Widespread dissemination of multidrug-resistant Acinetobacter baumannii producing OXA-23 carbapenemase and ArmA 16S ribosomal RNA methylase in a Bulgarian university hospital

Markova, Boyka; Marteva-Proevska, Yulia; Ivanova, Dobrinka; Mitov, Ivan

doi:10.1590/s1413-86702012000300020

Cited by 3 publications

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“…For example, Doi et al (19) first discovered that two of five A. baumannii isolates coproduced OXA-23 β-lactamase and ArmA in North America in 2007. In addition, further cases were reported in Korea (20,23), India (24), France (25), Bulgaria (26), Italy (27), Latvia (28), East Africa (29), Yemen (30), Japan (31), Brunei (32), Egypt (33) and China (21,34,35). The authors of the present study previously determined that extended-spectrum β-lactamase and 16S rRNA methylase are coproduced in A. baumannii (36).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of carbapenemases among high-level aminoglycoside-resistant Acinetobacter baumannii isolates in a university hospital in China

Wang

Shen

Yang

et al. 2016

Experimental and Therapeutic Medicine

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The prevalence of aminoglycoside resistant enzymes has previously been reported and extended-spectrum β-lactamase among Acinetobacter baumannii. To track the risk of multidrug-resistant A. baumannii, the present study aimed to determine the prevalence of carbapenemases in high-level aminoglycoside resistant A. baumannii over two years. A total of 118 strains of A. baumannii were consecutively collected in the First Affiliated Hospital of Chengdu Medical College, Chengdu, China. These isolates were investigated on the genetic basis of their resistance to aminoglycosides. The results showed that 75 (63.56%) isolates were high-level resistant to aminoglycosides, including gentamicin and amikacin (minimum inhibitory concentration, ≥256 µg/ml). Aminoglycoside-resistant genes ant(2″)-Ia, aac(6′)-Ib, aph(3′)-Ia, aac(3)-Ia, aac(3)-IIa, armA, rmtA, rmtB, rmtC, rmtD, rmtE, rmtF, rmtG, rmtH and npmA, and carbapenem-resistant genes blaOXA-23, blaOXA-24, blaOXA-51, blaOXA-58, blaSIM, blaIMP, blaNDM-1 and blaKPC, were analyzed using polymerase chain reaction. The positive rate of ant(2″)-Ia, aac(6′)-Ib, aph(3′)-Ia, aac(3)-Ia and aac(3)-IIa was 66.95, 69.49, 42.37, 39.83 and 14.41%, respectively. armA was present in 72.0% (54/75) of A. baumannii isolates with high-level resistance to aminoglycosides. The remaining nine 16S ribosomal RNA methlyase genes (rmtA, rmtB, rmtC, rmtD, rmtE, rmtF, rmtG, rmtH and npmA) and aminoglycoside-modifying enzyme gene aac(6′)-Ib-cr were not detected. Among the 54 armA-positive isolates, the prevalence of the carbapenem resistant blaOXA-23 and blaOXA-51 genes was 79.63 and 100%, respectively. armA, ant(2″)-Ia and aac(6′)-Ib were positive in 43 isolates. The results of multilocus sequence typing revealed 31 sequence types (STs) in all clinical strains. Among these STs, the high-level aminoglycoside-resistant A. baumannii ST92, which mostly harbored blaOXA-23, was the predominant clone (29/75). In conclusion, A. baumannii harboring carbapenemases and aminoglycoside-resistant enzymes are extremely prevalent in western China, emphasizing the need to adopt surveillance programs to solve the therapeutic challenges that this presents.

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Section: Introductionmentioning

confidence: 99%

Prevalence of carbapenemases among high-level aminoglycoside-resistant Acinetobacter baumannii isolates in a university hospital in China

Wang

Shen

Yang

et al. 2016

Experimental and Therapeutic Medicine

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“…Две независими проучвания в България доказаха, че свръхекспресията на MexXY-OprM ефлукс помпата е главна причина за карбапенемна резистентност при изолатите P. aeruginosa (16,28). При A. baumannii продукцията на OXA-23 карбапенемази е определящ фактор за този тип резистентност (17,(23)(24)(25).…”

Section: цел и методологияunclassified

Contemporary Therapeutic Options In Carbapenem-Resistant Non-Fermenters In Bulgaria

Petrova

Murdjeva

2018

vmf

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Въведение: Неферментиращите бактерии с клинично значение Acinetobacter baumannii и Pseudomonas aeruginosa, обичайно считани за опортюнистични патогени, днес заплашват да се превърнат в едни от най-проблемните причинители на инфекции. Терапевтичните рестрикции от една страна се дължат на тяхната вродена резистентност към широк набор от антибиотици, а от друга -на все по-нарастващата придобита резистентност. Цел: Да се анализират най-честите механизми на карбапенемна резистентност сред неферментиращите бактерии в страната и да се препоръчат опции за справяне с терапевтичните рестрикции. Методи: Обикновено се използват както фенотипни, така и генетични методи за определяне на резистентност към карбапенеми. Най-чести фенотипни методи за детекция на карбапенемази при неферментиращите бактерии са Модифицираният Ходж тест и Carba NP-тестът. Класически PCR се използва за доказване на гени, кодиращи карбапенемази, а qRT-PCR -за оценка на експресията на ключови ефлукс помпи, вродената AmpC и трансмембранния OprD-рецептор при Pseudomonas. Резултати и обсъждане: Две независими проучвания в България доказаха, че свръхекспресията на MexXY-OprM ефлукс помпата е главна при- ABSTRACT Introduction:The non-fermenters of clinical significance Acinetobacter baumannii and Pseudomonas aeruginosa, usually considered as opportunistic pathogens, nowadays emerge to evolve in some of the most problematic causative agents of infections. The therapeutic restrictions are determined on one hand due to their intrinsic resistance to a great variety of antibiotics and on the other, due to the arising acquired resistance.Aim: The aim of this article is to analyze the most often detected mechanisms of carbapenem resistance among non-fermenters in the country and to recommend options to manage the therapeutic restrictions.Methods: Both methods -phenotypic and genetic, are usually combined to evaluate the mechanisms of resistance to carbapenems. As phenotypic tests for detection of common carbapenemases a Modified Hodge test and a Carba NP-test are used. A classical PCR investigation is used to detect the most frequent carbapenemases for both microorganisms and a qRT-PCR to assess the expression of main efflux pumps, the intrinsic AmpC and the transmembrane receptor OprD in Pseudomonas.Results and Discussion: Two independent studies proved that in Bulgarian clinical isolates P. aeruginosa, the increased expression or overexpression of MexXY-OprM efflux pump, is the main mechanism of determining carbapenem resistance. The main reason for carbapenem resistance in A. baumannii iso-

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Antimicrobial Resistance Determinants in Acinetobacter baumannii Isolates Taken from Military Treatment Facilities

Taitt

Łęski

Stockelman

et al. 2014

Antimicrob Agents Chemother

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c Multidrug-resistant (MDR) Acinetobacter baumannii infections are of particular concern within medical treatment facilities, yet the gene assemblages that give rise to this phenotype remain poorly characterized. In this study, we tested 97 clinical A. baumannii isolates collected from military treatment facilities (MTFs) from 2003 to 2009 by using a molecular epidemiological approach that enabled for the simultaneous screening of 236 antimicrobial resistance genes. Overall, 80% of the isolates were found to be MDR, each strain harbored between one and 17 resistant determinants, and a total of 52 unique resistance determinants or gene families were detected which are known to confer resistance to ␤-lactam (e.g., bla GES-11 , bla TEM , bla OXA-58 ), aminoglycoside (e.g., aphA1, aacC1, armA), macrolide (msrA, msrB), tetracycline [e.g., tet(A), tet(B), tet(39)], phenicol (e.g., cmlA4, catA1, cat4), quaternary amine (qacE, qacE⌬1), streptothricin (sat2), sulfonamide (sul1, sul2), and diaminopyrimidine (dfrA1, dfrA7, dfrA19) antimicrobial compounds. Importantly, 91% of the isolates harbored bla OXA-51-like carbapenemase genes (including six new variants), 40% harbored the bla OXA-23 carbapenemase gene, and 89% contained a variety of aminoglycoside resistance determinants with up to six unique determinants identified per strain. Many of the resistance determinants were found in potentially mobile gene cassettes; 45% and 7% of the isolates contained class 1 and class 2 integrons, respectively. Combined, the results demonstrate a facile approach that supports a more complete understanding of the genetic underpinnings of antimicrobial resistance to better assess the load, transmission, and evolution of MDR in MTF-associated A. baumannii.

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Widespread dissemination of multidrug-resistant Acinetobacter baumannii producing OXA-23 carbapenemase and ArmA 16S ribosomal RNA methylase in a Bulgarian university hospital

Cited by 3 publications

References 4 publications

Prevalence of carbapenemases among high-level aminoglycoside-resistant Acinetobacter baumannii isolates in a university hospital in China

Prevalence of carbapenemases among high-level aminoglycoside-resistant Acinetobacter baumannii isolates in a university hospital in China

Contemporary Therapeutic Options In Carbapenem-Resistant Non-Fermenters In Bulgaria

Antimicrobial Resistance Determinants in Acinetobacter baumannii Isolates Taken from Military Treatment Facilities

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