Increasing carbapenem resistance due to the clonal dissemination of oxacillinase (OXA-23 and OXA-58)-producing Acinetobacter baumannii: report from the Turkish SENTRY Program sites

A significant increase in carbapenem-resistance rates among Acinetobacter baumannii isolates collected in two Turkish medical centres was detected in the 2000–2006 period (20–60 %) by the SENTRY Antimicrobial Surveillance Program. Carbapenem-resistant strains from 2006 were evaluated for the presence of encoding genes and epidemic clonality. OXA-58-like and OXA-23-like carbapenemase-producing strains were detected in both medical institutions. Seventeen out of 18 strains from Ankara were positive for bla OXA-58 primers and belonged to the same clone, whilst 26 isolates (25 from Istanbul and one from Ankara) harboured bla OXA-23-like genes and showed identical or similar PFGE patterns. Isolates producing OXA-23-like carbapenemases were more resistant than OXA-58-like carbapenemase producers to non-carbapenem antimicrobial agents. Carbapenem resistance in these institutions was observed to be largely driven by the dissemination of clones producing OXA-type carbapenemases.

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Prevalence of β-Lactamase-Encoding Genes among Enterobacteriaceae Bacteremia Isolates Collected in 26 U.S. Hospitals: Report from the SENTRY Antimicrobial Surveillance Program (2010)

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02252-12 ◽

2013 ◽

Vol 57 (7) ◽

pp. 3012-3020 ◽

Cited By ~ 73

Author(s):

Mariana Castanheira ◽

Sarah E. Farrell ◽

Lalitagauri M. Deshpande ◽

Rodrigo E. Mendes ◽

Ronald N. Jones

Keyword(s):

New York ◽

New York City ◽

Surveillance Program ◽

Content Type ◽

Carbapenem Resistant ◽

Antimicrobial Surveillance ◽

Genes Encoding ◽

Resistant Strains ◽

User Friendly ◽

Encoding Genes

ABSTRACTEnterobacteriaceaebacteremia isolates (n= 195; 6.4% overall) collected from 26 U.S. hospitals located in 20 states were screened for various β-lactamase classes. A total of 175 isolates carried one to eight acquired β-lactamase genes of 44 types that were detected in 55 combinations. Eighty-five (43.6%) strains carriedblaCTX-M, andblaCTX-M-15was the most prevalent (33.8%). Genes encoding OXA-1/30 (often associated withblaCTX-M-15), CMY-2, SHV extended-spectrum β-lactamase (ESBLs), and TEM-1 were also prevalent. Among 33 carbapenem-resistant strains, 28 carriedblaKPC-2orblaKPC-3(17 and 11 strains, respectively), and those were recovered mostly in the New York City area (16 strains) and Houston, TX (9 strains). Fourteen new SHV variants were identified amongKlebsiella pneumoniaeisolates carrying one or multiple SHV alleles, three carrying G238S and/or E240K amino acid alterations that confer ESBL activity. Only two of eightK. oxytocaisolates carried acquired β-lactamases, but most had mutations on theblaOXYpromoter region, and three new OXY-encoding genes were characterized. Concordance between a commercial nucleic acid-based microarray (Check-MDR CT101) and reference methods was noted for 105/109 (97.2%) strains. Thirty-two strains having genes that are not targeted by the commercial system were detected (OXA ESBLs, PER, PSE, or intrinsic genes). Overall, a great variety of enzymes were observed, with numerous strains carrying multiple genes. Rates of CTX-M-producing strains appear to be increasing in U.S. hospitals (26.6% in 2007 to 43.8% for 2010) participating in the SENTRY Program. Furthermore, the Check-Points system seems to be a reliable, robust, and user-friendly assay for detection of enzyme-mediated resistance.

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Molecular Characterization of Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates from Egyptian Patients

10.1101/2020.08.24.264911 ◽

2020 ◽

Author(s):

Reem M Hassan ◽

Sherifa T Salem ◽

Saly Ismail Mostafa Hassan ◽

Asmaa Sayed Hegab ◽

Yasmine S Elkholy

Keyword(s):

Acinetobacter Baumannii ◽

Molecular Characterization ◽

Antimicrobial Agents ◽

Treatment Options ◽

Carbapenem Resistance ◽

Clinical Isolates ◽

Common Mechanism ◽

Carbapenem Resistant ◽

Egyptian Patients ◽

Global Threat

AbstractAcinetobacter baumannii (A. baumannii) represents a global threat owing to its ability to resist most of the currently available antimicrobial agents. Moreover, emergence of carbapenem resistant A. baumannii (CR-AB) isolates limits the available treatment options. Enzymatic degradation by variety of ß-lactamases, have been identified as the most common mechanism of carbapenem resistance in A. baumannii. The alarming increase in the prevalence of CR-AB necessitates continuous screening and molecular characterization to appreciate the problem. The present study was performed to assess the prevalence and characterize carbapenemases among 206 CR-AB isolated from various clinical specimens collected from different intensive care units at Kasr Al-Aini Hospital.All isolates were confirmed to be A. baumannii by detection of the blaOXA-51-like gene. Molecular screening of 13 common Ambler class bla carbapenemases genes in addition to insertion sequence (IS-1) upstream OXA-23 was performed by using four sets of multiplex PCR, followed by identification using gene sequencing technology. Among the investigated genes, the prevalence of blaOXA-23, and blaOXA-58 were 77.7%, and 1.9%, respectively. The ISAba1 was detected in 10% of the blaOXA-23 positive isolates. The prevalence of metallo-β-lactamases (MBLs) studied; blaNDM-1, blaSPM, blaVIM, blaSIM-1 were 11.7%, 6.3%, 0.5%, and 0.5% respectively. One of class A; bla KPC was detected in 10.7% of the investigated isolates. blaOXA-24/40, blaIMP, blaGES, blaVEB and blaGIM were not detected in any of the studied isolates. Moreover, 18.4% of the isolates have shown to harbor two or more of the screened bla genes. We concluded that the most prevalent type of ß-lactamases genes among CR-AB isolates collected from Egyptian patients were blaOXA-23 followed by blaNDM-1 and blaKPC.Author summaryCarbapenem-resistant A. baumannii has become a real global health threat. The aim of the present study was to characterize and to assess the prevalence of carbapenemases among 206 CR-AB clinical isolates from Egyptian patients. We concluded that the most prevalent type of ß-lactamases genes among CR-AB isolates collected from Egyptian patients were blaOXA-23 followed by blaNDM-1 and blaKPC. In this study, ISAba1 was detected upstream 10% of blaOXA-23 positive isolates only which indicates that the spread of resistance among Acinetobacter isolates could be either chromosomal or plamid-mediated.

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Molecular Characterization of Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates from Egyptian Patients

10.21203/rs.3.rs-123397/v1 ◽

2020 ◽

Author(s):

Reem M Hassan ◽

Sherifa T Salem ◽

Saly Ismail Mostafa Hassan ◽

Asmaa Hegab ◽

Yasmine S Elkholy

Keyword(s):

Acinetobacter Baumannii ◽

Molecular Characterization ◽

Antimicrobial Agents ◽

Treatment Options ◽

Carbapenem Resistance ◽

Common Mechanism ◽

Carbapenem Resistant ◽

Egyptian Patients ◽

Global Threat

Abstract Acinetobacter baumannii (A. baumannii) represents a global threat owing to its ability to resist most of the currently available antimicrobial agents. Moreover, emergence of carbapenem resistant A. baumannii (CR-AB) isolates limits the available treatment options. Enzymatic degradation by variety of ß-lactamases, have been identified as the most common mechanism of carbapenem resistance in A. baumannii. The alarming increase in the prevalence of CR-AB necessitates continuous screening and molecular characterization to appreciate the problem. The present study was performed to assess the prevalence and characterize carbapenemases among 206 CR-AB isolated from various clinical specimens collected from different intensive care units at Kasr Al-Aini Hospital. All isolates were confirmed to be A. baumannii by detection of the blaOXA-51-like gene. Molecular screening of 13 common Ambler class bla carbapenemases genes in addition to insertion sequence (IS-1) upstream OXA-23 was performed by using four sets of multiplex PCR, followed by identification using gene sequencing technology. Among the investigated genes, the prevalence of blaOXA-23, and blaOXA-58 were 77.7%, and 1.9%, respectively. The ISAba1 was detected in 10% of the blaOXA-23 positive isolates. The prevalence of metallo-β-lactamases (MBLs) studied; blaNDM-1, blaSPM, blaVIM, blaSIM-1 were 11.7%, 6.3%, 0.5%, and 0.5% respectively. One of class A; bla KPC was detected in 10.7% of the investigated isolates. blaOXA-24/40, blaIMP, blaGES, blaVEB and blaGIM were not detected in any of the studied isolates. Moreover, 18.4% of the isolates have shown to harbor two or more of the screened bla genes. We concluded that the most prevalent type of ß-lactamases genes among CR-AB isolates collected from Egyptian patients were blaOXA-23 followed by blaNDM-1 and blaKPC.

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Arising Prevalence of OXA-48 producer Escherichia coli and OXA-48 with NDM co-producer Klebsiella pneumoniae Strains

Revista Romana de Medicina de Laborator ◽

10.2478/rrlm-2019-0030 ◽

2019 ◽

Vol 27 (3) ◽

pp. 319-326 ◽

Cited By ~ 2

Author(s):

Aylin Uskudar-Guclu ◽

Mustafa Guney ◽

Ali Korhan Sig ◽

Selcuk Kilic ◽

Mehmet Baysallar

Keyword(s):

Antimicrobial Agents ◽

Carbapenem Resistance ◽

Resistance Mechanisms ◽

Resistant Isolate ◽

Diffusion Method ◽

Clinical Samples ◽

Disc Diffusion ◽

E Coli ◽

Carbapenem Resistant ◽

Resistance Rates

Abstract Background/aim: This prospective study aimed to determine the presence of the most common carbapenemase genes, blaOXA-48, blaKPC, blaIMP, blaVIM and blaNDM on carbapenem resistant clinical K.pneumoniae and E.coli isolates. Materials and methods: Isolates were selected according to EUCAST guideline; gradient test and disc diffusion with both meropenem and ertapenem discs. Resistance rates of these isolates to other antimicrobial agents were also examined by disc diffusion method. Carbapenem resistance gene were investigated by using Real-Time PCR. Results: A total of 3845 E. coli and 1689 K.pneumoniae isolates from clinical samples between January 2015 and April 2017 were evaluated. The 419 isolates were found as carbapenem resistant but only the first resistant isolate (n=155; 126 K.pneumoniae and 29 E.coli) of each patient were included. Carbapenem resistant isolates were most frequently isolated from intensive care units (48.8%). Colistin was the most effective antibiotic (91.0%). The 121 (78.1%) of the tested isolates were positive for OXA-48 (103 K.pneumoniae and 18 E.coli) and 9 K. pneumoniae carrying blaNDM were also positive for blaOXA-48. VIM, IMP and KPC type carbapenemases were not detected in any isolates. Conclusion: Carbapenem-resistant pathogens have been shown to be able to develop resistance mechanisms with more than one carbapenemase encoding gene.

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P1339 Molecular characterisation of carbapenem-resistant Acinetobacter baumannii isolated in two Turkish medical centres in 2006: report from the SENTRY Antimicrobial Surveillance Program

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(07)71179-2 ◽

2007 ◽

Vol 29 ◽

pp. S370-S371

Author(s):

L. Deshpande ◽

H. Sader ◽

D. Gur ◽

V. Korten ◽

G. Soyletir ◽

...

Keyword(s):

Acinetobacter Baumannii ◽

Surveillance Program ◽

Molecular Characterisation ◽

Carbapenem Resistant ◽

Antimicrobial Surveillance

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Acinetobacter calcoaceticus–Acinetobacter baumannii complex species in clinical specimens in Singapore

Epidemiology and Infection ◽

10.1017/s0950268811001129 ◽

2011 ◽

Vol 140 (3) ◽

pp. 535-538 ◽

Cited By ~ 15

Author(s):

T. H. KOH ◽

T. T. TAN ◽

C. T. KHOO ◽

S. Y. NG ◽

T. Y. TAN ◽

...

Keyword(s):

Acinetobacter Baumannii ◽

Species Complex ◽

Carbapenem Resistance ◽

Acinetobacter Calcoaceticus ◽

Complex Species ◽

Clinical Specimens ◽

Carbapenem Resistant ◽

Acinetobacter Baumannii Complex ◽

Acinetobacter Pittii ◽

Resistant Strains

SUMMARYThis study was performed to determine the prevalence, distribution of specimen sources, and antimicrobial susceptibility of the Acinetobacter calcoaceticus–Acinetobacter baumannii (Acb) species complex in Singapore. One hundred and ninety-three non-replicate Acb species complex clinical isolates were collected from six hospitals over a 1-month period in 2006. Of these, 152 (78·7%) were identified as A. baumannii, 18 (9·3%) as ‘Acinetobacter pittii’ [genomic species (gen. sp.) 3], and 23 (11·9%) as ‘Acinetobacter nosocomialis’ (gen. sp. 13TU). Carbapenem resistance was highest in A. baumannii (72·4%), followed by A. pittii (38·9%), and A. nosocomialis (34·8%). Most carbapenem-resistant A. baumannii and A. nosocomialis possessed the blaOXA-23-like gene whereas carbapenem-resistant A. pittii possessed the blaOXA-58-like gene. Two imipenem-resistant strains (A. baumannii and A. pittii) had the blaIMP-like gene. Representatives of carbapenem-resistant A. baumannii were related to European clones I and II.

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MOLECULAR CHARACTERIZATION OF GENES ENCODING ACQUIRED CARBAPENEMASE OF CARBAPENEMRESISTANT ACINETOBACTER BAUMANNII ISOLATES

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.6 ◽

2017 ◽

pp. 52-57

Author(s):

Nu Xuan Thanh Le ◽

Thi Anh Ngoc Le ◽

Thi Nam Lien Nguyen ◽

Viet Quynh Tram Ngo ◽

Santona Antonella ◽

...

Keyword(s):

Acinetobacter Baumannii ◽

Carbapenem Resistance ◽

Resistance Rate ◽

University Hospital ◽

Resistant Bacteria ◽

Cross Sectional ◽

Carbapenem Resistant ◽

Genes Encoding ◽

Resistance Rates ◽

And Control

Background: Today carbapenem-resistant A. baumannii isolates are rising in several parts of the world including Vietnam, they are recognized to be among the most difficult resistant bacteria to treat and control. Carbapenem resistance is most commonly caused by the production of OXA-type carbapenemases and metallo-β-lactamases (MBLs). Objectives: Determine the rate and detect the genes encoding acquired carbapenemase of carbapenem-resistant A. baumannii isolates. Materials and methods: Study design is cross-sectional descriptive study. Carbapenem-resistant A. baumannii isolates in 90 A. baumannii (ACB) complex isolates were collected from Hue Central Hospital (HCH) and Hue University Hospital (HUP). Susceptibility to carbapenem of A. baumannii strains were performed by MicroScan method. Multiplex PCRs were performed to detect the genes encoding acquired carbapenemase. Results: Carbapenem resistance rates in A. baumannii were 88.5% and 87.5% in HCH and HHUMP, respectively. All of genes blaOXA-51, blaOXA-23, blaOXA-58, blaIMP, blaNDM as well as coexistence of two genes (blaIMP, blaNDM) or three genes ((blaOXA-51, blaOXA-23, blaOXA-58) or (blaIMP, blaNDM, blaOXA-58)) were detected in carbapenem resistant A. baumannii isolates. Conclusions: Carbapenem resistance rate in A. baumannii was relatively high. The emergence of carbapenem resistance in A. baumannii is associated with the production of OXA-type carbapenemases and metallo-β-lactamases (MBLs). Key words: Acinetobacter baumannii; carbapenem resistance; carbapenemase

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Emergence of carbapenem-resistant Acinetobacter baumannii in hospitals in Pakistan

Journal of Medical Microbiology ◽

10.1099/jmm.0.063925-0 ◽

2014 ◽

Vol 63 (1) ◽

pp. 50-55 ◽

Cited By ~ 28

Author(s):

Badrul Hasan ◽

Khalida Perveen ◽

Björn Olsen ◽

Rabaab Zahra

Keyword(s):

Drug Resistance ◽

Acinetobacter Baumannii ◽

The Other ◽

New Delhi ◽

National Surveillance ◽

Carbapenem Resistant ◽

Extreme Drug Resistance ◽

Resistant Strains ◽

Encoding Genes ◽

Inhibitor Combination

The emergence of pan-resistance in bacterial pathogens poses a threat to human health. Carbapenem-resistant Acinetobacter baumannii has emerged as a serious challenge, causing nosocomial infection and community-acquired outbreaks in hospitals globally, including in Pakistan. We collected 90 Acinetobacter isolates from patients with secondary or nosocomial infections from different hospitals in Pakistan and screened for carbapenem-resistant strains. Of the 90 isolates, 59 were resistant to carbapenems. Among oxacillinase -encoding genes, bla OXA-51-like was common in all isolates, including in combination with bla OXA-23-like in 14 isolates; however, bla OXA-24-like and bla OXA-58-like were completely absent. Among metallo-β-lactamase-encoding genes, only bla NDM-1 was found in one isolate, while the other three genes, bla IMP, bla VIM and bla SIM, were completely absent. None of the isolates was found to harbour the bla CTX-M gene. The isolates were also tested for susceptibilities to a panel of different antibiotics belonging to several classes. Of all the drugs tested, tigecycline was the most effective with 80 % sensitivity amongst isolates, followed by colistin with 50 % sensitivity. Three categories of resistance were found in these isolates: extreme drug resistance in 26, pan-drug resistance in 19 and multidrug resistance in 87 isolates. The isolates exhibited a high resistance to cephalosporins, trimethoprim–sulfamethoxazole and β-lactam antibiotics, followed by tetracycline and β-lactam/β-lactam inhibitor combination, fluoroquinolone and aminoglycosides. The results show a prominent level of antibiotic-resistance phenotypes in A. baumannii and strongly suggest the need for full-scale national surveillance of carbapenem-resistant A. baumannii with particular emphasis on the newly identified NDM-1 (New Delhi metallo-β-lactamase-1).

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Molecular characterization of carbapenem-resistant Acinetobacter baumannii clinical isolates from Egyptian patients

PLoS ONE ◽

10.1371/journal.pone.0251508 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0251508

Author(s):

Reem M. Hassan ◽

Sherifa T. Salem ◽

Saly Ismail Mostafa Hassan ◽

Asmaa Sayed Hegab ◽

Yasmine S. Elkholy

Keyword(s):

Acinetobacter Baumannii ◽

Molecular Characterization ◽

Antimicrobial Agents ◽

Treatment Options ◽

Carbapenem Resistance ◽

Common Mechanism ◽

Carbapenem Resistant ◽

Egyptian Patients ◽

Global Threat

Acinetobacter baumannii (A. baumannii) represents a global threat owing to its ability to resist most of the currently available antimicrobial agents. Moreover, emergence of carbapenem resistant A. baumannii (CR-AB) isolates limits the available treatment options. Enzymatic degradation by variety of ß-lactamases, have been identified as the most common mechanism of carbapenem resistance in A. baumannii. The alarming increase in the prevalence of CR-AB necessitates continuous screening and molecular characterization to appreciate the problem. The present study was performed to assess the prevalence and characterize carbapenemases among 206 CR-AB isolated from various clinical specimens collected from different intensive care units at Kasr Al-Aini Hospital. All isolates were confirmed to be A. baumannii by detection of the blaOXA-51-like gene. Molecular screening of 13 common Ambler class bla carbapenemases genes in addition to insertion sequence (IS-1) upstream OXA-23 were performed by using four sets of multiplex PCR, followed by identification using gene sequencing technology. Among the investigated genes, the prevalence of blaOXA-23, and blaOXA-58 were 77.7%, and 1.9%, respectively. The ISAba1 was detected in 10% of the blaOXA-23 positive isolates. The prevalence of metallo-β-lactamases (MBLs) studied; blaNDM-1, blaSPM, blaVIM, blaSIM-1 were 11.7%, 6.3%, 0.5%, and 0.5% respectively. One of class A; bla KPC was detected in 10.7% of the investigated isolates. blaOXA-24/40, blaIMP, blaGES, blaVEB and blaGIM were not detected in any of the studied isolates. Moreover, 18.4% of the isolates have shown to harbor two or more of the screened bla genes. We concluded that the most prevalent type of ß-lactamases genes among CR-AB isolates collected from Egyptian patients were blaOXA-23 followed by blaNDM-1 and blaKPC.

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Mobile Carbapenemase Genes in Pseudomonas aeruginosa

Frontiers in Microbiology ◽

10.3389/fmicb.2021.614058 ◽

2021 ◽

Vol 12 ◽

Author(s):

Eun-Jeong Yoon ◽

Seok Hoon Jeong

Keyword(s):

Pseudomonas Aeruginosa ◽

Carbapenem Resistance ◽

Mobile Genetic Elements ◽

Clinical Settings ◽

Genetic Elements ◽

Integrative And Conjugative Elements ◽

Carbapenem Resistant ◽

Resistance Rates ◽

Lactamase Gene ◽

Encoding Genes

Carbapenem-resistantPseudomonas aeruginosais one of the major concerns in clinical settings impelling a great challenge to antimicrobial therapy for patients with infections caused by the pathogen. While membrane permeability, together with derepression of the intrinsic beta-lactamase gene, is the global prevailing mechanism of carbapenem resistance inP. aeruginosa, the acquired genes for carbapenemases need special attention because horizontal gene transfer through mobile genetic elements, such as integrons, transposons, plasmids, and integrative and conjugative elements, could accelerate the dissemination of the carbapenem-resistantP. aeruginosa. This review aimed to illustrate epidemiologically the carbapenem resistance inP. aeruginosa, including the resistance rates worldwide and the carbapenemase-encoding genes along with the mobile genetic elements responsible for the horizontal dissemination of the drug resistance determinants. Moreover, the modular mobile elements including the carbapenemase-encoding gene, also known as theP. aeruginosaresistance islands, are scrutinized mostly for their structures.

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