OXA-23 and OXA-40 producing carbapenem-resistant Acinetobacter baumannii in Central Illinois

Koirala, Janak; Tyagi, Isha; Guntupalli, Lohitha; Koirala, Sameena; Chapagain, Udita; Quarshie, Christopher; Akram, Sami; Sundareshan, Vidya; Koirala, Sajan; Lawhorn, Jerry; Doi, Yohei; Olson, Michael E.

doi:10.1016/j.diagmicrobio.2020.114999

Cited by 11 publications

(5 citation statements)

References 35 publications

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“…Globally, the blaOXA23 gene has a high correlation with the carbapenem-resistant phenotype of AB, making it a powerful predictor for carbapenem resistance ( Piperaki et al, 2019 ; Zhang et al, 2021 ; Abouelfetouh et al, 2022 ). These findings are consistent with prior research studies conducted by our team and the others ( Oliveira et al, 2019 ; Douraghi et al, 2020 ; Koirala et al, 2020 ; Cui et al, 2021 ; Lombes et al, 2022 ; Zhang et al, 2022 ).…”

Section: Introductionsupporting

confidence: 93%

Development and clinical validation of a dual ddPCR assay for detecting carbapenem-resistant Acinetobacter baumannii in bloodstream infections

Kou,

Zhu,

Zhang

et al. 2024

Front. Microbiol.

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ObjectiveAcinetobacter baumannii (A. baumannii, AB) represents a major species of Gram-negative bacteria involved in bloodstream infections (BSIs) and shows a high capability of developing antibiotic resistance. Especially, carbapenem-resistant Acinetobacter baumannii (CRAB) becomes more and more prevalent in BSIs. Hence, a rapid and sensitive CRAB detection method is of urgent need to reduce the morbidity and mortality due to CRAB-associated BSIs.MethodsA dual droplet digital PCR (ddPCR) reaction system was designed for detecting the antibiotic resistance gene OXA-23 and AB-specific gene gltA. Then, the specificity of the primers and probes, limit of detection (LOD), linear range, and accuracy of the assay were evaluated. Furthermore, the established assay approach was validated on 37 clinical isolates and compared with blood culture and drug sensitivity tests.ResultsThe dual ddPCR method established in this study demonstrated strong primer and probe specificity, distinguishing CRAB among 21 common clinical pathogens. The method showed excellent precision (3 × 10−4 ng/μL, CV < 25%) and linearity (OXA-23: y = 1.4558x + 4.0981, R2 = 0.9976; gltA: y = 1.2716x + 3.6092, R2 = 0.9949). While the dual qPCR LOD is 3 × 10−3 ng/μL, the dual ddPCR’s LOD stands at 3 × 10−4 ng/μL, indicating a higher sensitivity in the latter. When applied to detect 35 patients with BSIs of AB, the results were consistent with clinical blood culture identification and drug sensitivity tests.ConclusionThe dual ddPCR detection method for OXA-23 and gltA developed in this study exhibits good specificity, excellent linearity, and a higher LOD than qPCR. It demonstrates reproducibility even for minute samples, making it suitable for rapid diagnosis and precision treatment of CRAB in BSIs.

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Section: Introductionsupporting

confidence: 93%

Development and clinical validation of a dual ddPCR assay for detecting carbapenem-resistant Acinetobacter baumannii in bloodstream infections

Kou,

Zhu,

Zhang

et al. 2024

Front. Microbiol.

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“…Among 86 AB isolates obtained during 2008–2015 in Central Illinois, 70.9% were nonsusceptible to carbapenems. Among the CRAB isolates, bla OXA-23 was the most frequently detected carbapenemase gene (52%) ( Koirala et al., 2020 ). However, it is suggested that ISAba1 is providing the promoter for bla OXA-51 and bla OXA-23 genes ( Turton et al., 2006 ).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance genes harbored in invasive Acinetobacter calcoaceticus-baumannii complex isolated from Korean children during the pre-COVID-19 pandemic periods, 2015–2020

Kang,

Kim,

Kim

et al. 2024

Front. Cell. Infect. Microbiol.

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BackgroundAcinetobacter baumannii (AB) has emerged as one of the most challenging pathogens worldwide, causing invasive infections in the critically ill patients due to their ability to rapidly acquire resistance to antibiotics. This study aimed to analyze antibiotic resistance genes harbored in AB and non-baumannii Acinetobacter calcoaceticus-baumannii (NB-ACB) complex causing invasive diseases in Korean children. MethodsACB complexes isolated from sterile body fluid of children in three referral hospitals were prospectively collected. Colistin susceptibility was additionally tested via broth microdilution. Whole genome sequencing was performed and antibiotic resistance genes were analyzed.ResultsDuring January 2015 to December 2020, a total of 67 ACB complexes were isolated from sterile body fluid of children in three referral hospitals. The median age of the patients was 0.6 (interquartile range, 0.1–7.2) years old. Among all the isolates, 73.1% (n=49) were confirmed as AB and others as NB-ACB complex by whole genome sequencing. Among the AB isolates, only 22.4% susceptible to carbapenem. In particular, all clonal complex (CC) 92 AB (n=33) showed multi-drug resistance, whereas 31.3% in non-CC92 AB (n=16) (P<0.001). NB-ACB showed 100% susceptibility to all classes of antibiotics except 3rd generation cephalosporin (72.2%). The main mechanism of carbapenem resistance in AB was the blaoxa23 gene with ISAba1 insertion sequence upstream. Presence of pmr gene and/or mutation of lpxA/C gene were not correlated with the phenotype of colistin resistance of ACB. All AB and NB-ACB isolates carried the abe and ade multidrug efflux pumps.ConclusionsIn conclusion, monitoring and research for resistome in ACB complex is needed to identify and manage drug-resistant AB, particularly CC92 AB carrying the blaoxa23 gene.

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“…Moreover, the P. aeruginosa isolate from patient 1 coproducing IMP and NDM carbapenemases also exhibited resistance to all antibiotics tested, including colistin and polymyxin B, which are considered last-line drugs for extensively drug-resistant gram-negative infections. 9 Although CRAB expressing OXA-23 like and OXA-40 has been previously reported in the United States, 10 coproduction of multiple variants of OXA-565 (OXA-23-like) and OXA-58 with NDM has never been reported.…”

Section: Discussionmentioning

confidence: 99%

Emergence of dual and multicarbapenemase coproducing organisms in the United States

Tadese

Olumuyiwa

Darkoh

2022

ASHE

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Carbapenemase-producing organisms commonly carry a single carbapenemase gene conferring resistant to carbapenems and other β-lactam antibiotics. Here, we report rare cases of multidrug-resistant Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii strains that coproduce multiple carbapenemases and exhibit extensive drug resistance. Such resistant strains are rarely identified in the United States.

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OXA-23 and OXA-40 producing carbapenem-resistant Acinetobacter baumannii in Central Illinois

Cited by 11 publications

References 35 publications

Development and clinical validation of a dual ddPCR assay for detecting carbapenem-resistant Acinetobacter baumannii in bloodstream infections

Development and clinical validation of a dual ddPCR assay for detecting carbapenem-resistant Acinetobacter baumannii in bloodstream infections

Antimicrobial resistance genes harbored in invasive Acinetobacter calcoaceticus-baumannii complex isolated from Korean children during the pre-COVID-19 pandemic periods, 2015–2020

Emergence of dual and multicarbapenemase coproducing organisms in the United States

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