OXA-235, a Novel Class D β-Lactamase Involved in Resistance to Carbapenems in Acinetobacter baumannii

Higgins, Paul G.; Pérez-Llarena, Francisco José; Zander, Esther; Fernández, Ana; Bou, Germán; Seifert, Harald

doi:10.1128/aac.02413-12

Cited by 198 publications

(153 citation statements)

References 35 publications

(53 reference statements)

Supporting

Mentioning

145

Contrasting

Unclassified

Order By: Relevance

“…Carbapenem resistance in Acinetobacter species is commonly associated with the presence of carbapenem-hydrolyzing class D ␤-lactamase-or oxacillinase-encoding genes such as bla and bla in Acinetobacter baumannii (7,8). A PCR assay and sequencing for all of the bla OXA genes frequently present in Acinetobacter species, i.e., bla OXA-23-like , bla OXA-51-like , bla OXA-40-like , and bla OXA-58-like , were performed (7-9).…”

Section: Case Reportmentioning

confidence: 99%

“…The isolate was resistant to all of the carbapenems tested, i.e., ceftazidime, cefotaxime, cefepime, cefoxitin, ticarcillin-clavulanic acid, trimethoprim-sulfamethoxazole, and ciprofloxacin (Table 1). Interestingly, this A. pittii isolate was susceptible to tetracycline, minocycline, colistin, and tigecycline (Table 1).Carbapenem resistance in Acinetobacter species is commonly associated with the presence of carbapenem-hydrolyzing class D ␤-lactamase-or oxacillinase-encoding genes such as bla and bla in Acinetobacter baumannii (7,8). A PCR assay and sequencing for all of the bla OXA genes frequently present in Acinetobacter species, i.e., bla OXA-23-like , bla OXA-51-like , bla OXA-40-like , and bla OXA-58-like , were performed (7-9).…”

mentioning

confidence: 99%

See 1 more Smart Citation

A Case of IMP-4-, OXA-421-, OXA-96-, and CARB-2-Producing Acinetobacterpittii Sequence Type 119 in Australia

et al. 2015

View full text Add to dashboard Cite

An IMP-4-producing Acinetobacter pittii strain coproducing oxacillinases was isolated from a leg wound of a 67-year-old female patient. Identification to the species level by rpoB and gyrB sequencing and multiplex-PCR-based analysis revealed that the isolate was A. pittii. Whole-genome sequencing of this A. pittii isolate determined the presence of bla OXA-96 , bla CARB-2 , and a novel bla OXA-421 gene. The position of this novel bla OXA-421 gene was similar to that of bla OXA-51 in A. baumannii, downstream of the phosphinothricin N-acetyltransferase gene and upstream of fxsA in the chromosome. This A. pittii isolate was found to belong to sequence type 119 (ST119). Here, we report the first isolation of IMP-4-producing A. pittii ST119 with a novel bla OXA-421 gene from a patient in Australia and characterize its draft genome. CASE REPORTA 67-year-old diabetic woman suffered a fall leading to a displaced distal spiral tibial plateau fracture. In the weeks prior to the fall, she had received multiple antimicrobials (clindamycin, lincomycin, cephalexin, ciprofloxacin, and ceftazidime) for an infected hematoma of the breast and a series of lower respiratory tract infections. The patient underwent definitive repair of the fracture but postoperatively developed osteomyelitis. Debridement of the leg wound was performed. Acinetobacter species and vancomycin-resistant Enterococcus strains were isolated from the tissue removed. This Acinetobacter species (CR12-42) was carbapenem resistant. Despite ongoing antibiotic treatment, the patient's leg required amputation in March 2013, after continuous inflammation, infections for more than 5 months, and an episode of severe Clostridium difficile infection resulting in colectomy. The leg infection was resolved by the amputation.The initial identification of this Acinetobacter species was done by Vitek 2. Antimicrobial susceptibility testing by Vitek 2 (bioMérieux) showed resistance to carbapenems, ceftazidime, ceftriaxone, cefepime, gentamicin, tobramycin, trimethoprimsulfamethoxazole, ticarcillin-clavulanic acid, and ciprofloxacin according to the EUCAST standard (1). The isolate was referred to our laboratory at the University of Queensland Centre for Clinical Research. The Acinetobacter isolate was identified to the species level by a gyrB multiplex PCR, which revealed that CR12-42 was Acinetobacter pittii (2). Partial rpoB sequencing (3) confirmed that CR12-42 was A. pittii.Phenotypic characterization to determine the class of carbapenemase was performed as previously described (4-6). The A. pittii isolate showed a metallo-␤-lactamase phenotype by producing a larger inhibition zone around carbapenem disks with EDTA than around carbapenem disks alone (Ͼ5-mm breakpoint increase in the size of the inhibition zone). The isolate also produced a positive result in the modified Hodge and Carba NP tests for carbapenemase production. MICs were determined with Etest (bioMérieux). The isolate was resistant to all of the carbapenems tested, i.e., ceftazidime, cefotaxime, cefepime, cefo...

show abstract

Section: Case Reportmentioning

confidence: 99%

mentioning

confidence: 99%

A Case of IMP-4-, OXA-421-, OXA-96-, and CARB-2-Producing Acinetobacterpittii Sequence Type 119 in Australia

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The most commonly identified examples are bla OXA-23-like (OXA-23, OXA-27, and OXA-49), bla OXA-24-like (OXA-24, OXA-25, OXA-26, OXA-40, and OXA-72), bla OXA-58-like , bla OXA-143-like (OXA-143, OXA-231, and OXA-253), bla , and bla OXA-51-like . The latter subgroup is intrinsic to A. baumannii species (8) (9) . Higher carbapenem hydrolysis rates have been reported to result from the acquisition of insertion sequences (ISs) that affect the expression of the bla OXA genes encoding oxacillinases (10) (11) (12) (13) (14) .…”

Section: Introductionmentioning

confidence: 99%

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

Kobs¹,

Ferreira

Bobrowicz

et al. 2016

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Introduction: Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Methods: Isolates identifi ed over 6 consecutive years in a general hospital in Joinville, Southern Brazil, were evaluated. The investigation of 5 families of genes encoding oxacillinases and the ISAba1 sequence location relative to bla OXA genes was conducted using polymerase chain reaction. Results: All isolates presented the bla OXA-51-like gene (n = 78), and 91% tested positive for the bla OXA-23-like gene (n = 71). The presence of ISAba1 was exclusively detected in isolates carrying the bla OXA-23-like gene. All isolates in which ISAba1 was found upstream of the bla OXA-23-like gene (n = 69) showed resistance to carbapenems, whereas the only isolate in which ISAba1 was not located near the bla OXA-23-like gene was susceptible to carbapenems. The ISAba1 sequence position of another bla OXA-23-like -positive isolate was inconclusive. The isolates exclusively carrying the bla OXA-51-like gene (n = 7) showed susceptibility to carbapenems. Conclusions: The presence of the ISAba1 sequence upstream of the bla OXA-23-like gene was strongly associated with carbapenem resistance in isolates of the A. calcoaceticus-A. baumannii complex in the hospital center studied.

show abstract

“…For critically ill patients with MDR infections, therapeutic options are limited, and colistin remains the last resource for treatment (5). Carbapenem resistance is mostly associated with the production of carbapenemhydrolyzing class D ␤-lactamases, including the acquired OXA-23, OXA-24, OXA-58, OXA-143, OXA-235, and the intrinsic OXA-51 enzyme (6,7). The significant contribution of OXA-type carbapenemases in A. baumannii has been emphasized, particularly when bla OXA genes are associated with ISAba sequences, which provide strong promoters for their expression (3).…”

mentioning

confidence: 99%

Epidemic Diffusion of OXA-23-Producing Acinetobacter baumannii Isolates in Italy: Results of the First Cross-Sectional Countrywide Survey

et al. 2014

View full text Add to dashboard Cite

e Carbapenem-resistant Acinetobacter baumannii (CRAb) is emerging worldwide as a public health problem in various settings. The aim of this study was to investigate the prevalence of CRAb isolates in Italy and to characterize their resistance mechanisms and genetic relatedness. A countrywide cross-sectional survey was carried out at 25 centers in mid-2011. CRAb isolates were reported from all participating centers, with overall proportions of 45.7% and 22.2% among consecutive nonreplicate clinical isolates of A. baumannii from inpatients (n ‫؍‬ 508) and outpatients (n ‫؍‬ 63), respectively. Most of them were resistant to multiple antibiotics, whereas all remained susceptible to colistin, with MIC 50 and MIC 90 values of <0.5 mg/liter. The genes coding for carbapenemase production were identified by PCR and sequencing. OXA-23 enzymes (found in all centers) were by far the most common carbapenemases (81.7%), followed by OXA-58 oxacillinases (4.5%), which were found in 7 of the 25 centers. In 6 cases, CRAb isolates carried both bla OXA-23-like and bla OXA-58-like genes. A repetitive extragenic palindromic (REP)-PCR technique, multiplex PCRs for group identification, and multilocus sequence typing (MLST) were used to determine the genetic relationships among representative isolates (n ‫؍‬ 55). Two different clonal lineages were identified, including a dominant clone of sequence type 2 (ST2) related to the international clone II (sequence group 1 [SG1], SG4, and SG5) and a clone of ST78 (SG6) previously described in Italy. Overall, our results demonstrate that OXA-23 enzymes have become the most prevalent carbapenemases and are now endemic in Italy. In addition, molecular typing profiles showed the presence of international and national clonal lineages in Italy.

show abstract

OXA-235, a Novel Class D β-Lactamase Involved in Resistance to Carbapenems in Acinetobacter baumannii

Cited by 198 publications

References 35 publications

A Case of IMP-4-, OXA-421-, OXA-96-, and CARB-2-Producing Acinetobacterpittii Sequence Type 119 in Australia

A Case of IMP-4-, OXA-421-, OXA-96-, and CARB-2-Producing Acinetobacterpittii Sequence Type 119 in Australia

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

Epidemic Diffusion of OXA-23-Producing Acinetobacter baumannii Isolates in Italy: Results of the First Cross-Sectional Countrywide Survey

Contact Info

Product

Resources

About