetobacter baumannii in ICU]. Zhonghua Jie He He Hu Xi Za Zhi, 2010, 33(9), 656-659.
[PMID: 21092631]
[11]
Michalopoulos, A.; Falagas, M.E. Treatment of Acinetobacter infections. Expert Opin. Pharmacother., 2010, 11(5), 779-788.
[http://dx.doi.org/10.1517/14656561003596350] [PMID: 20210684]
[12]
El Salabi, A.; Walsh, T.R.; Chouchani, C. Extended spectrum β-lactamases, carbapenemases and mobile genetic elements responsible for antibiotics resistance in Gram-negative bacteria. Crit. Rev. Microbiol., 2013, 39(2), 113-122.
[http://dx.doi.org/10.3109/1040841X.2012.691870] [PMID: 22667455]
[13]
Magnet, S.; Courvalin, P.; Lambert, T. Resistance-nodulation-cell division-type efflux pump involved in aminoglycoside resistance in Acinetobacter baumannii strain BM4454. Antimicrob. Agents Chemother., 2001, 45(12), 3375-3380.
[http://dx.doi.org/10.1128/AAC.45.12.3375-3380.2001] [PMID: 11709311]
[14]
Nemec, A.; Dolzani, L.; Brisse, S.; van den Broek, P.; Dijkshoorn, L. Diversity of aminoglycoside-resistance genes and their association with class 1 integrons among strains of pan-European Acinetobacter baumannii clones. J. Med. Microbiol., 2004, 53(Pt 12), 1233-1240.
[http://dx.doi.org/10.1099/jmm.0.45716-0] [PMID: 15585503]
[15]
SADEGHIFARD, NK; RANJBAR, R; GHASEMI, A A study of antimicrobial resistance of acinetobacterbaumannii and nonacinetobacterbaumannii strains isolated from three hospitals in Tehran., 2006.
[16]
Gu, B.; Tong, M.; Zhao, W.; Liu, G.; Ning, M.; Pan, S.; Zhao, W. Prevalence and characterization of class I integrons among Pseudomonas aeruginosa and Acinetobacter baumannii isolates from patients in Nanjing, China. J. Clin. Microbiol., 2007, 45(1), 241-243.
[http://dx.doi.org/10.1128/JCM.01318-06] [PMID: 17122024]
[17]
Liu, P.Y-F.; Wu, W-L. Use of different PCR-based DNA fingerprinting techniques and pulsed-field gel electrophoresis to investigate the epidemiology of Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Diagn. Microbiol. Infect. Dis., 1997, 29(1), 19-28.
[http://dx.doi.org/10.1016/S0732-8893(97)00080-1] [PMID: 9350411]
[18]
Nasonova, E.S. [Pulsed field gel electrophoresis: theory, instruments and applications]. Tsitologiia, 2008, 50(11), 927-935.
[PMID: 19140338]
[19]
Dehbalaei, M.A.; Najar-Peerayeh, S.; Behmanesh, M.; Taherikalani, M. Polyclonal Distribution of blaOXA-23 Gene Among Aci-netobacter baumannii Isolated from Intensive Care Unit Patients in Tehran; Pulsed-Field Gel Electrophoresis Analysis. Jundishapur J. Microbiol., 2018, 11(1)
[20]
Feizabadi, M.M.; Fathollahzadeh, B.; Taherikalani, M.; Rasoolinejad, M.; Sadeghifard, N.; Aligholi, M.; Soroush, S.; Mohammadi-Yegane, S. Antimicrobial susceptibility patterns and distribution of blaOXA genes among Acinetobacter spp. Isolated from patients at Tehran hospitals. Jpn. J. Infect. Dis., 2008, 61(4), 274-278.
[PMID: 18653968]
[21]
Rafei, R.; Dabboussi, F.; Hamze, M.; Eveillard, M.; Lemarié, C.; Gaultier, M-P.; Mallat, H.; Moghnieh, R.; Husni-Samaha, R.; Joly-Guillou, M.L.; Kempf, M. Molecular analysis of Acinetobacter baumannii strains isolated in Lebanon using four different typing methods. PLoS One, 2014, 9(12)e115969
[http://dx.doi.org/10.1371/journal.pone.0115969] [PMID: 25541711]
[22]
Lee, K.; Yong, D.; Jeong, S.H.; Chong, Y. Multidrug-resistant Acinetobacter spp.: increasingly problematic nosocomial pathogens. Yonsei Med. J., 2011, 52(6), 879-891.
[http://dx.doi.org/10.3349/ymj.2011.52.6.879] [PMID: 22028150]
[23]
Fournier, P.E.; Richet, H.; Weinstein, R.A. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin. Infect. Dis., 2006, 42(5), 692-699.
[http://dx.doi.org/10.1086/500202] [PMID: 16447117]
[24]
Towner, K.J. Acinetobacter: an old friend, but a new enemy. J. Hosp. Infect., 2009, 73(4), 355-363.
[http://dx.doi.org/10.1016/j.jhin.2009.03.032] [PMID: 19700220]
[25]
Wisplinghoff, H.; Schmitt, R.; Wöhrmann, A.; Stefanik, D.; Seifert, H. Resistance to disinfectants in epidemiologically defined clinical isolates of Acinetobacter baumannii. J. Hosp. Infect., 2007, 66(2), 174-181.
[http://dx.doi.org/10.1016/j.jhin.2007.02.016] [PMID: 17498843]
[26]
Prashanth, K.; Badrinath, S. In vitro susceptibility pattern of Acinetobacter species to commonly used cephalosporins, quinolones, and aminoglycosides. Indian J. Med. Microbiol., 2004, 22(2), 97-103.
[PMID: 17642704]
[27]
Van Looveren, M.; Goossens, H.; Group, A.S. ARPAC Steering Group Antimicrobial resistance of Acinetobacter spp. in Europe. Clin. Microbiol. Infect., 2004, 10(8), 684-704.
[http://dx.doi.org/10.1111/j.1469-0691.2004.00942.x] [PMID: 15301671]
[28]
Ruiz, M.; Marti, S.; Fernandez-Cuenca, F.; Pascual, A.; Vila, J. High prevalence of carbapenem-hydrolysing oxacillinases in epidemiologically related and unrelated Acinetobacter baumannii clinical isolates in Spain. Clin. Microbiol. Infect., 2007, 13(12), 1192-1198.
[http://dx.doi.org/10.1111/j.1469-0691.2007.01825.x] [PMID: 17850347]
[29]
Wang, S.H.; Sheng, W-H.; Chang, Y-Y.; Wang, L.H.; Lin, H.C.; Chen, M.L.; Pan, H.J.; Ko, W.J.; Chang, S.C.; Lin, F.Y. Healthcare-associated outbreak due to pan-drug resistant Acinetobacter baumannii in a surgical intensive care unit. J. Hosp. Infect., 2003, 53(2), 97-102.
[http://dx.doi.org/10.1053/jhin.2002.1348] [PMID: 12586567]
[30]
Hujer, K.M.; Hujer, A.M.; Hulten, E.A.; Bajaksouzian, S.; Adams, J.M.; Donskey, C.J.; Ecker, D.J.; Massire, C.; Eshoo, M.W.; Sampath, R.; Thomson, J.M.; Rather, P.N.; Craft, D.W.; Fishbain, J.T.; Ewell, A.J.; Jacobs, M.R.; Paterson, D.L.; Bonomo, R.A. Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. Antimicrob. Agents Chemother., 2006, 50(12), 4114-4123.
[http://dx.doi.org/10.1128/AAC.00778-06] [PMID: 17000742]
[31]
Simhon, A.; Rahav, G.; Shazberg, G.; Block, C.; Bercovier, H.; Shapiro, M. Acinetobacter baumannii at a tertiary-care teaching hospital in Jerusalem, Israel. J. Clin. Microbiol., 2001, 39(1), 389-391.
[http://dx.doi.org/10.1128/JCM.39.1.389-391.2001] [PMID: 11136809]
[32]
SA J-M; Sh, B. Risk factors and antimicrobial susceptibility in ventilator associated pneumonia: a brief report. Tehran Uni-versity Medical Journal TUMS Publications., 2012, 70(9), 577-582.
[33]
Zarrilli, R.; Giannouli, M.; Tomasone, F.; Triassi, M.; Tsakris, A. Carbapenem resistance in Acinetobacter baumannii: the molecular epidemic features of an emerging problem in health care facilities. J. Infect. Dev. Ctries., 2009, 3(5), 335-341.
[http://dx.doi.org/10.3855/jidc.240] [PMID: 19759502]
[34]
Szejbach, A.; Mikucka, A.; Bogiel, T.; Gospodarek, E. Usefulness of phenotypic and genotypic methods for metallo-beta-lactamases detection in carbapenem-resistant Acinetobacter baumannii strains. Med. Sci. Monit. Basic Res., 2013, 19, 32-36.
[http://dx.doi.org/10.12659/MSMBR.883744] [PMID: 23333953]
[35]
Sengstock, D.M.; Thyagarajan, R.; Apalara, J.; Mira, A.; Chopra, T.; Kaye, K.S. Multidrug-resistant Acinetobacter baumannii: an emerging pathogen among older adults in community hospitals and nursing homes. Clin. Infect. Dis., 2010, 50(12), 1611-1616.
[http://dx.doi.org/10.1086/652759] [PMID: 20462357]
[36]
Josheghani, S.B.; Moniri, R.; Firoozeh, F.; Sehat, M.; Dastehgoli, K.; Koosha, H. Emergence of bla OXA-Carrying Car-bapenem Resistance in Multidrug-Resistant Acinetobacter baumannii in the Intensive Care Unit. Iran. Red Crescent Med. J., 2017, 19(5)
[37]
Azimi, L.; Lari, A.R.; Talebi, M.; Namvar, A.E.; Jabbari, M. Comparison between phenotypic and PCR for detection of OXA-23 type and metallo-beta-lactamases producer Acinetobacter spp. GMS Hyg. Infect. Control, 2013, 8(2), Doc16.
[PMID: 24327942]
[38]
Shoja, S.; Moosavian, M.; Rostami, S.; Abbasi, F.; Tabatabaiefar, M.A.; Peymani, A. Characterization of oxacillinase and metallo-β-lactamas genes and molecular typing of clinical isolates of Acinetobacter baumannii in Ahvaz, South-West of Iran. Jundishapur J. Microbiol., 2016, 9(5)e32388
[http://dx.doi.org/10.5812/jjm.32388] [PMID: 27540456]
[39]
Shahcheraghi, F; Abbasalipour, M; Feizabadi, M; Ebrahimipour, G; Akbari, N Isolation and genetic characterization of metallo-β-lactamase and carbapenamase producing strains of Aci-netobacter baumannii from patients at Tehran hospitals. Iranian journal of microbiology., 2011, 3(2), 68.
[40]
NajarPeerayeh S; Karmostaji, AH. Distribution of OXA-type class D β-lactamase genes among nosocomial multi drug resistant Acinetobacter baumannii isolated in Teh-ran hospitals. Jundishapur J. Microbiol., 2013, 6(5), 1-5.
[41]
Salimizand, H; Modarresi, F; Azizi, O; Mansouri, S; Rahmati, M; Barkhordari, K. Antimicrobial Profile and Phenotypic Metallo-β-Lactamase Detection of Acinetobacter baumannii Isolated From Clinical and Environmental Specimens. Zahedan Journal of Research in Medical Sciences, 2015, 17(6)
[http://dx.doi.org/10.17795/zjrms993]
[42]
Peerayeh, S.N.; Karmostaji, A.; Sarasiabi, S.S.; Javadpour, S.; Davoodian, P.; Moradi, N. In vitro activity of tigecycline and colistin against clinical isolates of Acinetobacter baumannii in hospitals in Tehran and Bandar-Abbas, Iran. Electron. Physician, 2014, 6(3), 919-924.
[PMID: 25763168]
[43]
Khorsi, K.; Messai, Y.; Hamidi, M.; Ammari, H.; Bakour, R. High prevalence of multidrug-resistance in Acinetobacter baumannii and dissemination of carbapenemase-encoding genes blaOXA-23-like, blaOXA-24-like and blaNDM-1 in Algiers hospitals. Asian Pac. J. Trop. Med., 2015, 8(6), 438-446.
[http://dx.doi.org/10.1016/j.apjtm.2015.05.011] [PMID: 26194827]
[44]
Srinivasan, V.B.; Rajamohan, G.; Pancholi, P.; Stevenson, K.; Tadesse, D.; Patchanee, P.; Marcon, M.; Gebreyes, W.A. Genetic relatedness and molecular characterization of multidrug resistant Acinetobacter baumannii isolated in central Ohio, USA. Ann. Clin. Microbiol. Antimicrob., 2009, 8(1), 21.
[http://dx.doi.org/10.1186/1476-0711-8-21] [PMID: 19531268]
[45]
Lin, M-F.; Chang, K-C.; Lan, C-Y.; Chou, J.; Kuo, J-W.; Chang, C-K.; Liou, M.L. Molecular epidemiology and antimicrobial resistance determinants of multidrug-resistant Acinetobacter baumannii in five proximal hospitals in Taiwan. Jpn. J. Infect. Dis., 2011, 64(3), 222-227.
[PMID: 21617307]
[46]
Zarrilli, R.; Crispino, M.; Bagattini, M.; Barretta, E.; Di Popolo, A.; Triassi, M.; Villari, P. Molecular epidemiology of sequential outbreaks of Acinetobacter baumannii in an intensive care unit shows the emergence of carbapenem resistance. J. Clin. Microbiol., 2004, 42(3), 946-953.
[http://dx.doi.org/10.1128/JCM.42.3.946-953.2004] [PMID: 15004037]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy