Prevalence of OXA-Type β-Lactamase Genes among Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates in Thailand

Thirapanmethee, Krit; Srisiri-A-Nun, Thayapa; Houngsaitong, Jantana; Montakantikul, Preecha; Khuntayaporn, Piyatip; Chomnawang, Mullika Traidej

doi:10.3390/antibiotics9120864

Cited by 27 publications

(21 citation statements)

References 40 publications

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“…The findings of our study are consistent with those of an earlier report [ 25 ]. A. baumannii showed extensive drug resistance, and the diverse XDR strains had been reported by other studies [ 27 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 62%

Molecular Epidemiology of Extensively Drug-Resistant mcr Encoded Colistin-Resistant Bacterial Strains Co-Expressing Multifarious β-Lactamases

et al. 2021

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Plasmid-mediated colistin resistance (Col-R) conferred by mcr genes endangers the last therapeutic option for multifarious β-lactamase-producing bacteria. The current study aimed to explore the mcr gene molecular epidemiology in extensively drug-resistant (XDR) bacteria. Col-R gram-negative bacterial strains were screened using a minimum inhibitory concentration (MIC) breakpoint ≥4 µg/mL. Resistant isolates were examined for mcr variants, extended-spectrum β-lactamase, AmpC, and carbapenemase genes using polymerase chain reaction (PCR). The MIC breakpoints for mcr-positive strains were determined using broth microdilution and E-test strips. Overall, 19/718 (2.6%) gram-negative rods (GNRs) harboring mcr were identified, particularly in pus (p = 0.01) and tracheal secretions (p = 0.03). Molecular epidemiology data confirmed 18/19 (95%) mcr-1 and 1/19 (5%) mcr-2 genes. Integron detection revealed 15/17 (88%) Int-1 and 2/17 (12%) Int-2. Common co-expressing drug-resistant β-lactamase genes included 8/16 (50%) blaCTM-1, 3/16 (19%) blaCTM-15, 3/3 (100%) blaCMY-2, 2/8 (25%) blaNDM-1, and 2/8 (25%) blaNDM-5. The MIC50 and MIC90 values (µg/mL) were as follows: Escherichia coli, 12 and 24; Klebsiella pneumoniae, 12 and 32; Acinetobacter baumannii, 8 and 12; and Pseudomonas aeruginosa, 32 and 64, respectively. Treatment of XDR strains has become challenging owing to the co-expression of mcr-1, mcr-2, multifarious β-lactamase genes, and integrons.

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Section: Discussionmentioning

confidence: 62%

Molecular Epidemiology of Extensively Drug-Resistant mcr Encoded Colistin-Resistant Bacterial Strains Co-Expressing Multifarious β-Lactamases

et al. 2021

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“…The prevalence of the bla oxa-23-like gene was found to be relatively high worldwide [ 5 , 24 , 25 ]. Thirapanmethee et al also reported that the OXA-23-like gene was the most common carbapenemase gene among CRAB clinical isolates in Thailand (68.31%) [ 26 ]. In addition, many new enzyme variants of OXA-24/40-like carbapenemases have been reported, including OXA-72.…”

Section: Discussionmentioning

confidence: 99%

“…According to the Acinetobacter MLST database, some Thai ST2 clones and an ST215 A. baumannii clone have been present in the database since 2010, indicating local distribution over time [ 36 ]. Our previous work demonstrated that most carbapenem-resistant Acinetobacter baumannii isolates (CRAB) in Thailand were ST2 clones, but some belonged to ST25, ST98, ST129, ST164, ST215, ST338, and ST745 [ 26 ]. In Asia, ST2 has been reported as the most prevalent sequence type of CRAB in China and Lebanon [ 24 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although CC1 and CC2 have been identified as the key clonal lineages globally, no isolates belonging to CC1 were detected in this study. CC2 was by far the most abundant A. baumannii clone, with a broad international distribution over many continents [ 26 , 47 – 50 ]. CC2 in the Pasteur scheme corresponds to CC92 in the Oxford scheme and international clone II, as previously identified [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

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Predominance of international clone 2 multidrug-resistant Acinetobacter baumannii clinical isolates in Thailand: a nationwide study

Khuntayaporn

Kanathum

Houngsaitong

et al. 2021

Ann Clin Microbiol Antimicrob

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Background Acinetobacter baumannii has emerged as one of the common multidrug resistance pathogens causing hospital-acquired infections. This study was conducted to elucidate the distribution of antimicrobial resistance genes in the bacterial population in Thailand. Multidrug-resistant A. baumannii (MDR A. baumannii) isolates were characterized phenotypically, and the molecular epidemiology of clinical isolates in 11 tertiary hospitals was investigated at a country-wide level. Methods A total of 135 nonrepetitive MDR A. baumannii isolates collected from tertiary care hospitals across 5 regions of Thailand were examined for antibiotic susceptibility, resistance genes, and sequence types. Multilocus sequence typing (MLST) was performed to characterize the spread of regional lineages. Results ST2 belonging to IC2 was the most dominant sequence type in Thailand (65.19%), and to a lesser extent, there was also evidence of the spread of ST164 (10.37%), ST129 (3.70%), ST16 (2.96%), ST98 (2.96%), ST25 (2.96%), ST215 (2.22%), ST338 (1.48%), and ST745 (1.48%). The novel sequence types ST1551, ST1552, ST1553, and ST1557 were also identified in this study. Among these, the blaoxa-23 gene was by far the most widespread in MDR A. baumannii, while the blaoxa-24/40 and blaoxa-58 genes appeared to be less dominant in this region. The results demonstrated that the predominant class D carbapenemase was blaOXA-23, followed by the class B carbapenemase blaNDM-like, while the mcr-1 gene was not observed in any isolate. Most of the MDR A. baumannii isolates were resistant to ceftazidime (99.23%), gentamicin (91.85%), amikacin (82.96%), and ciprofloxacin (97.78%), while all of them were resistant to carbapenems. The results suggested that colistin could still be effective against MDR A. baumannii in this region. Conclusion This is the first molecular epidemiological analysis of MDR A. baumannii clinical isolates at the national level in Thailand to date. Studies on the clonal relatedness of MDR A. baumannii isolates could generate useful data to understand the local epidemiology and international comparisons of nosocomial outbreaks.

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“…Mediterranean counties have documented the emergence of A. baumannii belonging to ST2, with fewer identified isolates belonging to ST1. 41 , 42 A Lebanon study reported the detection of ST2 A. baumannii harboring NDM-1. 43 Several studies from Pakistan have described the detection of A. baumannii ST2 clones.…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology of Extensively-Drug Resistant Acinetobacter baumannii Sequence Type 2 Co-Harboring blaNDM and blaOXA From Clinical Origin

Ejaz¹,

Ahmad²,

Younas

et al. 2021

IDR

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Background:The therapeutic management of carbapenem-resistant Acinetobacter baumannii (CR-AB) represents a serious challenge to the public health sector because these pathogens are resistant to a wide range of antibiotics, resulting in limited treatment options. The present study was planned to investigate the clonal spread of CR-AB in a clinical setting. Methodology: A total of 174 A. baumannii clinical isolates were collected from a tertiary care hospitals in Lahore, Pakistan. The isolates were confirmed by VITEK 2 compact system and molecular identification of recA and bla OXA-51 . Antimicrobial profile and the screening of carbapenem-resistant genes were carried out using VITEK 2 system and PCR, respectively. The molecular typing of the isolates was performed according to the Pasteur scheme. Results: Of the 174 A. baumannii isolates collected, the majority were isolated from sputum samples (46.5%) and in the intensive care unit (ICU, 75%). Among these, 113/174 (64.9%) were identified as CR-AB, and 49.5% and 24.7% harbored bla OXA-23 and bla NDM-1 , respectively. A total of 11 (9.7%) isolates co-harbored bla OXA-51 , bla NDM-1 , and bla OXA-23 . Interestingly, 46.9% of the CR-AB belonged to sequence type 2 (ST2; CC1), whereas 15.9% belonged to ST1 (CC1). All of the CR-AB isolates showed extensive resistance to clinically relevant antibiotics, except colistin. Conclusion:The study concluded CR-AB ST2 clone harboring bla OXA-23 and bla NDM-1 are widely distributed in Pakistan's clinical settings, which could result in increased mortality. Strict compliance with the National Action Plan on Antimicrobial Resistance is necessary to reduce the impacts of these strains.

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Prevalence of OXA-Type β-Lactamase Genes among Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates in Thailand

Cited by 27 publications

References 40 publications

Molecular Epidemiology of Extensively Drug-Resistant mcr Encoded Colistin-Resistant Bacterial Strains Co-Expressing Multifarious β-Lactamases

Molecular Epidemiology of Extensively Drug-Resistant mcr Encoded Colistin-Resistant Bacterial Strains Co-Expressing Multifarious β-Lactamases

Predominance of international clone 2 multidrug-resistant Acinetobacter baumannii clinical isolates in Thailand: a nationwide study

Molecular Epidemiology of Extensively-Drug Resistant Acinetobacter baumannii Sequence Type 2 Co-Harboring blaNDM and blaOXA From Clinical Origin

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