Multidrug-resistant Acinetobacter baumannii strains carrying the blaOxA-23 and the blaGES-11 genes in a neonatology center in Tunisia

Charfi, Karama; Mansour, Wejdène; Khalifa, A. Ben Haj; Mastouri, Maha; Nordmann, Patrice; Aouni, Mahjoub; Poirel, Laurent

doi:10.1016/j.micpath.2014.07.003

Cited by 33 publications

(25 citation statements)

References 23 publications

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“…The dissemination of OXA-23 in Lebanon is consistent with the worldwide epidemiology of OXA-23 (15) and with reports of neighbouring countries including Egypt (24), Iraq (28), Iran (29), and the United Arab Emirates (30). However, the co-existence of both OXAtype and GES-type carbapenemases in A. baumannii is not frequent although previously reported in Kuwait (31) and recently in Tunisia (32). In addition, another OXA family, OXA-24 (groups 5 and 6), was found in Lebanon, a carbapenemase that has been described in A.…”

Section: Discussionmentioning

confidence: 88%

Spread of imipenem-resistant Acinetobacter baumannii co-expressing OXA-23 and GES-11 carbapenemases in Lebanon

Halat

Moubareck

Hakime

et al. 2015

International Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 88%

Spread of imipenem-resistant Acinetobacter baumannii co-expressing OXA-23 and GES-11 carbapenemases in Lebanon

Halat

Moubareck

Hakime

et al. 2015

International Journal of Infectious Diseases

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“…GES variants have already been described in association with other ␤-lactamases, such as carbapenemases like VIM, IMP, or OXA-23, especially in P. aeruginosa and in A. baumannii isolates (15)(16)(17). GES-1 and GES-5 were the two first GES variants identified in an epidemic P. aeruginosa clone ST235 in Spain (18).…”

mentioning

confidence: 82%

Spread of Plasmids Carrying Multiple GES Variants

Cuzon

Bogaerts

Bauraing

et al. 2016

Antimicrob Agents Chemother

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e Five GES-producing Enterobacteriaceae isolates that displayed an extended-spectrum ␤-lactamase (ESBL) phenotype harbored two GES variants: GES-7 ESBL and GES-6 carbapenemase. In all isolates, the two GES alleles were located on the same integron that was inserted into an 80-kb IncM1 self-conjugative plasmid. Whole-genome sequencing suggested in vivo horizontal gene transfer of the plasmid along with clonal diffusion of Enterobacter cloacae. To our knowledge, this is the first description in Europe of clustered Enterobacteriaceae isolates carrying two GES ␤-lactamases, of which one has extended activity toward carbapenems. GES-type extended-spectrum ␤-lactamases (ESBLs) are increasingly reported in Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae (1, 2, 3). More than 27 GES variants have now been identified throughout the world (3). One feature of these enzymes is that they may modify their spectrum of hydrolysis by point mutations. GES-2 was the first described example of an ESBL that extended its spectrum of activity against carbapenems through a single point mutation (4). To date, at least 12 variants possess a substitution at position 170 and are theoretically able to hydrolyze carbapenems. Some variants also have the ability to hydrolyze cefoxitin (GES-4, GES-5, GES-6, and GES-11) and/or aztreonam (GES-9 and GES-14) (3). The bla GES genes have been essentially described as gene cassettes associated with class 1 or class 3 integrons on plasmids with different types of replicases (3, 5).Here, we describe enterobacterial isolates recovered from a Belgian hospital that harbored two variants of bla GES genes that were inserted back to back in the same integron, one coding for an ESBL and the second one coding for a carbapenemase.In May 2007, an ESBL-producing Enterobacter cloacae isolate (EB-1) was isolated from the stool sample of a two-year-old girl who was hospitalized in the pediatric surgical ward of a Belgian hospital for a follow-up after a second liver transplantation. This patient underwent a first transplantation in Israel in January 2006 and was transferred to Belgium for a second transplantation. During initial hospitalization, all of the stool samples obtained for screening of ESBL carriage remained negative. The child left the hospital in May 2006 and did not travel until rehospitalization in May 2007. One week after the first case, an ESBL-producing Citrobacter youngae isolate (EB-2), displaying a similar resistance pattern, was cultured from the urine sample of a 1-year-old girl who was hospitalized for acute pyelonephritis in the same ward. A third child, a 3-year-old boy transferred from Macedonia for a liver transplant in November 2007, was negative for ESBL carriage at admission. He was found to be colonized with ESBL-producing Enterobacteriaceae in December 2007, first with an E. cloacae isolate (EB-3) and then with another E. cloacae isolate (EB-4) and a K. pneumoniae isolate (EB-5).Antibiograms performed by disk diffusion and interpreted accord...

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“…16 blaOXA-66 and blaOXA-23 were found in two A. baumannii strains that were only sensitive to rifampin and colistin in 2011, 20 with the blaGES-11 ESBL gene being harbored on a GR6 plasmid (90 kb) in one of the isolates in which the OXA-23 carbapenemase was chromosomally encoded. The second isolate harbored the bla OXA-23 gene on a 90 kb GR6 plasmid (which harbored the aci6 replicase gene).…”

Section: Tunisiamentioning

confidence: 98%

“…The presence of the GR6 plasmids with blaOXA-48-like genes and blaGES-11/blaGES-14 has been widely detected, and shows the possibly endemic nature of these plasmids among CRAB strains in Tunisia. 3,20 Libya Clinical specimens from casualties of the Libyan conflict transferred to Europe, most of whom had not been hospitalized in Libya, 54 Table S1). 35,40 This suggests the possible endemicity of K. pneumoniae and A. baumannii producing carbapenemases in the Libyan community and underscores the need for thorough surveillance.…”

Section: Tunisiamentioning

confidence: 99%

The Molecular Epidemiology and Genetic Environment of Carbapenemases Detected in Africa

Sekyere

Govinden

Essack

2016

Microbial Drug Resistance

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Research articles describing carbapenemases and their genetic environments in Gram-negative bacteria were reviewed to determine the molecular epidemiology of carbapenemases in Africa. The emergence of resistance to the carbapenems, the last resort antibiotic for difficult to treat bacterial infections, affords clinicians few therapeutic options, with a resulting increase in morbidities, mortalities, and healthcare costs. However, the molecular epidemiology of carbapenemases throughout Africa is less described. Research articles and conference proceedings describing the genetic environment and molecular epidemiology of carbapenemases in Africa were retrieved from Google Scholar, Scifinder, Pubmed, Web of Science, and Science Direct databases. Predominant carbapenemase genes so far described in Africa include the blaOXA-48 type, blaIMP, blaVIM, and blaNDM in Acinetobacter baumannii, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter spp., and Escherichia coli carried on various plasmid types and sizes, transposons, and integrons. Class D and class B carbapenemases, mainly prevalent in A. baumannii, K. pneumoniae, E. cloacae, Citrobacter spp., and E. coli were the commonest carbapenemases. Carbapenemases are mainly reported in North and South Africa as under-resourced laboratories, lack of awareness and funding preclude the detection and reporting of carbapenemase-mediated resistance. Consequently, the true molecular epidemiology of carbapenemases and their genetic environment in Africa is still unknown.

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Multidrug-resistant Acinetobacter baumannii strains carrying the blaOxA-23 and the blaGES-11 genes in a neonatology center in Tunisia

Cited by 33 publications

References 23 publications

Spread of imipenem-resistant Acinetobacter baumannii co-expressing OXA-23 and GES-11 carbapenemases in Lebanon

Spread of imipenem-resistant Acinetobacter baumannii co-expressing OXA-23 and GES-11 carbapenemases in Lebanon

Spread of Plasmids Carrying Multiple GES Variants

The Molecular Epidemiology and Genetic Environment of Carbapenemases Detected in Africa

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