Molecular characterization of carbapenem-insensitive Acinetobacter baumannii in Egypt
Al-Agamy M.H.; Khalaf N.G.; Tawfick M.M.; Shibl A.M.; El Kholy A.A.
Date issued:
2014
Publisher:
Elsevier B.V.
Series Info:
International Journal of Infectious Diseases
22
Type:
Article
Keywords:
Antimicrobial resistance
,
Carbapenem-insensitive Acinetobacter baumannii
,
ESBL
,
PCR
,
amikacin
,
amoxicillin
,
aztreonam
,
beta lactamase
,
carbapenem
,
carbapenemase
,
cefepime
,
cefotaxime
,
ceftazidime
,
ciprofloxacin
,
clavulanic acid
,
colistin
,
imipenem
,
antiinfective agent
,
carbapenem derivative
,
Acinetobacter baumannii
,
antibiotic resistance
,
article
,
bacterial gene
,
bacterial genetics
,
bacterium detection
,
bacterium isolate
,
Egypt
,
gene identification
,
minimum inhibitory concentration
,
nonhuman
,
phenotype
,
polymerase chain reaction
,
upregulation
,
Acinetobacter baumannii
,
Acinetobacter Infections
,
antibiotic resistance
,
classification
,
enzymology
,
epidemiology
,
female
,
gene expression
,
genetics
,
human
,
isolation and purification
,
male
,
metabolism
,
microbial sensitivity test
,
microbiology
,
molecular epidemiology
,
plasmid
,
Acinetobacter baumannii
,
Acinetobacter Infections
,
Anti-Bacterial Agents
,
beta-Lactam Resistance
,
beta-Lactamases
,
Carbapenems
,
Egypt
,
Female
,
Gene Expression
,
Humans
,
Male
,
Microbial Sensitivity Tests
,
Molecular Epidemiology
,
Plasmids
Abstract:
Objectives: This study investigated the prevalence of diverse Ambler class ?-lactamase-encoding genes in 40 carbapenem-insensitive Acinetobacter baumannii isolates collected from two hospitals in Egypt during the period January-March 2012. Methods: The resistance levels to different groups of antimicrobial agents were determined. PCR was used to detect the different Ambler class ?-lactamases encoding the following genes: blaTEM, blaSHV, blaCTX-M, blaVEB, blaPER, blaGES, blaVIM, blaIMP, blaSIM, blaSPM, blaGIM, blaNDM, blaADC, blaOXA-23, blaOXA-24, blaOXA-51, and blaOXA-58. ISAba1 and int1 were detected by PCR. Results: The isolates were 100% resistant to amoxicillin-clavulanate, aztreonam, cefepime, cefotaxime, and ceftazidime. Of the isolates, 5% were resistant to colistin, 45% to amikacin, 70% to imipenem, and 85% to ciprofloxacin. The blaADC- and blaOXA-51-like genes were detected in the entire collection. The prevalences of blaOXA-23, blaOXA-24, and blaOXA-58 were 50%, 7.5%, and 5%, respectively. However, the prevalences of blaTEM-, blaPER-, and blaGES-like genes were 87.5%, 55%, and 27.5%, respectively. SHV, CTX-M, VEB, KPC, and MBL encoding genes were not detected. The ISAba1 was found upstream to blaOXA-51, blaOXA-23, and blaADC in 85%, 80%, and 50%, respectively. Of note, 45% (18/40) of the isolates co-produced extended-spectrum ?-lactamases (PER and GES) and carbapenemases (OXA-23 and OXA-58). Conclusions: The blaADC-, blaTEM-, blaPER-, blaOXA-23-, and blaGES-like genes were found to be the most prevalent types of ?-lactamase-encoding gene in A. baumannii collected from Egypt. A high level of carbapenem resistance is mediated by blaOXA-23, blaOXA-24, and blaOXA-58 (minimum inhibitory concentration (MIC) 32 to >256?g/ml), and a low level of carbapenem resistance is mediated by blaGES (MIC 4-16?g/ml) and by up-regulation of ISAba1-OXA-51 (MIC 1-4?g/ml). Class B MBL was not identified to play a role in carbapenem resistance in A. baumannii isolates from Egypt. � 2014 The Authors.
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