Emergence of carbapenem-resistant Acinetobacter in a temperate north Indian State

Bali, Nargis; Fomda, Bashir Ahmad; Bashir, Humaira; Zahoor, Danish; Lone, Suhail; Koul, Parvaiz A

doi:10.1080/09674845.2013.11669950

Cited by 14 publications

(11 citation statements)

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“…Two samples (2.25%) were observed to be positive for both blaOXA51 and blaOXA23 genes. The results of our study show similarities with those of previous studies (Ciftci et al, 2010;Amudhan et al, 2011;Bali et al, 2013;Mohajeri et al, 2013). In a recent study, Ciftci et al (2010) identified the frequencies of blaOXA23, blaOXA51 and blaOXA58 genes in carbapenem-resistant A.baumannii clinical isolates.…”

Section: Discussionsupporting

confidence: 82%

“…Amudhan et al (2011) reported that blaOXA-23 and blaOXA 51 genes are the most common types of OXA carbapenamases. Bali et al (2013) reported that blaOXA-23 and blaOXA-51 were the major factors underlying the pathogenicity for carbapenem-resistant Acinetobacter. Mohajeri et al (2013) reported that blaOXA-51-like and blaOXA-23-like genes were the predominant mechanisms of resistance to imipenem in A. baumannii.…”

Section: Discussionmentioning

confidence: 99%

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Investigations on the genomic diversity of OXA from isolated Acinetobacter baumannii

Zhou

Wang

et al. 2015

Genet. Mol. Res.

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ABSTRACT. We distinguished the four OXA-type carbapenemase subgroup alleles present in 120 strains of Acinetobacter baumannii by using polymerase chain reaction (PCR) and investigated the distributions of the OXA subgroups in clinically isolated samples. Amplification of the OXA genes blaOXA-23, blaOXA-24, blaOXA-51, and blaOXA-58 was performed by multiplex PCR. Antibiotics susceptibility test was conducted for determine the sensitivity of the A. baumannii to clinical common used antibiotics by Kirby-Bauer method. Results revealed that 46 (51.69%) of the samples were positive for only the blaOXA51 gene and 41 (46.07%) were positive for both the blaOXA51 and blaOXA58 genes in the 89 isolates of A. baumannii. Among these, 45 were carbapenem-resistant and 44 carbapenem-sensitive. Strains containing either blaOXA51 or blaOXA58 showed resistance or sensitivity to carbapenems, respectively. A. baumannii isolated from intensive care units showed significantly higher resistance rate to Cefepime, Piperacillin-tazobactam, Amikacin, Ceftazidime, Cefotaxime, Sulfamethoxazole-trimethoprim, and Gentamicin than those isolated from other departments (P < 0.05). In conclusion, we found that the presence of blaOXA-51 and blaOXA-58 appears to convey a mechanism of resistance or sensitivity to carbapenems, respectively, in A. baumannii clinical isolates.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Investigations on the genomic diversity of OXA from isolated Acinetobacter baumannii

Zhou

Wang

et al. 2015

Genet. Mol. Res.

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“…Resistance rates are even higher in eastern and southern Europe, Latin America, and many Asian countries. Overall, the proportion of global XDR strains of A. baumannii has increased from Ͻ4% in 2000 to Ͼ60%, while the proportion of XDR strains of A. baumannii in some regional nosocomial settings has more recently approached 90% (27,31,35,42,43,(183)(184)(185)(186)(187)(188)(189)(190).…”

Section: Antibiotic Resistance Drives Outcomesmentioning

confidence: 99%

Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges

et al. 2017

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SUMMARY Acinetobacter is a complex genus, and historically, there has been confusion about the existence of multiple species. The species commonly cause nosocomial infections, predominantly aspiration pneumonia and catheter-associated bacteremia, but can also cause soft tissue and urinary tract infections. Community-acquired infections by Acinetobacter spp. are increasingly reported. Transmission of Acinetobacter and subsequent disease is facilitated by the organism's environmental tenacity, resistance to desiccation, and evasion of host immunity. The virulence properties demonstrated by Acinetobacter spp. primarily stem from evasion of rapid clearance by the innate immune system, effectively enabling high bacterial density that triggers lipopolysaccharide (LPS)–Toll-like receptor 4 (TLR4)-mediated sepsis. Capsular polysaccharide is a critical virulence factor that enables immune evasion, while LPS triggers septic shock. However, the primary driver of clinical outcome is antibiotic resistance. Administration of initially effective therapy is key to improving survival, reducing 30-day mortality threefold. Regrettably, due to the high frequency of this organism having an extreme drug resistance (XDR) phenotype, early initiation of effective therapy is a major clinical challenge. Given its high rate of antibiotic resistance and abysmal outcomes (up to 70% mortality rate from infections caused by XDR strains in some case series), new preventative and therapeutic options for Acinetobacter spp. are desperately needed.

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“…The results from recent reports (published from 2010) with a high number (Ͼ100) of sequential nonduplicate AB isolates tested are summarized in Table 2. Based on the summary in Table 2, carbapenem resistance rates in AB have generally exceeded 40% throughout all of India (53)(54)(55)(56)(57)(58)(59)(60), and OXA enzymes are the predominant carbapenemases in AB in India (61). CRAB remains a health care-associated opportunistic pathogen, and there are no significant reports of CRAB in the community in India to our knowledge.…”

Section: South Asiamentioning

confidence: 99%

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

et al. 2017

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SUMMARY Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.

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Emergence of carbapenem-resistant Acinetobacter in a temperate north Indian State

Cited by 14 publications

References 1 publication

Investigations on the genomic diversity of OXA from isolated Acinetobacter baumannii

Investigations on the genomic diversity of OXA from isolated Acinetobacter baumannii

Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

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