First report of blaOXA-23 in Acinetobacter baumannii isolates from Chilean hospitals

Carbapenem-resistant Acinetobacter baumannii is the top-ranked pathogen in the World Health Organization priority list of antibiotic-resistant bacteria. It emerged as a global pathogen due to the successful expansion of a few epidemic lineages, or international clones (ICs), producing acquired class D carbapenemases (OXA-type). During the past decade, however, reports regarding IC-I isolates in Latin America are scarce and are non-existent for IC-II and IC-III isolates. This study evaluates the molecular mechanisms of carbapenem resistance and the epidemiology of 80 non-duplicate clinical samples of A. baumannii collected from February 2014 through April 2016 at two tertiary care hospitals in Lima. Almost all isolates were carbapenem-resistant (97.5%), and susceptibility only remained high for colistin (95%). Pulsed-field gel electrophoresis showed two main clusters spread between both hospitals: cluster D containing 51 isolates (63.8%) associated with sequence type 2 (ST2) and carrying OXA-72, and cluster F containing 13 isolates (16.3%) associated with ST79 and also carrying OXA-72. ST2 and ST79 were endemic in at least one of the hospitals. ST1 and ST3 OXA-23-producing isolates were also identified. They accounted for sporadic hospital isolates. Interestingly, two isolates carried the novel OXA-253 variant of OXA-143 together with an upstream novel insertion sequence (ISAba47). While the predominant A. baumannii lineages in Latin America are linked to ST79, ST25, ST15, and ST1 producing OXA-23 enzymes, we report the emergence of highly resistant ST2 (IC-II) isolates in Peru producing OXA-72 and the first identification of ST3 isolates (IC-III) in Latin America, both considered a serious threat to public health worldwide.

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Emergence and spread of carbapenem-resistant Acinetobacter baumannii international clones II and III in Lima, Peru

Levy-Blitchtein

Roca

Plasencia-Rebata

et al. 2018

Emerging Microbes & Infections

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The epidemiology of carbapenemases in Latin America and the Caribbean

Escandón-Vargas

Reyes

Gutiérrez

et al. 2016

Expert Review of Anti-infective Therapy

106

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Enterobacteriaceae, Pseudomonas spp., and Acinetobacter spp. infections are major causes of morbidity and mortality, especially due to the emergence and spread of β-lactamases. Carbapenemases, which are β-lactamases with the capacity to hydrolyze or inactivate carbapenems, have become a serious concern as they have the largest hydrolytic spectrum and therefore limit the utility of most β-lactam antibiotics. Areas covered: Here, we present an update of the current status of carbapenemases in Latin America and the Caribbean. Expert commentary: The increased frequency of reports on carbapenemases in Latin America and the Caribbean shows that they have successfully spread and have even become endemic in some countries. Countries such as Brazil, Colombia, Argentina, and Mexico account for the majority of these reports. Early suspicion and detection along with implementation of antimicrobial stewardship programs in all healthcare settings are crucial for the control and prevention of carbapenemase-producing bacteria.

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Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Kurihara

Sales

Silva

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Introduction: The increase in the prevalence of multidrug-resistant Acinetobacter baumannii infections in hospital settings has rapidly emerged worldwide as a serious health problem. Methods: This review synthetizes the epidemiology of multidrug-resistant A. baumannii, highlighting resistance mechanisms. Conclusions: Understanding the genetic mechanisms of resistance as well as the associated risk factors is critical to develop and implement adequate measures to control and prevent acquisition of nosocomial infections, especially in an intensive care unit setting.

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First report of blaOXA-23 in Acinetobacter baumannii isolates from Chilean hospitals

Cited by 3 publications

References 5 publications

Emergence and spread of carbapenem-resistant Acinetobacter baumannii international clones II and III in Lima, Peru

Emergence and spread of carbapenem-resistant Acinetobacter baumannii international clones II and III in Lima, Peru

The epidemiology of carbapenemases in Latin America and the Caribbean

Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

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