scholarly journals Epidemiological and genomic characteristics of Acinetobacter baumannii from different infection sites using comparative genomics

BMC Genomics ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xingchen Bian ◽  
Xiaofen Liu ◽  
Xuefei Zhang ◽  
Xin Li ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Virulence Factors ◽  
Capsular Polysaccharide ◽  
Carbapenem Resistance ◽  
Resistance Rate ◽  
Multi Drug Resistance ◽  
Genetic Characteristics ◽  
Polysaccharide Biosynthesis ◽  
Epidemiological Characteristics

Abstract Background Acinetobacter baumannii is a common nosocomial pathogen that poses a huge threat to global health. Owing to the severity of A. baumannii infections, it became necessary to investigate the epidemiological characteristics of A. baumannii in Chinese hospitals and find the reasons for the high antibiotic resistance rate and mortality. This study aimed to investigate the epidemiologic and genetic characteristics of A. baumannii isolated from patients with hospital acquired pneumonia (HAP), bloodstream infection (BSI) and urinary tract infection (UTI) in China and uncover potential mechanisms for multi-drug resistance and virulence characteristics of A. baumannii isolates. Results All isolates were classified into two primary clades in core gene-based phylogenetic relationship. Clonal complex 208 (CC208) mainly consisted of ST195 (32 %) and ST208 (24.6 %). CC208 and non-CC208 isolates had carbapenem resistance rates of 96.2 and 9.1 %, respectively. Core genes were enriched in ‘Amino acid transport and metabolism’, ‘Translation’, ‘Energy production and conversion’, ‘Transcription’, ‘Inorganic ion transport and metabolism’ and ‘Cell wall/membrane/envelope synthesis’. Most isolates possessed virulence factors related to polysaccharide biosynthesis, capsular polysaccharide synthesis and motility. Eleven isolates belong to ST369 or ST191 (oxford scheme) all had the virulence factor cap8E and it had a higher positive rate in UTI (35.3 %) than in BSI (18.9 %) and HAP (12.9 %). ABGRI1 antibiotic resistance islands were responsible for streptomycin, tetracycline and sulfonate resistance. The blaOXA−23 gene was the most probable cause for carbapenem resistance, although the blaOXA−66 gene with nonsynonymous SNPs (F82L, I129L) was not. Conclusions A. baumannii is a genomically variable pathogen that has the potential to cause a range of infectious diseases. There is high proportion of carbapenem resistance in isolates from all three infection sites (HAP, BSI and UTI), which can be attributed to the blaOXA−23 gene. CC208 is the predominant clone in blaOXA−23-carrying A. baumannii that should be monitored. Virulence factors involving bacteria motility and polysaccharide biosynthesis which are widespread in clinical A. baumannii strains deserve our attention.

scholarly journals Epidemiological and genomic characteristics of Acinetobacter baumannii from different infection sites using comparative genomics

2020 ◽  
Author(s):  
Xingchen Bian ◽  
Xiaofen Liu ◽  
Xuefei Zhang ◽  
Xin Li ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Molecular Mechanisms ◽  
Capsular Polysaccharide ◽  
Carbapenem Resistance ◽  
Resistance Rate ◽  
Multi Drug Resistance ◽  
Genetic Characteristics ◽  
Epidemiological Characteristics

Abstract Background Acinetobacter baumannii is a common nosocomial pathogen that poses a huge threat to global health. Owing to the severity of A. baumannii infections, it became necessary to investigate the epidemiological characteristics of A. baumannii in Chinese hospitals and ascertain the reasons for the high antibiotic resistance rate and severe infections. This study aimed to investigate the epidemiologic and genetic characteristics of A. baumannii isolated from patients with hospital acquired pneumonia (HAP), bloodstream infection (BSI) and urinary tract infection (UTI) in China and uncover potential mechanisms for multi-drug resistance using whole genome sequencing. Results All isolates were classified into one of two primary clades. Clonal complex 208 (CC208) mainly consisted of ST195 (32%) and ST208 (24.6%). CC208 and non-CC208 isolates had carbapenem resistance rates of 96.2% and 9.1%, respectively. UTI isolates possessed the greatest number of unique genes enriched in 'Replication, recombination, and repair' and ‘Amino acid transport and metabolism’ although the numbers of genes specific to HAP-isolates were fewer. No specific virulence gene was identified when comparing isolates from the three infection sites, but most isolates possessed virulence factors related to polysaccharide biosynthesis, capsular polysaccharide synthesis and motility. ABGRI1 antibiotic resistance islands were responsible for streptomycin, tetracycline and sulfonate resistance. The blaOXA−23 gene was the most probable cause for carbapenem resistance, although the blaOXA−66 gene with nonsynonymous SNPs (F82L, I129L) was not. Conclusions Our study illustrates epidemiological and genomic characteristics of A. baumannii from HAP, BSI and UTI in China and reveals possible molecular mechanisms of multi-drug resistance. The differential resistance, virulence and genetic features provide supportive evidence for the diverse sites of infection caused by A. baumannii.

Proteomic Analyses Uncover the Mechanisms Underlying Antibiotic Resistance Differences among Three Acinetobacter baumannii Isolates

2016 ◽  
Vol 26 (6) ◽  
pp. 401-409 ◽  
Author(s):  
Junrui Wang ◽  
Junli Zhang ◽  
Quan Fu ◽  
Sufang Guo ◽  
La Ta ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Molecular Mechanisms ◽  
Carbapenem Resistance ◽  
Enrichment Analysis ◽  
Functional Enrichment Analysis ◽  
Absolute Quantification ◽  
Functional Enrichment ◽  
Resistant Isolate ◽  
Gentamicin Resistance

This study aimed to investigate the molecular mechanisms underlying the antibiotic resistance difference among three <i>Acinetobacter baumannii</i> isolates. Fifty <i>A. baumannii</i> isolates were first subjected to an antimicrobial susceptibility test, then three isolates differing in antibiotic resistance were selected and subjected to iTRAQ (isobaric tags for relative and absolute quantification)-based proteomics analysis. Differential proteins among the three <i>A. baumannii</i> isolates were further identified and subjected to gene ontology functional enrichment analysis. A resistant isolate (A1), a less resistant one (A8) and a susceptible one (A9) were selected. In total, there were 424 differentially expressed proteins (DEPs) between the A1 and A8 isolates, 1,992 DEPs between the A9 and A1 isolates, and 1,956 DEPs between the A8 and A9 isolates. The upregulation of I6TUC8 and Q0GA83 in the A1 and A8 isolates may be responsible for their higher resistance to ceftriaxone. The higher gentamicin resistance of <i>A. baumannii</i> isolates A1 and A8 when compared to A9 may be related to the higher expression levels of O05286 and D0CCK1, while the higher Q2FCY1 expression level may contribute more to strong gentamicin resistance in A1. The higher levels of L9LWL7, L9MDB0, K9C9W3, E2IGU7, B6E129, G8HYR7, D2XTB0 and D2XTB0 may be responsible for the higher carbapenem resistance of isolate A1 as compared to A8.

scholarly journals Emerging Concern for Silver Nanoparticle Resistance in Acinetobacter baumannii and Other Bacteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Oliver McNeilly ◽  
Riti Mann ◽  
Mohammad Hamidian ◽  
Cindy Gunawan
Keyword(s):  
Heavy Metal ◽  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Bacterial Resistance ◽  
Bacterial Pathogen ◽  
Significant Rise ◽  
Multi Drug Resistance ◽  
Resistant Bacteria ◽  
Toxic Heavy Metals ◽  
Ample Evidence

The misuse of antibiotics combined with a lack of newly developed ones is the main contributors to the current antibiotic resistance crisis. There is a dire need for new and alternative antibacterial options and nanotechnology could be a solution. Metal-based nanoparticles, particularly silver nanoparticles (NAg), have garnered widespread popularity due to their unique physicochemical properties and broad-spectrum antibacterial activity. Consequently, NAg has seen extensive incorporation in many types of products across the healthcare and consumer market. Despite clear evidence of the strong antibacterial efficacy of NAg, studies have raised concerns over the development of silver-resistant bacteria. Resistance to cationic silver (Ag+) has been recognised for many years, but it has recently been found that bacterial resistance to NAg is also possible. It is also understood that exposure of bacteria to toxic heavy metals like silver can induce the emergence of antibiotic resistance through the process of co-selection. Acinetobacter baumannii is a Gram-negative coccobacillus and opportunistic nosocomial bacterial pathogen. It was recently listed as the “number one” critical level priority pathogen because of the significant rise of antibiotic resistance in this species. NAg has proven bactericidal activity towards A. baumannii, even against strains that display multi-drug resistance. However, despite ample evidence of heavy metal (including silver; Ag+) resistance in this bacterium, combined with reports of heavy metal-driven co-selection of antibiotic resistance, little research has been dedicated to assessing the potential for NAg resistance development in A. baumannii. This is worrisome, as the increasingly indiscriminate use of NAg could promote the development of silver resistance in this species, like what has occurred with antibiotics.

scholarly journals Emergence of OXA-10 and OXA-48 like carbapenemases among Enterobacter isolates from inpatients in southern Iran

2021 ◽  
Author(s):  
Melika Moradi ◽  
Reza Khashei ◽  
Yalda Malekzadegan ◽  
Jamal Sarvari
Keyword(s):  
Carbapenem Resistance ◽  
Common Species ◽  
Resistance Rate ◽  
Health Concern ◽  
Multi Drug Resistance ◽  
Class 1 Integron ◽  
Carbapenem Resistant ◽  
Microbiological Methods ◽  
Global Spread ◽  
Class 1

Abstract Background The global spread of carbapenemase-producing Enterobacteriaceae represents a public health concern. The aim of this study was to investigate prevalence of carbapenem resistance, oxacillinase types and the presence of class 1–3 integrons among Enterobacter clinical isolates from an Iranian inpatients’ population. Methods Ninety Enterobacter isolates recovered from hospitalized patients were diagnosed by the standard microbiological methods. Antibiogram pattern was also determined. The presence of class 1–3 integrons and four types of oxacillinase genes were assessed using PCR. Results Of the 90 Enterobacter isolates, the most common species was identified as E. aerogenes, (45.6%), followed by E. cloacae (30%). The highest resistance rate was against to ampicillin (96.7%). Multi-drug resistance (MDR) was substantial (93%). Carbapenemase producers were detected in 96% of carbapenem resistant isolates by mCIM test. The frequency of evaluated genes was as follows: intI1 = 50 (55.6%), intI2 = 12 (13.3%), blaoxa−1 =6 (6.7%), blaoxa−2 =5 (5.6%), blaoxa−10 =18 (20%), and blaoxa−48 =18 (20%). Conclusion The determinants of class 1 integron with OXA-10 and OXA-48 like carbapememases have been responsible of relatively considerable of carbapenem resistance among isolates. This is the first OXA-10 and OXA-48-producing Enterobacter spp. in Iran, indicating that the prevalence of oxacillinases might be on the rise in country.

scholarly journals In vitro activity of colistin against multidrug-resistant Acinetobacter baumannii isolates harboring blaOXA-23-like and blaOXA-24-like genes: A multicenter based study

2020 ◽  
Vol 67 (3) ◽  
pp. 182-186
Author(s):  
Susan Khanjani ◽  
Hadi Sedigh Ebrahim-Saraie ◽  
Mohammad Shenagari ◽  
Ali Ashraf ◽  
Ali Mojtahedi ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Cross Sectional ◽  
The North ◽  
North Of Iran

AbstractThis study was aimed to evaluate occurrence of antibiotic resistance and the presence of resistance determinants among clinical isolates of Acinetobacter baumannii. This cross-sectional study from January to September 2018 was performed on 59 A. baumannii strains isolated from clinical samples in the north of Iran. Isolates were identified by standard microbiologic tests and molecular method. Antimicrobial susceptibility testing was carried out by disk diffusion and broth microdilution methods. The presence of carbapenem resistance genes was detected by PCR method. All isolates were resistant to cefepime, meropenem, imipenem and ceftazidime. The lowest resistance rate was observed against doxycycline with 33.9%. Minimum inhibitory concentration (MIC) results showed that all carbapenem-resistant A. baumannii (CRAB) isolates were susceptible to colistin with MIC50 and MIC90 values of 1/2 µg/mL. Among 59 CRAB, blaOXA-23-like was the most prevalent gene (86.4%) followed by blaOXA-24-like (69.5%). Meanwhile, none of the clinical isolates harbored blaOXA-58-like gene. We found a high prevalence of CRAB strains harboring OXA-type carbapenemases in the north of Iran. Our results suggests that the presence of OXA-type genes was not directly correlated with the increase of imipenem MIC level, but can be clinically important as they contribute to the selection of CRAB strains.

scholarly journals Prevalence of pathogenic Klebsiella pneumoniae based on PCR capsular typing harbouring carbapenemases encoding genes in Uganda tertiary hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kenneth Ssekatawa ◽  
Denis K. Byarugaba ◽  
Jesca L. Nakavuma ◽  
Charles D. Kato ◽  
Francis Ejobi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Virulence Factors ◽  
Carbapenem Resistance ◽  
Clinical Isolates ◽  
Genotypic Resistance ◽  
Pathogenic Potential ◽  
Phenotypic Resistance ◽  
Tertiary Hospitals ◽  
Encoding Genes

Abstract Background Klebsiella pneumoniae is an opportunistic pathogen that has been implicated as one of commonest cause of hospital and community acquired infections. The K. pneumoniae infections have considerably contributed to morbidity and mortality in patients with protracted ailments. The capacity of K. pneumoniae to cause diseases depends on the presence of an array virulence factors. Coexistence and expression of virulence factors and genetic determinants of antibiotic resistance complicates treatment outcomes. Thus, emergence of pathogenic MDR K. pneumoniae poses a great threat to the healthcare system. However, the carriage of antibiotic resistance among pathogenic K. pneumoniae is yet to be investigated in Uganda. We sought to investigate the carbapenem resistance profiles and pathogenic potential based on capsular serotypes of K. pneumoniae clinical isolates. Methods This was a cross sectional study involving use of archived Klebsiella pneumoniae isolates collected between January and December, 2019 at four tertiary hospitals in Uganda. All isolates were subject to antimicrobial susceptibility assays to determine phenotypic antibiotic resistance, pentaplex PCR to detect carbapenemases encoding genes and heptaplex PCR to identify capsular serotypes K1, K2, K3, K5, K20, K54 and K57. Results The study found an overall phenotypic carbapenem resistance of 23.3% (53/227) and significantly higher genotypic resistance prevalence of 43.1% (98/227). Over all, the most prevalent gene was blaOXA-48-like (36.4%), followed by blaIMP-type (19.4%), blaVIM-type (17.1%), blaKPC-type (14.0%) and blaNDM-type (13.2%). blaVIM-type and blaOXA-48-like conferred phenotypic resistance in all isolates and 38.3% of isolates that harbored them respectively. Capsular multiplex PCR revealed that 46.7% (106/227) isolates were pathogenic and the predominantly prevalent pathotype was K5 (18.5%) followed by K20 (15.1%), K3 (7.1%), K2 (3.1%) and K1 (2.2%). Of the 106 capsular serotypes, 37 expressed phenotypic resistance; thus, 37 of the 53 carbapenem resistant K. pneumoniae were pathogenic. Conclusion The high prevalence of virulent and antibiotic resistant K. pneumoniae among clinical isolates obtained from the four tertiary hospital as revealed by this study pose a great threat to healthcare. Our findings underline the epidemiological and public health risks and implications of this pathogen.

scholarly journals Carriage of Carbapenem-Resistant Enterobacterales in Adult Patients Admitted to a University Hospital in Italy

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 61
Author(s):  
Pamela Barbadoro ◽  
Daniela Bencardino ◽  
Elisa Carloni ◽  
Enrica Omiccioli ◽  
Elisa Ponzio ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Coli Strain ◽  
Adult Patients ◽  
University Hospital ◽  
E Coli ◽  
Genetic Features ◽  
Phenotypic Tests

The emerging spread of carbapenemase-producing Enterobacterales (CPE) strains, in particular, Klebsiella pneumoniae and Escherichia coli, has become a significant threat to hospitalized patients. Carbapenemase genes are frequently located on plasmids than can be exchanged among clonal strains, increasing the antibiotic resistance rate. The aim of this study was to determine the prevalence of CPE in patients upon their admission and to analyze selected associated factors. An investigation of the antibiotic resistance and genetic features of circulating CPE was carried out. Phenotypic tests and molecular typing were performed on 48 carbapenemase-producing strains of K. pneumoniae and E. coli collected from rectal swabs of adult patients. Carbapenem-resistance was confirmed by PCR detection of resistance genes. All strains were analyzed by PCR-based replicon typing (PBRT) and multilocus sequence typing (MLST) was performed on a representative isolate of each PBRT profile. More than 50% of the strains were found to be multidrug-resistant, and the blaKPC gene was detected in all the isolates with the exception of an E. coli strain. A multireplicon status was observed, and the most prevalent profile was FIIK, FIB KQ (33%). MLST analysis revealed the prevalence of sequence type 512 (ST512). This study highlights the importance of screening patients upon their admission to limit the spread of CRE in hospitals.

scholarly journals Colistin and Carbapenem-Resistant Acinetobacter baumannii Aci46 in Thailand: Genome Analysis and Antibiotic Resistance Profiling

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1054
Author(s):  
Nalumon Thadtapong ◽  
Soraya Chaturongakul ◽  
Sunhapas Soodvilai ◽  
Padungsri Dubbs
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Antibiotic Resistance Genes ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Whole Genome ◽  
Disk Diffusion Method ◽  
Genome Data ◽  
Carbapenem Resistant

Resistance to the last-line antibiotics against invasive Gram-negative bacterial infection is a rising concern in public health. Multidrug resistant (MDR) Acinetobacter baumannii Aci46 can resist colistin and carbapenems with a minimum inhibitory concentration of 512 µg/mL as determined by microdilution method and shows no zone of inhibition by disk diffusion method. These phenotypic characteristics prompted us to further investigate the genotypic characteristics of Aci46. Next generation sequencing was applied in this study to obtain whole genome data. We determined that Aci46 belongs to Pasture ST2 and is phylogenetically clustered with international clone (IC) II as the predominant strain in Thailand. Interestingly, Aci46 is identical to Oxford ST1962 that previously has never been isolated in Thailand. Two plasmids were identified (pAci46a and pAci46b), neither of which harbors any antibiotic resistance genes but pAci46a carries a conjugational system (type 4 secretion system or T4SS). Comparative genomics with other polymyxin and carbapenem-resistant A. baumannii strains (AC30 and R14) identified shared features such as CzcCBA, encoding a cobalt/zinc/cadmium efflux RND transporter, as well as a drug transporter with a possible role in colistin and/or carbapenem resistance in A. baumannii. Single nucleotide polymorphism (SNP) analyses against MDR ACICU strain showed three novel mutations i.e., Glu229Asp, Pro200Leu, and Ala138Thr, in the polymyxin resistance component, PmrB. Overall, this study focused on Aci46 whole genome data analysis, its correlation with antibiotic resistance phenotypes, and the presence of potential virulence associated factors.

scholarly journals Epidemiological Characteristics and Drug Resistance Analysis of Multidrug-Resistant Acinetobacter baumannii in a China Hospital at a Certain Time

2014 ◽  
Vol 63 (3) ◽  
pp. 275-281 ◽  
Author(s):  
MEIJIE JIANG ◽  
ZHIJUN ZHANG ◽  
SHUPING ZHAO
Keyword(s):  
Acinetobacter Baumannii ◽  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Molecular Characteristics ◽  
Type D ◽  
Type C ◽  
Methylase Gene ◽  
Different Strains ◽  
Epidemiological Characteristics

Multidrug-resistant Acinetobacter baumannii is an important bacterium causing nosocomial infections; A. baumannii infections have increased in our hospital since 2009. However, multidrug-resistant A. baumannii, which was mainly isolated from patients in each intensive care unit (ICU), rapidly increased from December 2012 to January 2013. Therefore, we described the molecular characteristics of A. baumannii by pulsed-field gel electrophoresis (PFGE). We also detected resistance genes for β-lactam, aminoglycosides, and plasmid-mediated quinolones. Disinfectant-resistant genes were also detected in the clinical isolates of blaOXA-51-positive multidrug-resistant A. baumannii. The conjugative test was performed to detect whether or not resistance genes can be transferred to different strains. Carbonyl cyanide m-chlorophenylhydrazone (CCCP) inhibition test was conducted to analyze the factors influencing the resistance of A. baumannii to imipenem, meropenem, ceftazidime, levofloxacin, and tigecycline. PFGE profiles contained 12 strains, including 20 type C strains (47.6%), 4 type D strains (9.5%), and 1 to 3 strains of other types; 38 strains were distributed in patients in each ICU. In our test samples, the presence of blaOXA-23 was closely related to carbapenem resistance. The 16S rRNA methylase gene armA was associated with resistance to amikacin, gentamicin, and tobramycin. The multidrug-resistant A. baumannii was closely related to various resistance genes. These results indicated that multidrug-resistant A. baumannii with type C strains was predominant in our hospital in this period.

scholarly journals Phenotypic and Genotypic Evaluation of Antibiotic Resistance of Acinetobacter baumannii Bacteria Isolated from Surgical ICU Patients in Pakistan

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Nureen Zahra ◽  
Basit Zeshan ◽  
Muhammad Mubeen Ali Qadri ◽  
Musarat Ishaq ◽  
Muhammad Afzal ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Pcr Amplification ◽  
Carbapenem Resistance ◽  
Surgical Intensive Care ◽  
Phenotypic Resistance ◽  
Carbapenem Resistant ◽  
Resistance Patterns ◽  
Surgical Icus ◽  
Surgical Icu

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a significant nosocomial pathogen, causing serious threats concerning community-wide outbreaks globally, as well as in Pakistan. Antimicrobial resistance in A. baumannii is increasing day by day. Objectives: The study aimed to find out the antibiotic resistance (AMR) patterns and evaluate the AMR genes in clinical isolates from patients admitted to the surgical Intensive Care units (ICUs) at different hospitals in Lahore, Pakistan. Methods: A total of 593 clinical specimens were collected from patients admitted to the surgical ICUs of three different local hospitals in Lahore, Pakistan. From these samples, a total of 90 A. baumannii isolates were identified and further investigated to observe phenotypic resistance patterns and detect carbapenemases resistance genes. Results: The results showed that phenotypic resistance against amikacin was 27.2%, ceftriaxone 100%, ceftazidime 27.2%, cefepime 63.3%, ciprofloxacin and co-trimoxazole 100%, gentamicin 40%, imipenem 22.2%, meropenem 21.1%, piperacillin-tazobactam 27.2%, tigecycline 27.2%, and tetracycline 63.3%. All A. baumannii isolates were found to be sensitive to colistin (CT), polymixin-B (PB), and tobramycin (TOB). The PCR amplification of carbapenemases genes revealed the prevalence of blaOXA-23, blaOXA-51, and blaOXA-40 in 73, 90, and 64.4% of the isolates, respectively, along with blaNDM1 (92.2%), blaVIM (40%), blaIMP (90%), ISAba1 (85.5%), sul1 (16.6%), sul2 (20%), armA (32.2%), and PER-1 (12%) while the blaOXA-24 and blaOXA-58 genes were not detected in the isolates. The sequence analysis of the blaOXA-23 and blaOXA-51 genes showed 98% and 95% similarity with previously reported sequences in the GenBank database. Conclusions: The present study indicated that the emergence of high carbapenem resistance in CRAB isolates has increased, which may pose serious limitations in the choice of drugs for nosocomial infections.

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