Molecular Epidemiology of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Tertiary Care Hospital in Egypt: Clonal Spread of <i>bla</i>OXA-23

Bannah, Afaf Mohamed Samy El; Nawar, Nada; Hassan, Reem; Salem, Sherifa T

doi:10.1089/mdr.2017.0057

Cited by 23 publications

(21 citation statements)

References 30 publications

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“…ST585 is the single loci variant (SLV) of ST391, which was first reported in India by Rynga et al [56]. Another study from Egypt showed that the study isolates belonging to ST391 carries bla OXA-23 alone or bla NDM alone or bla OXA-23 with bla KPC , which is in contrast to the current study where CIAT758 belongs to ST589 and carries bla OXA-23 with bla OXA-58 [36]. Such findings indicate that despite diverse sequence types, bla OXA-23 is the major contributor of carbapenem resistance in A. baumannii worldwide.…”

Section: Multi-locus Sequence Typing (Mlst)contrasting

confidence: 84%

“…Presence of bla OXA-23 and bla OXA-58 in six CRAB isolates was previously reported by Principe et al [35]. El Bannah et al reported that 86 % of carbapenem resistance could be due to the presence of either bla OXA-23 alone or bla OXA-23 together with bla KPC [36]. However, in this study bla OXA-23, bla OXA-58 and bla NDM-1 was present, but bla KPC was not observed.…”

Section: Resistance Determinantssupporting

confidence: 51%

“…Such findings indicate that despite diverse sequence types, bla OXA-23 is the major contributor of carbapenem resistance in A. baumannii worldwide. As discussed by El Bannah et al, certain STs are endemic in particular countries whereas others belong to a worldwide clonal complex and disseminate globally [36]. Similarly, a previous study by the same authors reported ST208 as the endemic sequence type, which is a SLV of globally disseminated ST92 [57].…”

Section: Multi-locus Sequence Typing (Mlst)mentioning

confidence: 89%

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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

Vijayakumar

Wattal

Oberoi

et al. 2020

Access Microbiology

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Carbapenem resistance in Acinetobacter baumannii is due to bla OXA-23, which is endemic in India. Recently, the sporadic presence of bla OXA-58 as well as the occurrence of dual carbapenemases were observed. The mobility as well as the dissemination of these resistance genes were mainly mediated by various mobile genetic elements. The present study was aimed at characterizing the genetic arrangement of bla OXA-23, bla NDM-1 and bla OXA-58 identified in two complete genomes of carbapenem-resistant A. baumannii (CRAB). Complete genomes obtained using a hybrid-assembly approach revealed the accurate arrangement of Tn2006 with bla OXA-23, ISAba125 with bla NDM and ISAba3 with bla OXA-58. In addition, the association of IntI1 integrase with the bla CARB-2 gene and several virulence factors required for type-IV pili assembly, motility and biofilm formation have been identified. The current study provided deeper insight into the complete characterization of insertion sequences and transposons associated with the carbapenem-resistant genes using short reads of IonTorrent PGM and long reads of MinIon in A. baumannii .

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Section: Multi-locus Sequence Typing (Mlst)contrasting

confidence: 84%

Section: Resistance Determinantssupporting

confidence: 51%

Section: Multi-locus Sequence Typing (Mlst)mentioning

confidence: 89%

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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

Vijayakumar

Wattal

Oberoi

et al. 2020

Access Microbiology

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“…The noticeable prevalence of bla OXA-23 -carrying Acinetobacter in Egypt is a crucial health-care concern that necessitates strict interventions to eliminate such infections [13] , [12] . Neither bla OXA-24 nor bla OXA-58 was found among the tested isolates.…”

Section: Discussionmentioning

confidence: 99%

First report of colistin resistance among carbapenem-resistant Acinetobacter baumannii isolates recovered from hospitalized patients in Egypt

Abdulzahra

Khalil

Elkhatib

2018

New Microbes and New Infections

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Acinetobacter baumannii is an opportunistic pathogen that poses an increasing threat in the health-care community. Colistin is one of the promising options for treatment of multidrug-resistant A. baumannii. The current study investigated the emergence of colistin resistance among carbapenem-resistant strains of A. baumannii in Egypt. It involved identification of clinically recovered A. baumannii isolates using the VITEK-2 system, and screening of their antimicrobial susceptibilities using broth microdilution techniques. Characterizations of carbapenemase and 16S rRNA methyltransferase genes were performed using PCR. Colistin-resistance determinants were characterized by sequencing. Carbapenem-resistant A. baumannii isolates (n = 40) showed resistance to amoxicillin-clavulanic acid, cefotaxime, gentamicin and amikacin. Most isolates revealed resistance to ciprofloxacin (95%; n = 38) and co-trimoxazole (92.5%; n = 37). Resistance to tobramycin and doxycycline was 80% (n = 32) and 62.5% (n = 25), respectively. Only two A. baumannii isolates demonstrated colistin resistance. Carbapenemase activity was tested by modified Hodge test and 78% of isolates were positive. All isolates carried blaOXA-51-like genes whereas bla-OXA-23 was detected in 80% (n = 32) of isolates. Among 16S rRNA methylase genes, armA was detected in 22.5% (n = 9) of the isolates. Analyses of lpxA, lpxC, lpxD and pmrCAB genetic sequences suggest that colistin resistance could be attributed to mutations in pmrCAB genes. Alarmingly, colistin resistance was associated with high levels of resistance to other antimicrobials. The current findings represent a serious health-care problem capable of restraining future therapeutic options.

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“…Our results showed that the bla OXA-23 gene existed in most CRAB isolates but was absent for most CSAB isolates, which indicated that bla OXA-23 was the major mechanism for carbapenem resistance of CRAB isolated from CSF and blood. The bla OXA-23 gene was also the most important mechanism for carbapenem resistance in CRAB in China [18,23] and some other countries [24][25][26]. On the other hand, the bla OXA-24 gene was another mechanism for carbapenem resistance, as bla OXA-24 -positive but bla OXA-23 -negative isolates in this study showed meropenem-resistance and imipenem-sensitive characteristics.…”

Section: Discussionmentioning

confidence: 46%

Molecular Characterization and Antibiotic Resistance of Acinetobacter baumannii in Cerebrospinal Fluid and Blood

Shi

Wang

et al. 2020

Preprint

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BackgroundThe increasing rates of carbapenem-resistant Acinetobacter baumannii (CRAB) caused nosocomial infections generate significant comorbidity and sometime cause death among patients. Current treatment options are limited. These infections pose great difficulties for infection control and clinical treatment. This study identifies the antimicrobial resistance, carbapenemases and genetic relatedness of A. baumannii isolates from cerebrospinal fluid (CSF) and blood in a hospital in Shandong, China. Methods A total of 50 nonrepetitive CSF A. baumannii isolates and 44 blood isolates were collected. The resistance phenotypes were determined according to the Clinical and Laboratory Standards Institute guidelines. We performed Polymerase Chain Reaction (PCR) experiments to detect the carbapenem resistance mechanism. Finally, we conducted Multilocus Sequence Typing (MLST) to depict the genetic relatedness of these isolates. Results We observed that eighty-eight of the 94 isolates collected were resistant to imipenem or meropenem. Among them, the bla OXA-23 gene was the most prevalent carbapenemase gene with a 91.5% (86/94) detection rate, followed by the bla OXA-24 gene that showed a 2.1% (2/94) detection rate isolates. Among all CRAB observations in this study, isolates with the bla OXA-23 gene were resistant to both imipenem and meropenem. However, isolates positive for the bla OXA-24 gene but negative for the bla OXA-23 gene showed an imipenem-sensitive but meropenem-resistant phenotype. The outcome of multilocus sequence typing analysis showed 21 different STs were distinguished, of which ST195 (25.5%), ST540 (12.8%) and ST208 (11.7%) were most frequently observed. Eighty of the 94 isolates (85.1%) were clustered into CC92, and all CC92 isolates showed a carbapenem resistance phenotype (except AB13). Five novel STs were detected, and most of them were CRAB, some of which belonged to CC92. Conclusion A high level of carbapenem resistance was detected in this study. The CC92 and bla OXA-23 gene were predominant. Five novel STs were detected, and these new STs require further investigation to understand the nature of and to prevent outbreaks caused by A. baumannii . Our study provides additional observations and epidemiological data of CSF and blood A. baumannii strains, which may improve future infection control measures and aid in potential clinical treatment in hospitals and other clinical settings.

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Molecular Epidemiology of Carbapenem-Resistant Acinetobacter baumannii in a Tertiary Care Hospital in Egypt: Clonal Spread of blaOXA-23

Cited by 23 publications

References 30 publications

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

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

First report of colistin resistance among carbapenem-resistant Acinetobacter baumannii isolates recovered from hospitalized patients in Egypt

Molecular Characterization and Antibiotic Resistance of Acinetobacter baumannii in Cerebrospinal Fluid and Blood

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