First Report of bla _NDM and bla _OXA-58 Coexistence in Acinetobacter junii

Abstract

A cinetobacter species are a major cause of hospital-acquired infections, especially in intensive care units (ICUs) (1). This, in part, is due to the bacteria's ability to survive long-term on hospital environment surfaces and their ability to acquire antibiotic resistance genes (2). One of the Acinetobacter species most often associated with high morbidity and mortality is A. baumannii (1). However, other Acinetobacter species have also been associated with acquiring broad-spectrum antibiotic resistance genes and causing severe disease (3-6). Here we report the isolation of an A. junii strain that was resistant to all ␤-lactam antibiotics, including the carbapenems, and the aminoglycosides. This isolate's carbapenem resistance mechanism was a result of acquiring two carbapenem resistance genes, bla NDM-1 and bla OXA-58. To our knowledge, this is the first report of the coexistence of bla NDM-1 and bla OXA-58 in A. junii. The A. junii strain was isolated from surveillance swabs collected from a 5-day-old baby girl who was referred to Caritas Baby Hospital (CBH) on 9 October 2012 from another hospital located in the northern part of Palestine. Upon admission to CBH's pediatric ward, surveillance (nose, rectal, and umbilical) swabs were collected from the patient on Copan Transystem swabs (Copan Diagnostics, Corona, CA) and transferred to the clinical laboratory within 30 min. This is part of the infection control policies that were followed at CBH to evaluate the presence of bacteria resistant to broad-spectrum antibiotics in high-risk patients referred from other medical institutions. The Caritas Baby Hospital Medical Research Committee approved the study (MRC-14). The specimens were inoculated on a selective agar medium (MacConkey-cefotaxime [10 g/ml] and MacConkey-meropenem [0.5 g/ml]) and incubated for 24 h at 37°C as previously described (7, 8). A weakly lactose-fermenting, oxidase-negative, Gram-negative coccobacillus was isolated on both selective media and was presumptively identified as Acinetobacter species. The identification of the isolate as A. junii was obtained after sequencing the first 500 bp of the amplified 16S rRNA gene as previously described (9). Antimicrobial susceptibility testing was performed by disk diffusion (Oxoid, United Kingdom) according to the standards of the Clinical and Laboratory Standards Institute (10). For the antimicrobial agent colistin, we used the Etest (AB Biodisk; bioMérieux, France) to determine its MIC. The antibiogram showed a total resistance to all ␤-lactam antibiotics and the aminoglycosides (Table 1). On the other hand, the isolate was susceptible to the fluoroquinolones, tetracyclines, trimethoprim-sulfamethoxazole, and colistin (Table 1). In order to identify the carbapenem resistance mechanism that mediated A. junii's resistance, PCR using primers for the class A carbapenemases (bla NCM , bla SME , bla IMI , bla GES , and bla KPC), the class D oxacillinases (bla OXA-58-like , bla OXA-23-like , bla OXA-24-like , bla OXA-51-like , bla OXA-23 , bla OXA-24 , bla ...

Insights into the complete genomes of carbapenem-resistant Acinetobacter baumannii harbouring bla OXA-23, bla OXA-420 and bla NDM-1 genes using a hybrid-assembly approach

“…The genome ACN21 was devoid of bla OXA-23 , while the presence of bla NDM-1 and bla OXA-420 could be encoding for carbapenem resistance. In ACN21, bla NDM-1 resides in chromosome and bla OXA-420 in plasmids whereas previous studies reported the co-presence of bla NDM and bla OXA-58 on the same plasmid [31][32][33][34]. In CIAT 758, bla OXA-58 was carried on the plasmid (Table 1).…”

Genomic study of Acinetobacter baumannii strains co-harboring blaOXA-58 and blaNDM-1 reveals a large multidrug-resistant plasmid encoding these carbapenemases in Brazil

“…Only the strains isolated in Malaysia and China have the bla OXA-58 and bla NDM-1 genes located on the same plasmid ( Alattraqchi et al, 2021 ; Liu et al, 2021 ) ( Figure 2B ), while in the Algerian isolate, the genes were chromosomally located ( Ramoul et al, 2016 ), and the genome of the Japanese strain is a draft ( Oinuma et al, 2016 ). Other non- baumannii Acinetobacter carrying bla OXA-58 and bla NDM-1 genes have been reported from Malaysia ( Alattraqchi et al, 2021 ), China ( Zhou et al, 2015 ; Chen et al, 2019 ; Li et al, 2022a , b ), and Palestine ( Regeen et al, 2014 ). Of these reports, three isolates were sequenced and found to carry these genes on the same plasmids ( Alattraqchi et al, 2021 ; Li et al, 2022a , b ) ( Figure 2B ).…”

A Case of Acinetobacter junii Cavitary Pneumonia With Bacteremia in a Patient With Systemic Lupus Erythematosus

“…Curiously in the same study, the authors noted that over the study period, a significant proportion of strains developed Colistin resistance (35%). Carbapenem-resistant A. junii infections have been recently reported in the literature [ 20 ].…”