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Mumtaz L, Farid A, Yousef Alomar S, Ahmad N, Nawaz A, Andleeb S, Amin A. Assesment of polyphenolic compounds against biofilms produced by clinical Acinetobacter baumannii strains using in silico and in vitro models. Saudi J Biol Sci 2023; 30:103743. [PMID: 37564783 PMCID: PMC10410175 DOI: 10.1016/j.sjbs.2023.103743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/05/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
Several types of microbial infections are caused by Acinetobacter baumanii that has developed resistance to antimicrobial agents. We therefore investigated the role of plant polyphenols against A. baumannii using in silico and in vitro models. The clinical strains of A. baumannii were investigated for determination of resistance pattern and resistance mechanisms including efflux pump, extended spectrum beta lactamase, phenotype detection of AmpC production, and Metallo-β-lactamase. The polyphenolic compounds were docked against transcription regulator BfmR (PDB ID 6BR7) and antimicrobial, antibiofilm, and anti-quorum sensing activities were performed. The antibiogram studies showed that all isolated strains were resistant. Strain A77 was positive in Metallo-β-lactamase production. Similarly, none of strains were producers of AmpC, however, A77, A76, A75 had active efflux pumps. Molecular docking studies confirmed a strong binding affinity of Rutin and Catechin towards transcription regulator 6BR7. A significant antimicrobial activity was recorded in case of quercetin and syringic acid (MIC 3.1 µg/mL) followed by vanillic acid and caffeic acid (MIC 12.5 µg/mL). All tested compounds presented a strong antibiofilm activity against A. baumanii strain A77 (65 to 90%). It was concluded that all tested polyphenols samples posess antimicrobial and antibiofilm activities, and hence they may be utilized to treat multidrug resistance A. baumannii infections.
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Affiliation(s)
- Laraib Mumtaz
- Gomal Centre of Biochemistry and Biotechnology(GCBB), Gomal University, KPK, 29050 D.I.Khan, Pakistan
- Gomal Centre of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, D.I.Khan 29050, Pakistan
| | - Arshad Farid
- Gomal Centre of Biochemistry and Biotechnology(GCBB), Gomal University, KPK, 29050 D.I.Khan, Pakistan
| | - Suliman Yousef Alomar
- Doping Research Chair, Zoology Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Naushad Ahmad
- Department of Chemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Asif Nawaz
- Gomal Centre of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, D.I.Khan 29050, Pakistan
| | - Saadia Andleeb
- Atta Ur Rehman School of Biological Sciences, National University of Science and Technology, Islamabad Pakistan
| | - Adnan Amin
- Gomal Centre of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, D.I.Khan 29050, Pakistan
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Al-Rashed N, Bindayna KM, Shahid M, Saeed NK, Darwish A, Joji RM, Al-Mahmeed A. Prevalence of Carbapenemases in Carbapenem-Resistant Acinetobacter baumannii Isolates from the Kingdom of Bahrain. Antibiotics (Basel) 2023; 12:1198. [PMID: 37508294 PMCID: PMC10376280 DOI: 10.3390/antibiotics12071198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Acinetobacter baumannii is regarded as a significant cause of death in hospitals. The WHO recently added carbapenem-resistant Acinetobacter baumannii (CRAB) to its global pathogen priority list. There is a dearth of information on CRAB from our region. METHODS Fifty CRAB isolates were collected from four main hospitals in Bahrain for this study. Bacterial identification and antibiotic susceptibility tests were carried out using the BD PhoenixTM and VITEK-2 compact, respectively. Using conventional PCR, these isolates were further screened for carbapenem resistance markers (blaOXA-51, blaOXA-23, blaOXA-24, blaOXA-40, blaIMP, blaNDM, blaVIM, and blaKPC). RESULTS All of the isolates were resistant to imipenem (100%), meropenem (98%), and cephalosporins (96-98%), followed by other commonly used antibiotics. All these isolates were least resistant to gentamicin (64%). The detection of resistance determinants showed that the majority harbored blaOXA-51 (100%) and blaIMP (94%), followed by blaOXA-23 (82%), blaOXA-24 (46%), blaOXA-40 (14%), blaNDM (6%), blaVIM (2%), and blaKPC (2%). CONCLUSION The study isolates showed a high level of antibiotic resistance. Class D carbapenemases were more prevalent in our CRAB isolate collection. The resistance genes were found in various combinations. This study emphasizes the importance of strengthening surveillance and stringent infection control measures in clinical settings to prevent the emergence and further spread of such isolates.
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Affiliation(s)
- Nouf Al-Rashed
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain
| | - Khalid M Bindayna
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain
| | - Mohammad Shahid
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain
| | - Nermin Kamal Saeed
- Department of Pathology, Microbiology Section, Al- Salmaniya Medical Complex, Manama P.O. Box 12, Bahrain
| | - Abdullah Darwish
- Department of Pathology, Microbiology Section, Bahrain Defense Force Hospital, West Riffa P.O. Box 28743, Bahrain
| | - Ronni Mol Joji
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain
| | - Ali Al-Mahmeed
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain
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Identification and Characterization of Plasmids and Genes from Carbapenemase-Producing Klebsiella pneumoniae in Makkah Province, Saudi Arabia. Antibiotics (Basel) 2022; 11:antibiotics11111627. [PMID: 36421271 PMCID: PMC9686665 DOI: 10.3390/antibiotics11111627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022] Open
Abstract
Klebsiella pneumoniae (K. pneumoniae) is involved in several hospital and community-acquired infections. The prevalence of K. pneumoniae-producing-carbapenemase (KPC) resistance genes rapidly increases and threatens public health worldwide. This study aimed to assess the antibiotic resistance level of K. pneumoniae isolates from Makkah Province, Saudi Arabia, during the Islamic ‘Umrah’ ritual and to identify the plasmid types, presence of genes associated with carbapenem hydrolyzing enzymes, and virulence factors. The phenotypic and genotypic analyses based on the minimum inhibitory concentration (MIC), biofilm formation, PCR, and characterization of KPC-encoding plasmids based on the replicon typing technique (PBRT) were explored. The results showed that most isolates were resistant to carbapenem antibiotics and other antibiotics classes. This study identified sixteen different replicons of plasmids in the isolates and multiple genes encoding carbapenem factors, with blaVIM and blaOXA-48 being the most prevalent genes identified in the isolates. However, none of the isolates exhibited positivity for the KPC production activity. In addition, this study also identified six virulence-related genes, including kfu, wabG, uge, rmpA, fimH, and a capsular polysaccharide (CPS). Together, the data reported in this study indicate that the isolated K. pneumoniae during the pilgrimage in Makkah were all resistant to carbapenem antibiotics. Although the isolates lacked KPC production activity, they carried multiple carbapenem-resistant genes and virulence factors, which could drive their resistant phenotype. The need for specialized methods for KPC detection, monitoring the possibility of nosocomial transmission, and diverse therapeutic alternatives are necessary for controlling the spreading of KPC. This study can serve as a reference for clinicians and researchers on types of K. pneumoniae commonly found during religious gathering seasons in Saudi Arabia.
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Kanapathy S, Obande GA, Chuah C, Shueb RH, Yean CY, Banga Singh KK. Sequence-Specific Electrochemical Genosensor for Rapid Detection of blaOXA-51-like Gene in Acinetobacter baumannii. Microorganisms 2022; 10:1413. [PMID: 35889132 PMCID: PMC9322073 DOI: 10.3390/microorganisms10071413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
Acinetobacter baumannii (A. baumannii) are phenotypically indistinguishable from the Acinetobacter calcoaceticus−A. baumannii (ACB) complex members using routine laboratory methods. Early diagnosis plays an important role in controlling A. baumannii infections and this could be assisted by the development of a rapid, yet sensitive diagnostic test. In this study, we developed an enzyme-based electrochemical genosensor for asymmetric PCR (aPCR) amplicon detection of the blaOXA-51-like gene in A. baumannii. A. baumanniiblaOXA-51-like gene PCR primers were designed, having the reverse primer modified at the 5′ end with FAM. A blaOXA-51-like gene sequence-specific biotin labelled capture probe was designed and immobilized using a synthetic oligomer (FAM-labelled) deposited on the working electrode of a streptavidin-modified, screen-printed carbon electrode (SPCE). The zot gene was used as an internal control with biotin and FAM labelled as forward and reverse primers, respectively. The blaOXA-51-like gene was amplified using asymmetric PCR (aPCR) to generate single-stranded amplicons that were detected using the designed SPCE. The amperometric current response was detected with a peroxidase-conjugated, anti-fluorescein antibody. The assay was tested using reference and clinical A. baumannii strains and other nosocomial bacteria. The analytical sensitivity of the assay at the genomic level and bacterial cell level was 0.5 pg/mL (1.443 µA) and 103 CFU/mL, respectively. The assay was 100% specific and sensitive for A. baumannii. Based on accelerated stability performance, the developed genosensor was stable for 1.6 years when stored at 4 °C and up to 28 days at >25 °C. The developed electrochemical genosensor is specific and sensitive and could be useful for rapid, accurate diagnosis of A. baumannii infections even in temperate regions.
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Affiliation(s)
- Swarnaletchumi Kanapathy
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.K.); (C.C.); (R.H.S.); (C.Y.Y.)
| | - Godwin Attah Obande
- Department of Microbiology, Faculty of Science, Federal University of Lafia, Lafia 950101, Nasarawa State, Nigeria;
| | - Candy Chuah
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.K.); (C.C.); (R.H.S.); (C.Y.Y.)
- Faculty of Health Sciences, Universiti Teknologi MARA, Kampus Bertam, Kepala Batas 13200, Penang, Malaysia
| | - Rafidah Hanim Shueb
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.K.); (C.C.); (R.H.S.); (C.Y.Y.)
| | - Chan Yean Yean
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.K.); (C.C.); (R.H.S.); (C.Y.Y.)
| | - Kirnpal Kaur Banga Singh
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.K.); (C.C.); (R.H.S.); (C.Y.Y.)
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Chandra P, V R, M S, Cs S, Mk U. Multidrug-resistant Acinetobacter baumannii infections: looming threat in the Indian clinical setting. Expert Rev Anti Infect Ther 2021; 20:721-732. [PMID: 34878345 DOI: 10.1080/14787210.2022.2016393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The recent increase in multidrug-resistant strains of A. baumannii has increased the incidences of ventilator-associated pneumoniae, catheter-associated urinary tract infections, and central line-associated blood stream infections, together increasing hospital stay, treatment cost, and mortality. Resistance genes blaOXA and blaNDM are dominant in India. Carbapenem-resistant A. baumannii (CRAB) International clone-2 (IC-2) are rising in India. High dependency on carbapenems and last-resort combination of tigecycline and polymyxins have aggravated outcomes. Despite nursing barriers, ward closure, environmental disinfections etc for detecting and controlling transmission, MDR isolates and CRAB nosocomial outbreaks continue. Treatment cost overruns by AMR adversely affect 80% of Indians without insurance cover. AREA COVERED This narrative review will cover epidemiology, resistance pattern, genetic diversity, device-related infection, cost, and mortality due to multidrug-resistant and CRAB in India. A comprehensive literature search in PubMed and Google Scholar using appropriate keywords at different time points yielded relevant articles. EXPERT OPINION It is challenging to enforce policies to control MDR A. baumannii in India. Government and hospitals should enforce stringent infection control measures, surveillance, and antimicrobial stewardship to prevent further spread and emergence of more virulent and resistant strains. Knowledge on antibiotic resistance mechanisms can help design novel antibiotics that can evade, resistance.
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Affiliation(s)
- Prashant Chandra
- Department of Pharmacy Practice, Centre for Pharmaceutical care, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Rajesh V
- Department of Pharmacy Practice, Centre for Pharmaceutical care, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India.,Department of Pharmacy Practice, Nitte Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, Nitte University, Mangaluru, India
| | - Surulivelrajan M
- Department of Pharmacy Practice, Centre for Pharmaceutical care, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Shastry Cs
- Department of Pharmacy Practice, Nitte Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, Nitte University, Mangaluru, India
| | - Unnikrishnan Mk
- Department of Pharmacy Practice, Nitte Gulabi Shetty Memorial Institute of Pharmaceutical Sciences, Nitte University, Mangaluru, India
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Rameshkumar MR, Arunagirinathan N, Senthamilselvan B, Swathirajan CR, Solomon SS, Vignesh R, Balakrishnan P, Aljowaie RM, Almaary KS, Chen TW. Occurrence of extended-spectrum β-lactamase, AmpC, and carbapenemase-producing genes in gram-negative bacterial isolates from human immunodeficiency virus infected patients. J Infect Public Health 2021; 14:1881-1886. [PMID: 34810142 DOI: 10.1016/j.jiph.2021.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Progressive decline of immune response in HIV patients makes them susceptible to frequent bacterial infections. High usage of antibiotics influences the emergence of multidrug-resistant bacteria and worsens the clinical outcomes. In this study, the occurrence of drug-resistant genes in Gram-negative bacterial isolates from HIV patients in South India was analyzed. METHODS A total of 173 Gram-negative bacterial (GNB) isolates from HIV patients were screened for antibiotic susceptibility profile using the Kirby-Bauer diskdiffusion method. Positivity of drug-resistant genes was analyzed using polymerase chain reaction method. RESULTS In this study, 72.8% of bacterial isolates were obtained from urine specimens, and Escherichia coli (47.4%) was the predominantly isolated bacterium. Overall, 87.3% and 83.2% of GNB were resistant to 3rd generation cephalosporin antibiotics such as cefotaxime and ceftazidime, respectively, 56.6% were resistant to cephamycin (cefoxitin) and 43% to carbapenem (imipenem) antibiotics. Extended-spectrum β-lactamases (ESBL) production was noted among 79.5% of GNB isolates, followed by AmpC (57.1%) and Metallo β-lactamases (37.3%). Molecular analysis revealed that ESBL genes such as blaTEM (94.1%), blaCTX-M (89.2%), and blaSHV (24.2%) were detected at higher levels among GNB isolates. Carbapenemase-producing genes such as blaOXA-48 (20%), blaOXA-23 (2.6%), and both blaOXA-23 and blaOXA-51 like genes (2.6%) and AmpC producing genes such as blaCIT (26.7%), blaDHA (3.6%), and blaACC (1.8%) were detected at low-level. CONCLUSIONS This study concludes that ESBL producing genes are detected at high level among gram-negative bacterial isolates from HIV patients in South India.
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Affiliation(s)
- Marimuthu Ragavan Rameshkumar
- Department of Microbiology and Biotechnology, Presidency College (Autonomous), Affiliated to University of Madras, Chennai, Tamil Nadu, India
| | - Narasingam Arunagirinathan
- Department of Microbiology and Biotechnology, Presidency College (Autonomous), Affiliated to University of Madras, Chennai, Tamil Nadu, India; Central Research Laboratory, Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, India.
| | - Balasubramanian Senthamilselvan
- Department of Microbiology and Biotechnology, Presidency College (Autonomous), Affiliated to University of Madras, Chennai, Tamil Nadu, India
| | | | - Sunil Suhas Solomon
- HIV Clinic, Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, India; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Ramachandran Vignesh
- Infectious Diseases Laboratory, Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, India; Preclinical Department, Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak (RCMP UniKL), Ipoh, Malaysia
| | - Pachamuthu Balakrishnan
- Infectious Diseases Laboratory, Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, India
| | - Reem M Aljowaie
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. 2455, Riyadh, Saudi Arabia
| | - Khalid S Almaary
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. 2455, Riyadh, Saudi Arabia
| | - Tse-Wei Chen
- Department of Materials, Imperial College London, London, SW7 2AZ, United Kingdom
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Enrofloxacin Alters Fecal Microbiota and Resistome Irrespective of Its Dose in Calves. Microorganisms 2021; 9:microorganisms9102162. [PMID: 34683483 PMCID: PMC8537546 DOI: 10.3390/microorganisms9102162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 12/27/2022] Open
Abstract
Enrofloxacin is a fluoroquinolone drug used to prevent and control bovine respiratory disease (BRD) complex in multiple or single doses, ranging from 7.5 to 12.5 mg/kg body weight. Here, we examined the effects of high and low doses of a single subcutaneously injected enrofloxacin on gut microbiota and resistome in calves. Thirty-five calves sourced for this study were divided into five groups: control (n = 7), two low dose groups (n = 14, 7.5 mg/kg), and two high dose groups (n = 14, 12.5 mg/kg). One group in the low and high dose groups was challenged with Mannheimia haemolytica to induce BRD. Both alpha and beta diversities were significantly different between pre- and post-treatment microbial communities (q < 0.05). The high dose caused a shift in a larger number of genera than the low dose. Using metagenomic ProxiMeta Hi-C, 32 unique antimicrobial resistance genes (ARGs) conferring resistance to six antibiotic classes were detected with their reservoirs, and the high dose favored clonal expansion of ARG-carrying bacterial hosts. In conclusion, enrofloxacin treatment can alter fecal microbiota and resistome irrespective of its dose. Hi-C sequencing provides significant benefits for unlocking new insights into the ARG ecology of complex samples; however, limitations in sample size and sequencing depth suggest that further work is required to validate the findings.
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Sharma M, Singhal L, Gautam V, Ray P. Distribution of carbapenemase genes in clinical isolates of Acinetobacter baumannii & a comparison of MALDI-TOF mass spectrometry-based detection of carbapenemase production with other phenotypic methods. Indian J Med Res 2021; 151:585-591. [PMID: 32719232 PMCID: PMC7602923 DOI: 10.4103/ijmr.ijmr_1383_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background & objectives: Carbapenemase-producing Acinetobacter baumannii (CRAB) poses a continuous threat to the current antimicrobial era with its alarming spread in critical care settings. The present study was conducted to evaluate the diagnostic potential of phenotypic methods for carbapenemase [carbapenem-hydrolyzing class D β-lactamases (CHDLs) and metallo-β-lactamases (MBLs)] production, by comparing with molecular detection of genes. Methods: One hundred and fifty clinical CRAB isolates collected between August 2013 and January 2014 were studied. Multiplex PCR was performed to identify the carbapenemases produced (class D blaOXA-51, blaOXA-23, blaOXA-48,blaOXA-58; class B blaVIM, blaNDM-1, blaIMP; class A blaKPC). Each isolate was evaluated for carbapenemase production by studying the pattern of imipenem hydrolysis using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results: The most commonly encountered carbapenemase genes were blaOXA-51 (100%), blaOXA-23 (98%), blaVIM (49.3%), blaNDM-1 (18.7%) and blaOXA-58 (2%). MALDI-TOF MS was able to detect 30.6 per cent carbapenemases within three hours (P=0.001 for MBL and P>0.05 for CHDL) and 65.3 per cent within six hours (P=0.001 for MBL and P>0.05 for CHDL). Interpretation & conclusions: MALDI-TOF MS reliably detected carbapenemase activity within a short span of time, thus helping in tailoring patient therapy. MALDI-TOF MS, once optimized, can prove to be a useful tool for timely detection of carbapenemase production by A. baumannii and consequently in directing appropriate antimicrobial therapy.
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Affiliation(s)
- Megha Sharma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Lipika Singhal
- Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
| | - Vikas Gautam
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Pallab Ray
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Bogue AL, Panmanee W, McDaniel CT, Mortensen JE, Kamau E, Actis LA, Johannigman JA, Schurr MJ, Satish L, Kotagiri N, Hassett DJ. AB569, a non-toxic combination of acidified nitrite and EDTA, is effective at killing the notorious Iraq/Afghanistan combat wound pathogens, multi-drug resistant Acinetobacter baumannii and Acinetobacter spp. PLoS One 2021; 16:e0247513. [PMID: 33657146 PMCID: PMC7928478 DOI: 10.1371/journal.pone.0247513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/08/2021] [Indexed: 11/19/2022] Open
Abstract
Multi-drug resistant (MDR) Acinetobacter baumannii (Ab) and Acinetobacter spp. present monumental global health challenges. These organisms represent model Gram-negative pathogens with known antibiotic resistance and biofilm-forming properties. Herein, a novel, nontoxic biocide, AB569, consisting of acidified nitrite (A-NO2-) and ethylenediaminetetraacetic acid (EDTA), demonstrated bactericidal activity against all Ab and Acinetobacter spp. strains, respectively. Average fractional inhibitory concentrations (FICs) of 0.25 mM EDTA plus 4 mM A-NO2- were observed across several clinical reference and multiple combat wound isolates from the Iraq/Afghanistan wars. Importantly, toxicity testing on human dermal fibroblasts (HDFa) revealed an upper toxicity limit of 3 mM EDTA plus 64 mM A-NO2-, and thus are in the therapeutic range for effective Ab and Acinetobacter spp. treatment. Following treatment of Ab strain ATCC 19606 with AB569, quantitative PCR analysis of selected genes products to be responsive to AB569 revealed up-regulation of iron regulated genes involved in siderophore production, siderophore biosynthesis non-ribosomal peptide synthetase module (SBNRPSM), and siderophore biosynthesis protein monooxygenase (SBPM) when compared to untreated organisms. Taken together, treating Ab infections with AB569 at inhibitory concentrations reveals the potential clinical application of preventing Ab from gaining an early growth advantage during infection followed by extensive bactericidal activity upon subsequent exposures.
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Affiliation(s)
- Amy L. Bogue
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- Wright-Patterson Air Force Base, Dayton (Wright-Patterson Air Force Base), Dayton, OH, United States of America
| | - Warunya Panmanee
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
| | - Cameron T. McDaniel
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
| | - Joel E. Mortensen
- Diagnostic Infectious Disease Testing Laboratory and Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Edwin Kamau
- Walter Reed National Military Medical Center (WRNMMC), Bethesda, MD, United States of America
| | - Luis A. Actis
- Department of Microbiology, Miami University, Oxford, OH, United States of America
| | - Jay A. Johannigman
- U.S. Army Institute of Surgical Research, San Antonio, TX, United States of America
| | - Michael J. Schurr
- Department of Immunology and Microbiology, University of Colorado Anschutz School of Medicine, Denver, CO, United States of America
| | - Latha Satish
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- College of Pharmacy, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
| | - Nalinikanth Kotagiri
- Research Department, Shriners Hospitals for Children- Cincinnati, Cincinnati, OH, United States of America
| | - Daniel J. Hassett
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- * E-mail:
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Hassan PA, Khider AK. Correlation of biofilm formation and antibiotic resistance among clinical and soil isolates of Acinetobacter baumannii in Iraq. Acta Microbiol Immunol Hung 2020; 67:161-170. [PMID: 31833386 DOI: 10.1556/030.66.2019.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/17/2019] [Indexed: 01/09/2023]
Abstract
Acinetobacter baumannii is an opportunistic pathogen that is reported as a major cause of nosocomial infections. The aim of this study was to investigate the biofilm formation by A. baumannii clinical and soil isolates, to display their susceptibility to 11 antibiotics and to study a possible relationship between formation of biofilm and multidrug resistance. During 8 months period, from June 2016 to January 2017, a total of 52 clinical and 22 soil isolates of A. baumannii were collected and identified through conventional phenotypic, chromo agar, biochemical tests, API 20E system, and confirmed genotypically by PCR for blaOXA-51-like gene. Antibiotic susceptibility of isolates was determined by standard disk diffusion method according to Clinical and Laboratory Standard Institute. The biofilm formation was studied using Congo red agar, test tube, and microtiter plate methods. The clinical isolates were 100% resistance to ciprofloxacin, ceftazidime, piperacillin, 96.15% to gentamicin, 96.15% to imipenem, 92.31% to meropenem, and 78.85% to amikacin. The soil A. baumannii isolates were 100% sensitive to imipenem, meropenem, and gentamicin, and 90.1% to ciprofloxacin. All A. baumannii isolates (clinical and soil) were susceptible to polymyxin B. The percentage of biofilm formation in Congo red agar, test tube, and microtiter plate assays was 10.81%, 63.51%, and 86.48%, respectively. More robust biofilm former population was mainly among non-MDR isolates. Isolates with a higher level of resistance tended to form weaker biofilms. The soil isolates exhibited less resistance to antibiotics than clinical isolates. However, the soil isolates produce stronger biofilms than clinical isolates.
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Affiliation(s)
- Pakhshan A. Hassan
- 1 Department of Biology, College of Science, Salahaddin University, Erbil, Iraq
| | - Adel K. Khider
- 2 Department of Biology, College of Education, Salahaddin University, Erbil, Iraq
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Antibiogram, Prevalence of OXA Carbapenemase Encoding Genes, and RAPD-Genotyping of Multidrug-Resistant Acinetobacter baumannii Incriminated in Hidden Community-Acquired Infections. Antibiotics (Basel) 2020; 9:antibiotics9090603. [PMID: 32942596 PMCID: PMC7558960 DOI: 10.3390/antibiotics9090603] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 12/16/2022] Open
Abstract
Acinetobacter spp. has gained fame from their ability to resist difficult conditions and their constant development of antimicrobial resistance. This study aimed to investigate the prevalence, susceptibility testing, OXA carbapenemase-encoding genes, and RAPD-genotyping of multidrug resistant Acinetobacter baumannii incriminated in hidden community-acquired infections in Egypt. The antimicrobial susceptibility testing was assessed phenotypically using Kirby–Bauer disk diffusion method. Also, Modified-Hodge test (MHT) was carried out to detect the carbapenemases production. Multiplex-PCR was used to detect the carbapenemase-encoding genes. Furthermore, the genetic relationship among the isolated strains was investigated using RAPD fingerprinting. The bacteriological examination revealed that, out of 200 Gram-negative non-fermentative isolates, 44 (22%) were identified phenotypically and biochemically as Acinetobacter spp. and 23 (11.5%) were molecularly confirmed as A.baumannii. The retrieved A.baumannii strains were isolated from urine (69%), sputum (22%), and cerebrospinal fluid (csf) (9%). The isolated A. baumannii strains exhibited multidrug resistance and the production rates of carbapenemases were 56.5, 60.9, and 78.3% with meropenem, imipenem, and ertapenem disks, respectively. The blaOXA-24-like genes were the most predominant among the tested strains (65.2%), followed by blaOXA-23 (30.4%) and blaOXA-58 (17.4%), in addition, the examined strains are harbored IMP, VIM, and NDM genes with prevalence of 60.9, 43.5, and 13%, respectively, while KPC and GES genes were not detected. RAPD-PCR revealed that the examined strains are clustered into 11 different genotypes at ≥90% similarity. Briefly, to the best of our knowledge, this study is the first report concerning community-associated A. baumannii infections in Egypt. The high prevalence of hidden multidrug-resistant (MDR) and extensively drug-resistant (XDR) A.baumannii strains associated with non-hospitalized patients raises an alarm for healthcare authorities to set strict standards to control the spread of such pathogens with high rates of morbidity and mortality.
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12
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Swathi C, Sudhaharan S, Lakshmi V, Suguna Ratnakar K, Sritharan V. Direct Detection and Discrimination of Carbapenemases of Acinetobacter baumannii from Uncultured Tracheal Aspirates. Microb Drug Resist 2020; 26:1153-1162. [PMID: 32364821 DOI: 10.1089/mdr.2019.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Carbapenemases play important roles in conferring resistance to beta-lactam antibiotics, including the carbapenems. Detection of carbapenemase activity helps to understand the possible mechanism(s) of carbapenem resistance. Identification of carbapenemases is currently being done by various phenotypic methods and molecular methods. However, innovative biochemical and spectrophotometric methods are desirable as they will be easy to perform, affordable, and rapid. A novel chromogenic method called Carba NP test was introduced recently to screen for carbapenemases in clinical isolates of gram-negative pathogens. We adopted this assay (1) to detect the total carbapenemase activity, (2) to discriminate Class A, B, and D carbapenemases with inhibitors, (3) to compare with carbapenemase genotype, and (4) for direct differential diagnosis of carbapenemases in uncultured clinical sample such as tracheal aspirate. The study included 132 purulent tracheal aspirates. All samples were processed and screened by a protocol optimized in our laboratory, which showed good sensitivity and correlation with genotyping and conventional phenotyping. Our protocol not only offers the fastest way to identify the pathogen but also its carbapenemase profile, directly from uncultured clinical samples in less than 4 hr. Our protocol is currently being validated on other types of clinical specimens in our laboratory.
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Affiliation(s)
- Cheguri Swathi
- Department of Molecular Diagnostics & Biomarkers, Global Medical Education and Research Foundation (GMERF), Hyderabad, India
| | - Sukanya Sudhaharan
- Department of Microbiology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, India
| | - Vemu Lakshmi
- Department of Microbiology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, India
| | - Kamaraju Suguna Ratnakar
- Department of Molecular Diagnostics & Biomarkers, Global Medical Education and Research Foundation (GMERF), Hyderabad, India
| | - Venkataraman Sritharan
- Department of Molecular Diagnostics & Biomarkers, Global Medical Education and Research Foundation (GMERF), Hyderabad, India
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Vijayakumar S, Mathur P, Kapil A, Das BK, Ray P, Gautam V, Sistla S, Parija SC, Walia K, Ohri VC, Anandan S, Subramani K, Ramya I, Veeraraghavan B. Molecular characterization & epidemiology of carbapenem-resistant Acinetobacter baumannii collected across India. Indian J Med Res 2019; 149:240-246. [PMID: 31219089 PMCID: PMC6563728 DOI: 10.4103/ijmr.ijmr_2085_17] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background & objectives Acinetobacter baumannii is an opportunistic pathogen responsible for causing nosocomial infections. A. baumannii develops resistance to various antimicrobial agents including carbapenems, thereby complicating the treatment. This study was performed to characterize the isolates for the presence of various β-lactamases encoding genes and to type the isolates to compare our clones with the existing international clones across five centres in India. Methods A total 75 non-repetitive clinical isolates of A. baumannii from five different centres were included in this study. All the isolates were confirmed as A. baumannii by bl aOXA-51-likePCR. Multiplex PCR was performed to identify the presence of extended spectrum β-lactamases (ESBL) and carbapenemases. Multilocus sequence typing was performed to find the sequence type (ST) of the isolates. e-BURST analysis was done to assign each ST into respective clonal complex. Results blaOXA-51-likewas present in all the 75 isolates. The predominant Class D carbapenemase was blaOXA-23-likefollowed by Class B carbapenemase, blaNDM-like. Class A carbapenemase was not observed. blaPER-likewas the predominant extended spectrum β-lactamase. ST-848, ST-451 and ST-195 were the most common STs. Eight-novel STs were identified. e-BURST analysis showed that the 75 A. baumannii isolates were clustered into seven clonal complexes and four singletons, of which, clonal complex 208 was the largest. Interpretation & conclusions Most of the isolates were grouped under clonal complex 208 which belongs to the international clonal lineage 2. High occurrence of ST-848 carrying blaOXA-23-likegene suggested that ST-848 could be an emerging lineage spreading carbapenem resistance in India.
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Affiliation(s)
- Saranya Vijayakumar
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Purva Mathur
- Department of Lab Medicine, Jai Prakash Narayan Apex Trauma Centre, New Delhi, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bimal K Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Pallab Ray
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Vikas Gautam
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sujatha Sistla
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - Subhash Chandra Parija
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - Kamini Walia
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - V C Ohri
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Shalini Anandan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Kandasamy Subramani
- Department of Surgical Intensive Care Unit, Christian Medical College, Vellore, India
| | - Iyyadurai Ramya
- Department of Medicine, Christian Medical College, Vellore, India
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Girija SA, Priyadharsini JV, Paramasivam A. Prevalence of carbapenem-hydrolyzing OXA-type β-lactamases among Acinetobacter baumannii in patients with severe urinary tract infection. Acta Microbiol Immunol Hung 2019; 67:49-55. [PMID: 31813258 DOI: 10.1556/030.66.2019.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/02/2019] [Indexed: 11/19/2022]
Abstract
Acinetobacter baumannii produces carbapenemase-hydrolyzing class D β-lactamases (CHDLs) as one of the major drug resistance mechanisms. This investigation is thus aimed to assess the prevalence and to characterize the CHDL-producing strains of A. baumannii by both phenotypic assays and genotypic characterization. A total of 73 isolates of A. baumannii were phenotypically and genotypically characterized from patients (N = 1,000) with severe urinary tract infection. Tested strains were subjected to double disk synergy testing by Kirby-Bauer disk diffusion method with modified Hodge test (MHT) for carbapenemase production. Plasmid DNA was molecularly screened for CHDL-encoding blaoxa-51, blaoxa-23, and blaoxa-143 genes by polymerase chain reaction. Carbapenem-resistant profile showed 100%, 61.64%, and 67.12% resistance by Kirby-Bauer disk diffusion method that correlated with MHT positivity for 100% (n = 73), 80% (n = 36), and 78% (n = 38) of the isolates against imipenem, doripenem, and meropenem, respectively. The blaoxa-51 and blaoxa-23 were observed in 41.09% (n = 30) and 35.61% (n = 26) with co-occurrence in 4.10% (n = 3) of the isolates. MHT-positive isolates showed 100%, 91.66%, and 71.4% for blaoxa-51 and 91.78%, 51.11%, and 34.69% for blaoxa-23 with imipenem, doripenem, and meropenem resistance, respectively. None of the strains yielded blaoxa-143 gene. The findings of this study showed prevalence of carbapenem resistance and high frequency of blaoxa-51 and blaoxa-23 among A. baumannii.
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Affiliation(s)
- Smiline As Girija
- Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | | | - Arumugam Paramasivam
- BRULAC-DRC, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
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15
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Khaledi M, Shahini Shams Abadi M, Validi M, Zamanzad B, Vafapour R, Gholipour A. Phenotypic and genotypic detection of metallo-β-lactamases in A. baumanii isolates obtained from clinical samples in Shahrekord, southwest Iran. BMC Res Notes 2019; 12:597. [PMID: 31533853 PMCID: PMC6751628 DOI: 10.1186/s13104-019-4636-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/11/2019] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Acinetobacter baumanii is a pathogenic bacterium that is the cause of many nosocomial infections. This study aimed to determine metallo-β-lactamases (MBL) produced by the A. baumanii isolates obtained from clinical samples in Shahrekord, southwest Iran. RESULTS A total of 100 A. baumanii were isolated from 250 clinical samples between June 2013 and June 2014. Then, the isolates were identified by biochemical tests, and MBL screening was conducted by the phenotypic tests modified Hodge, EDTA-disk synergy (EDS), combined disk (CD) and AmpC disc after antibiotic sensitivity test. Using PCR technique the bla genes were detected. Eighty-five (85%) isolates were resistant to meropenem and imipenem. Phenotypic tests showed that out of the 100 isolates, 46, 59, 50, 65 and 65 isolates were positive: AmpC disk, CD, EDS, Modified Hodge and E-test MBL respectively. Gene detection by PCR showed that 23 isolates carried the VIM-1 gene and only three isolates carried the IMP-1 gene. The prevalence of metallo-β-lactamases isolates containing A. baumanii is increasing. Furthermore, the coexistence of various carbapenemases is dominantly act as a major problem. Continuous monitoring of the infections related to these bacteria should be considered to plan an alternative and new therapeutic strategies.
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Affiliation(s)
- Mansoor Khaledi
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
| | - Milad Shahini Shams Abadi
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
| | - Majid Validi
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
| | - Behnam Zamanzad
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
| | - Rezvan Vafapour
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
| | - Abolfazl Gholipour
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
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16
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Park YJ, Hong DJ, Yoon EJ, Kim D, Choi MH, Hong JS, Lee H, Yong D, Jeong SH. Differences in Colistin-resistant Acinetobacter baumannii Clinical Isolates Between Patients With and Without Prior Colistin Treatment. Ann Lab Med 2018; 38:545-554. [PMID: 30027698 PMCID: PMC6056399 DOI: 10.3343/alm.2018.38.6.545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/26/2018] [Accepted: 06/08/2018] [Indexed: 11/30/2022] Open
Abstract
Background The increasing morbidity and mortality rates associated with Acinetobacter baumannii are due to the emergence of drug resistance and the limited treatment options. We compared characteristics of colistin-resistant Acinetobacter baumannii (CR-AB) clinical isolates recovered from patients with and without prior colistin treatment. We assessed whether prior colistin treatment affects the resistance mechanism of CR-AB isolates, mortality rates, and clinical characteristics. Additionally, a proper method for identifying CR-AB was determined. Methods We collected 36 non-duplicate CR-AB clinical isolates resistant to colistin. Antimicrobial susceptibility testing, Sanger sequencing analysis, molecular typing, lipid A structure analysis, and in vitro synergy testing were performed. Eleven colistin-susceptible AB isolates were used as controls. Results Despite no differences in clinical characteristics between patients with and without prior colistin treatment, resistance-causing genetic mutations were more frequent in isolates from colistin-treated patients. Distinct mutations were overlooked via the Sanger sequencing method, perhaps because of a masking effect by the colistin-susceptible AB subpopulation of CR-AB isolates lacking genetic mutations. However, modified lipid A analysis revealed colistin resistance peaks, despite the population heterogeneity, and peak levels were significantly different between the groups. Conclusions Although prior colistin use did not induce clinical or susceptibility differences, we demonstrated that identification of CR-AB by sequencing is insufficient. We propose that population heterogeneity has a masking effect, especially in colistin non-treated patients; therefore, accurate testing methods reflecting physiological alterations of the bacteria, such as phosphoethanolamine-modified lipid A identification by matrix-assisted laser desorption ionization-time of flight, should be employed.
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Affiliation(s)
- Yu Jin Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Duck Jin Hong
- Department of Laboratory Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE
| | - Eun Jeong Yoon
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University, Seoul, Korea
| | - Dokyun Kim
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University, Seoul, Korea
| | - Min Hyuk Choi
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Sung Hong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University, Seoul, Korea
| | - Dongeun Yong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University, Seoul, Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University, Seoul, Korea.
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17
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Guzel M, Afsar Y, Akdogan D, Moncheva P, Hristova P, Erdem G. Evaluation of metallo-beta-lactamase production in multiple antibiotic-resistant Pseudomonas spp. and Acinetobacter baumannii strains. BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2018.1500146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Mustafa Guzel
- Microbiology Laboratory, Private Maltepe Medical Center, Istanbul, Turkey
| | - Yusuf Afsar
- Microbiology Laboratory, Ağrı State Hospital, Ağrı, Turkey
| | - Dogan Akdogan
- Microbiology Laboratory, 29 Mayıs State Hospital, Ankara, Turkey
| | - Penka Moncheva
- Department of Microbiology, Faculty of Biology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Petya Hristova
- Department of Microbiology, Faculty of Biology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Gul Erdem
- Department of Medical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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18
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Braun SD, Jamil B, Syed MA, Abbasi SA, Weiß D, Slickers P, Monecke S, Engelmann I, Ehricht R. Prevalence of carbapenemase-producing organisms at the Kidney Center of Rawalpindi (Pakistan) and evaluation of an advanced molecular microarray-based carbapenemase assay. Future Microbiol 2018; 13:1225-1246. [PMID: 29938540 DOI: 10.2217/fmb-2018-0082] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM A DNA microarray-based assay for the detection of antimicrobial resistance (AMR) genes was used to study carbapenemase-producing organisms at the Kidney Center of Rawalpindi, Pakistan. METHODS The evaluation of this assay was performed using 97 reference strains with confirmed AMR genes. Testing of 7857 clinical samples identified 425 Gram-negative bacteria out of which 82 appeared carbapenem resistant. These isolates were analyzed using VITEK-2 for phenotyping and the described AMR assay for genotyping. RESULTS The most prevalent carbapenemase gene was blaNDM and in 12 isolates we detected two carbapenemase genes (e.g., blaNDM/blaOXA-48). CONCLUSION Our prevalence data from Pakistan show that - as in other parts of the world - carbapenemase-producing organisms with different underlying resistance mechanisms are emerging, and this warrants intensified and constant surveillance.
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Affiliation(s)
- Sascha D Braun
- Research & Development, Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Bushra Jamil
- Department of Biogenetics, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Muhammad A Syed
- Department of Microbiology, University of Haripur, Haripur, Pakistan
| | - Shahid A Abbasi
- Department of Pathology, Al-Sayed Hospital (Pvt) Ltd, 1-Hill Park, Opp. Ayub Park, Jhelum Road, Rawalpindi, Pakistan
| | - Daniel Weiß
- Research & Development, Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Peter Slickers
- Research & Development, Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Stefan Monecke
- Research & Development, Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany.,Technische Universität Dresden, Medizinische Fakultät "Carl Gustav Carus", Dresden, Germany
| | - Ines Engelmann
- Research & Development, Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Ralf Ehricht
- Research & Development, Abbott (Alere Technologies GmbH), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
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Helmy OM, Kashef MT. Different phenotypic and molecular mechanisms associated with multidrug resistance in Gram-negative clinical isolates from Egypt. Infect Drug Resist 2017; 10:479-498. [PMID: 29263684 PMCID: PMC5726372 DOI: 10.2147/idr.s147192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES We set out to investigate the prevalence, different mechanisms, and clonal relatedness of multidrug resistance (MDR) among third-generation cephalosporin-resistant Gram-negative clinical isolates from Egypt. MATERIALS AND METHODS A total of 118 third-generation cephalosporin-resistant Gram-negative clinical isolates were included in this study. Their antimicrobial susceptibility pattern was determined using Kirby-Bauer disk diffusion method. Efflux pump-mediated resistance was tested by the efflux-pump inhibitor-based microplate assay using chlorpromazine. Detection of different aminoglycoside-, β-lactam-, and quinolone-resistance genes was done using polymerase chain reaction. The genetic diversity of MDR isolates was investigated using random amplification of polymorphic DNA. RESULTS Most of the tested isolates exhibited MDR phenotypes (84.75%). The occurrence of efflux pump-mediated resistance in the different MDR species tested was 40%-66%. Acinetobacter baumannii isolates showed resistance to most of the tested antibiotics, including imipenem. The blaOXA-23-like gene was detected in 69% of the MDR A. baumannii isolates. The MDR phenotype was detected in 65% of Pseudomonas aeruginosa isolates, of which only 23% exhibited efflux pump-mediated resistance. On the contrary, efflux-mediated resistance to piperacillin and gentamicin was recorded in 47.5% of piperacillin-resistant and 25% of gentamicin-resistant MDR Enterobacteriaceae. Moreover, the plasmid-mediated quinolone-resistance genes (aac(6')-Ib-cr, qnrB, and qnrS) were detected in 57.6% and 83.33% of quinolone-resistant MDR Escherichia coli and Klebsiella pneumoniae isolates, respectively. The β-lactamase-resistance gene blaSHV-31 was detected for the first time in one MDR K. pneumoniae isolate from an endotracheal tube specimen in Egypt, accompanied by blaTEM-1, blaCTX-M-15, blaCTX-M-14, aac(6')-Ib-cr, qnrS, and multidrug efflux-mediated resistance. CONCLUSION MDR phenotypes are predominant among third-generation cephalosporin-resistant Gram-negative bacteria in Egypt and mediated by different mechanisms, with an increased role of efflux pumps in Enterobacteriaceae.
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Affiliation(s)
- Omneya M Helmy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Mona T Kashef
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Molecular Study of Acinetobacter baumannii Isolates for Metallo- β-Lactamases and Extended-Spectrum- β-Lactamases Genes in Intensive Care Unit, Mansoura University Hospital, Egypt. Int J Microbiol 2017; 2017:3925868. [PMID: 28567057 PMCID: PMC5439075 DOI: 10.1155/2017/3925868] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 03/28/2017] [Accepted: 04/10/2017] [Indexed: 11/17/2022] Open
Abstract
Acinetobacter baumannii (A. baumannii) has been known as a causative pathogen of hospital acquired infections. The aim of this study is to examine the presence of A. baumannii among clinical isolates from intensive care unit (ICU) in Mansoura University Hospital (MUH), its antibiotic resistance pattern, and prevalence of antibiotic resistance genes metallo-β-lactamases (MBLs) and extended-spectrum-β-lactamases (ESBLs) among A. baumannii isolates. A. baumannii was identified by colony morphology, API 20E, and confirmed by detecting the bla OXA-51-like carbapenemase gene by PCR. Phenotypic expression of MBLs resistance was demonstrated by Combined Disk Test (CDT) in 273 isolates (97.5%) and of ESBLs was demonstrated by double disc synergy method (DDST) in 6 isolates (2.1%). MBLs genes were positive in 266 isolates (95%) and ESBLs genes were positive in 8 isolates (2.9%). The most frequent genes of MBLs studied genes were IMP (95.7%) followed by SIM and GIM (47.1% and 42.9%; resp.). For ESBL genes, the most frequent gene was TEM (2.9%). From this study, we conclude that multidrug resistant (MDR) A. baumannii with MBLs activity was the most common isolate. Careful monitoring for the presence of MDR A. baumannii among hospitalized patients is recommended to avoid wide dissemination of antibiotic resistance.
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21
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Saranathan R, Kumari R, Kalaivani R, Suresh S, Rani A, Purty S, Prashanth K. Detection of ISAba1 in association with a novel allelic variant of the β-lactamase ADC-82 and class D β-lactamase genes mediating carbapenem resistance among the clinical isolates of MDR A. baumannii. J Med Microbiol 2017; 66:103-111. [PMID: 28260590 DOI: 10.1099/jmm.0.000395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The objective of the present study is to investigate the diverse resistance determinants, their association with insertion sequence mobile elements and predilection of a particular clone for such associations in Acinetobacter baumannii. METHODOLOGY Fifty-four consecutive isolates collected during 2011-2012 from a tertiary care hospital were subjected to susceptibility testing followed by PCR screening of commonly reported β-lactamases and 16S rRNA methyltransferase encoding genes. The integrity of resistance-nodulation-cell division efflux pump-related genes in their respective operons was also investigated. RESULTS β-Lactamase genes such as blaADC (100 %), blaOXA-23 (81 %), blaPER-1 (81 %), blaIMP-1 (31 %) and blaNDM-1 (15 %) were found to be present more frequently while blaVIM-2 and blaOXA-24 were not observed in our study population. ISAba1 was associated only with blaOXA-51-like like (30 %), blaOXA-23-like (55 %) and blaADC-like (33 %). armA was found in 87 % of isolates and ISAba1 linked with one novel variant of ADC, namely blaADC-82, which was identified to have 15 nucleotide differences with blaADC-79, and this finding is of much significance. In many isolates, efflux pump genes were not intact, resulting in severely altered effluxing functions. For the first time, we have identified ISAba1-mediated disruption of adeN among the isolates of ST 195B, which would have led to overexpression of AdeIJK efflux pump causing elevated resistance. Multilocus sequence typing revealed the predominance of CC 92B (IC-IIB) and CC 447B clonal complexes. CONCLUSION High incidence of IC-II clones, novel resistance determinants (ADC-82) and elevated resistance mediated by ISAba1 reported here will be of enormous importance while assessing the emergence of extremely resistant A. baumannii in India.
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Affiliation(s)
- Rajagopalan Saranathan
- Department of Biotechnology, School of Life Sciences, Pondicherry University, Pondicherry, India
| | - Rinki Kumari
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India.,Department of Biotechnology, School of Life Sciences, Pondicherry University, Pondicherry, India
| | - Ramakrishnan Kalaivani
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.,Department of Clinical Microbiology, Pondicherry Institute of Medical Sciences (PIMS), Pondicherry, India
| | - Sah Suresh
- Department of Biotechnology, School of Life Sciences, Pondicherry University, Pondicherry, India
| | - Anshu Rani
- Department of Biotechnology, School of Life Sciences, Pondicherry University, Pondicherry, India
| | - Shashikala Purty
- Department of Clinical Microbiology, Pondicherry Institute of Medical Sciences (PIMS), Pondicherry, India
| | - K Prashanth
- Department of Biotechnology, School of Life Sciences, Pondicherry University, Pondicherry, India
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Laishram S, Anandan S, Devi BY, Elakkiya M, Priyanka B, Bhuvaneshwari T, Peter JV, Subramani K, Balaji V. Determination of synergy between sulbactam, meropenem and colistin in carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii isolates and correlation with the molecular mechanism of resistance. J Chemother 2017; 28:297-303. [PMID: 27461479 DOI: 10.1080/1120009x.2016.1143261] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Treatment of infections with carbapenem-resistant Gram negative organism is a major challenge especially among intensive care patients. Combinations of sulbactam, meropenem and colistin was studied for its synergistic activity against 100 invasive isolates of carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii-calcoaceticus complex by checkerboard assay and time kill assay (TKA). In addition, presence of carbapenemase production was determined by multiplex PCR. Time kill assay detected more synergy than checkerboard assay. Good bactericidal activity of 70-100% was noted with the combinations tested. Among K. pneumoniae, isolates producing NDM carbapenemase alone showed significantly more synergy than isolates producing OXA-48-like carbapenemases. In treatment of infection with carbapenem-resistant organisms, the site of infection and the type of carbapenemase produced may help to determine the most effective combination of antimicrobials.
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Affiliation(s)
- Shakti Laishram
- a Department of Microbiology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Shalini Anandan
- a Department of Microbiology , Christian Medical College , Vellore , Tamil Nadu , India
| | | | - Munusamy Elakkiya
- a Department of Microbiology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Babu Priyanka
- a Department of Microbiology , Christian Medical College , Vellore , Tamil Nadu , India
| | | | - John Victor Peter
- b Medical Intensive Care Unit , Christian Medical College , Vellore , Tamil Nadu , India
| | - Kandasmy Subramani
- c Surgical Intensive Care Unit , Christian Medical College , , Vellore , Tamil Nadu , India
| | - Veeraraghavan Balaji
- a Department of Microbiology , Christian Medical College , Vellore , Tamil Nadu , India
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23
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Pragasam AK, Vijayakumar S, Bakthavatchalam YD, Kapil A, Das BK, Ray P, Gautam V, Sistla S, Parija SC, Walia K, Ohri VC, Anandan S, Veeraraghavan B. Molecular characterisation of antimicrobial resistance in Pseudomonas aeruginosa and Acinetobacter baumannii during 2014 and 2015 collected across India. Indian J Med Microbiol 2017; 34:433-441. [PMID: 27934820 DOI: 10.4103/0255-0857.195376] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Surveillance of antimicrobial resistance (AMR) is of great importance. Pseudomonas aeruginosa and Acinetobacter baumannii are important pathogens and emergence of resistance in these have increased the morbidity and mortality rates. This surveillance study was initiated by the Government of India - Indian Council of Medical Research. The aim of this study is to determine the antimicrobial susceptibility profile and to characterise the enzyme mediated antimicrobial resistance such as extended spectrum beta-lactamases (ESBLs) and carbapenemases among multidrug-resistant (MDR) P. aeruginosa and A. baumannii. MATERIALS AND METHODS A multi-centric study was conducted from January 2014 to December 2015 with a total number of 240 MDR P. aeruginosa and 312 MDR A. baumannii isolated from blood, cerebrospinal fluid, respiratory, pus, urine and intra-abdominal infections. Kirby-Bauer disc diffusion was done to determine the antimicrobial susceptibility profile. Further, MDR isolates were characterised by multiplex polymerase chain reaction to determine the resistance genes for ESBLs and carbapenemases. RESULTS Among the ESBLs, blaVEB (23%), blaTEM (5%) and blaSHV (0.4%) in P. aeruginosa and blaPER (54%), blaTEM (16%) and blaSHV (1%) in A. baumannii were the most prevalent. Likewise, blaVIM (37%), blaNDM (14%), blaGES (8%) and blaIMP (2%) in P. aeruginosa and blaOXA-23like (98%), blaOXA-58like (2%), blaNDM (22%) and blaVIM (3%) in A. baumannii were found to be the most prevalent carbapenemases. blaOXA-51like gene, intrinsic to A. baumannii was present in all the isolates tested. CONCLUSION The data shown highlight the wide difference in the molecular mechanisms of AMR profile between P. aeruginosa and A. baumannii. In P. aeruginosa, plasmid-mediated mechanisms are much lesser than the chromosomal mediated mechanisms. In A. baumannii, class D oxacillinases are more common than other mechanisms. Continuous surveillance to monitor the trends in AMR among MDR pathogens is important for implementation of infection control and to guide appropriate empirical antimicrobial therapy.
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Affiliation(s)
- A K Pragasam
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Vijayakumar
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Y D Bakthavatchalam
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Kapil
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - B K Das
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - P Ray
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - V Gautam
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sistla
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S C Parija
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K Walia
- Division of Epidemiology and Communicable Diseases, n Council for Medical Research, New Delhi, India
| | - V C Ohri
- Division of Epidemiology and Communicable Diseases, n Council for Medical Research, New Delhi, India
| | - S Anandan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - B Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
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Wu X, Chavez JD, Schweppe DK, Zheng C, Weisbrod CR, Eng JK, Murali A, Lee SA, Ramage E, Gallagher LA, Kulasekara HD, Edrozo ME, Kamischke CN, Brittnacher MJ, Miller SI, Singh PK, Manoil C, Bruce JE. In vivo protein interaction network analysis reveals porin-localized antibiotic inactivation in Acinetobacter baumannii strain AB5075. Nat Commun 2016; 7:13414. [PMID: 27834373 PMCID: PMC5114622 DOI: 10.1038/ncomms13414] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 09/30/2016] [Indexed: 12/13/2022] Open
Abstract
The nosocomial pathogen Acinetobacter baumannii is a frequent cause of hospital-acquired infections worldwide and is a challenge for treatment due to its evolved resistance to antibiotics, including carbapenems. Here, to gain insight on A. baumannii antibiotic resistance mechanisms, we analyse the protein interaction network of a multidrug-resistant A. baumannii clinical strain (AB5075). Using in vivo chemical cross-linking and mass spectrometry, we identify 2,068 non-redundant cross-linked peptide pairs containing 245 intra- and 398 inter-molecular interactions. Outer membrane proteins OmpA and YiaD, and carbapenemase Oxa-23 are hubs of the identified interaction network. Eighteen novel interactors of Oxa-23 are identified. Interactions of Oxa-23 with outer membrane porins OmpA and CarO are verified with co-immunoprecipitation analysis. Furthermore, transposon mutagenesis of oxa-23 or interactors of Oxa-23 demonstrates changes in meropenem or imipenem sensitivity in strain AB5075. These results provide a view of porin-localized antibiotic inactivation and increase understanding of bacterial antibiotic resistance mechanisms.
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Affiliation(s)
- Xia Wu
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Juan D. Chavez
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Devin K. Schweppe
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Chunxiang Zheng
- Department of Chemistry, University of Washington, Seattle, Washington 98109, USA
| | - Chad R. Weisbrod
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Jimmy K. Eng
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Ananya Murali
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Samuel A. Lee
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Elizabeth Ramage
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - Larry A. Gallagher
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | | | - Mauna E. Edrozo
- Department of Microbiology, University of Washington, Seattle, Washington 98195, USA
| | | | | | - Samuel I. Miller
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
- Department of Microbiology, University of Washington, Seattle, Washington 98195, USA
- Department of Medicine, University of Washington, Seattle, Washington 98195, USA
| | - Pradeep K. Singh
- Department of Microbiology, University of Washington, Seattle, Washington 98195, USA
- Department of Medicine, University of Washington, Seattle, Washington 98195, USA
| | - Colin Manoil
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
| | - James E. Bruce
- Department of Genome Sciences, University of Washington, 850 Republican Street, Brotman Building Room 154, Seattle, Washington 98109, USA
- Department of Chemistry, University of Washington, Seattle, Washington 98109, USA
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25
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Vijayakumar S, Gopi R, Gunasekaran P, Bharathy M, Walia K, Anandan S, Veeraraghavan B. Molecular Characterization of Invasive Carbapenem-Resistant Acinetobacter baumannii from a Tertiary Care Hospital in South India. Infect Dis Ther 2016; 5:379-87. [PMID: 27553951 PMCID: PMC5019981 DOI: 10.1007/s40121-016-0125-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Acinetobacter baumannii is an important opportunistic pathogen responsible for causing nosocomial infections. Carbapenems are considered to be the drug of choice to treat infections caused by multidrug-resistant A. baumannii. The prevalent mechanism of carbapenem resistance in A. baumannii is enzymatic degradation by β-lactamases. Therefore, the aim of the study is to determine the prevalence and distribution of molecular determinants among the clinical isolates of carbapenem-resistant A. baumannii. METHODS A total of 103 consecutive, non-duplicate carbapenem-resistant A. baumannii isolated from blood and endotracheal aspirates (ETAs) were included in the study. The CarbAcineto NP test was performed for the screening of carbapenemase production. Polymerase chain reaction (PCR) was performed to detect extended spectrum β-lactamases (ESBLs), metallo-β-lactamases (MBLs) and oxacillinases (OXAs). PCR was done for the detection of ISAba1 elements, and mapping PCR was performed to identify the position of ISAba1 with respect to the OXA-23-like gene. RESULTS Among the 103 A. baumannii isolates, 94 were phenotypically identified as carbapenemase producers. blaPER was the most common among the ESBLs. Among MBLs, blaNDM was predominant followed by the blaVIM gene. blaOXA-51 and blaOXA-23 were the most common and present in all 103 isolates. Almost 80% of the isolates had ISAba1 upstream blaOXA-23 gene. CONCLUSION The blaOXA-23 and blaNDM genes are the most common type of oxacillinases and metallo β-lactamases, respectively, and contribute to carbapenem resistance in clinical isolates of A. baumannii. The presence of ISAba1 upstream of the blaOXA-23 gene suggests that the insertion element acts as a promoter for its increased expression. FUNDING Indian Council of Medical Research, New Delhi, India (ref. no. AMR/TF/54/13ECDHII dated 23 October 2013).
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Affiliation(s)
- Saranya Vijayakumar
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, 632 004, India
| | - Radha Gopi
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, 632 004, India
| | - Priya Gunasekaran
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, 632 004, India
| | - Manjurekar Bharathy
- School of Biosciences and Technology, VIT University, Vellore, Tamil Nadu, 632014, India
| | - Kamini Walia
- Indian Council of Medical Research, New Delhi, India
| | - Shalini Anandan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, 632 004, India
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, 632 004, India.
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26
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Kateete DP, Nakanjako R, Namugenyi J, Erume J, Joloba ML, Najjuka CF. Carbapenem resistant Pseudomonas aeruginosa and Acinetobacter baumannii at Mulago Hospital in Kampala, Uganda (2007-2009). SPRINGERPLUS 2016; 5:1308. [PMID: 27547682 PMCID: PMC4978656 DOI: 10.1186/s40064-016-2986-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/02/2016] [Indexed: 11/29/2022]
Abstract
Background Multidrug resistant Pseudomonas aeruginosa and Acinetobacter baumannii are common causes of health care associated infections worldwide. Carbapenems are effective against infections caused by multidrug resistant Gram-negative bacteria including Pseudomonas and Acinetobacter species. However, their use is threatened by the emergence of carbapenemase-producing strains. The aim of this study was to determine the prevalence of carbapenem-resistant P. aeruginosa and A. baumannii at Mulago Hospital in Kampala Uganda, and to establish whether the hospital environment harbors carbapenem-resistant Gram-negative rods. Results Between February 2007 and September 2009, a total of 869 clinical specimens were processed for culture and sensitivity testing yielding 42 (5 %) P. aeruginosa and 29 (3 %) A. baumannii isolates, of which 24 % (10/42) P. aeruginosa and 31 % (9/29) A. baumannii were carbapenem-resistant. Additionally, 80 samples from the hospital environment were randomly collected and similarly processed yielding 58 % (46/80) P. aeruginosa and 14 % (11/80) A. baumannii, of which 33 % (15/46) P. aeruginosa and 55 % (6/11) A. baumannii were carbapenem-resistant. The total number of isolates studied was 128. Carbapenemase genes detected were blaIMP-like (36 %, 9/25), blaVIM-like (32 %, 8/25), blaSPM-like (16 %, 4/25); blaNDM-1-like (4 %, 1/25) in carbapenem-resistant P. aeruginosa, and blaOXA-23-like (60 %, 9/15), blaOXA-24-like (7 %, 1/15), blaOXA-58-like (13 %, 2/15), and blaVIM-like (13 %, 2/15) in carbapenem-resistant A. baumannii. Furthermore, class 1 integrons were detected in 38 % (48/128) of P. aeruginosa and Acinetobacter, 37 % (26/71) of which were in clinical isolates and 39 % (22/57) in environment isolates. Gene cassettes were found in 25 % (12/48) of integron-positive isolates. These were aminoglycoside adenylyltransferase ant(4′)-IIb (3 isolates); trimethoprim-resistant dihydrofolate reductase dfrA (2 isolates); adenyltransferase aadAB (3 isolates); QacE delta1 multidrug exporter (2 isolates); quinolone resistance pentapeptide repeat protein qnr (1 isolate); and metallo-β-lactamase genes blaVIM-4-like, blaIMP-19-like, and blaIMP-26-like (1 isolate each). Gene cassettes were missing in 75 % (36/48) of the integron-positive isolates. Conclusions The prevalence of carbapenem-resistant P. aeruginosa and Acinetobacter among hospitalized patients at Mulago Hospital is low compared to rates from South-East Asia. However, it is high among isolates and in the environment, which is of concern given that the hospital environment is a potential source of infection for hospitalized patients and health care workers. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-2986-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David P Kateete
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda ; Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ritah Nakanjako
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda ; College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Juliet Namugenyi
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda ; College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda ; Makerere University-Johns Hopkins University (MU-JHU) Core Lab at the Infectious Diseases Institute (IDI), College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joseph Erume
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Moses L Joloba
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda ; Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Christine F Najjuka
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
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Pragasam AK, Sahni RD, Anandan S, Sharma A, Gopi R, Hadibasha N, Gunasekaran P, Veeraraghavan B. A Pilot Study on Carbapenemase Detection: Do We See the Same Level of Agreement as with the CLSI Observations. J Clin Diagn Res 2016; 10:DC09-13. [PMID: 27630840 DOI: 10.7860/jcdr/2016/16417.8152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 04/12/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Rapid identification of carbapenemase producing organisms is of great importance for timely detection, treatment and implementation of control measures to prevent the spread. The Modified Hodge Test (MHT) and Carba NP test is recommended by CLSI for the detection of carbapenemases in Enterobacteriaceae. However, MHT may give false positive results or fail to detect metallo β-lactamases (MBLs). In the US, MHT is the most widely used test for detection of carbapenemases and has been found to have a sensitivity and specificity of >90% for bla KPC producers. However, in India, the prevalence of bla NDM is higher than bla KPC producers. AIM To evaluate the usefulness of CarbaNP in an Indian setting. MATERIALS AND METHODS A total of 260 isolates of carbapenem resistant E.coli (n=57), Klebsiella spp. (n=85), Pseudomonas aeruginosa (n=60), and Acinetobacter baumannii (58) isolated from clinical specimens between 2012-2014 at the Christian Medical College, Vellore were included in the study. All the carbapenem resistant isolates were subjected to CarbaNP, MHT and multiplex PCR for detection of carbapenemase genes. RESULTS CarbaNP was found to be positive in 88% (n=50/57), 81% (n=69/51), 38% (n=23/60) and 81% (n=47/58) for E.coli, Klebsiella spp., P. aeruginosa, and A. baumannii respectively. While in MHT it showed, 89% (n=51/57) and 81 % (n=69/85) for E.coli and Klebsiella spp. respectively. In P.aeruginosa, synergy testing of imipenem plus cloxacillin showed that, 65% of CarbaNP negatives were ampC producers. Overall, the sensitivity and specificity of CarbaNP was found to be 94% and 100 for bla NDM; 77% and 100 % for bla OXA-48 like producers and 81% and 100% for CarbAcinetoNP respectively. CONCLUSION This observation was more than what was reported in CLSI guidelines. Therefore, it is advisable to evaluate an assay for better laboratory diagnosis at respective regions.
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Affiliation(s)
- Agila Kumari Pragasam
- Research Associate, Department of Clinical Microbiology, Christian Medical College , Vellore, India
| | - Rani Diana Sahni
- Professor, Department of Clinical Microbiology, Christian Medical College , Vellore, India
| | - Shalini Anandan
- Professor, Department of Clinical Microbiology, Christian Medical College , Vellore, India
| | - Archa Sharma
- Registrar, Department of Clinical Microbiology, Christian Medical College , Vellore, India
| | - Radha Gopi
- Research Associate, Department of Clinical Microbiology, Christian Medical College , Vellore, India
| | - Noorjahan Hadibasha
- Research Associate, Department of Clinical Microbiology, Christian Medical College , Vellore, India
| | - Priya Gunasekaran
- Research Associate, Department of Clinical Microbiology, Christian Medical College , Vellore, India
| | - Balaji Veeraraghavan
- Professor & Head, Department of Clinical Microbiology, Christian Medical College , Vellore, India
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Zanganeh Z, Eftekhar F. Correlation of Oxacillinase Gene Carriage With the Genetic Fingerprints of Imipenem-Resistant Clinical Isolates of Acinetobacter baumannii. Jundishapur J Microbiol 2015; 8:e26545. [PMID: 26495112 PMCID: PMC4609178 DOI: 10.5812/jjm.26545] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/03/2015] [Accepted: 05/15/2015] [Indexed: 02/06/2023] Open
Abstract
Background: Emergence of multidrug-resistant Acinetobacter baumannii has resulted in the treatment failure of related infections and an increase in patient mortality. The presence of class D β-lactamases (oxacillinases) in this organism is an important mechanism underlying resistance to beta-lactam antibiotics. Objectives: The aim of this work was to investigate the correlation between oxacillinase gene carriage and genetic fingerprints in imipenem-resistant burn and non-burn isolates of A. baumannii. Materials and Methods: Fifty-eight A. baumannii isolates were collected from October 2011 to April 2012, which included 28 burn isolates from Shahid Motahari Hospital and 30 non-burn isolates from Imam Hossein Hospital. The minimum inhibitory and minimum bactericidal concentrations (MIC and MBC) of imipenem were measured by the broth microdilution method. The presence of oxacillinase genes (OXA-23-, OXA-24-, OXA-51-, and OXA-58-like genes) was shown using type-specific primers and PCR. Genetic profiles were generated by RAPD-PCR fingerprinting. Results: OXA-23 was observed in 81% of the isolates and its distribution was similar within the two groups. The presence of OXA-51 was shown in 58.6% of the isolates, of which most were burn isolates (67.6%). OXA-24 was present in 20.7% of the isolates, all belonging to the burn group; OXA-58 was not observed in any of the isolates. RAPD-PCR fingerprints revealed two clusters at a similarity level of 70% (A, B). At a similarity level of 85%, nine different groups were observed for burn and non-bun isolates. Conclusions: Our results showed that blaOXA-23 was the most prevalent gene, followed by blaOXA-51, among the burn and non-burn clinical isolates of A. baumannii. BlaOXA-24-like genes were detected at a lower level and were only found among the burn isolates, which also showed higher heterogeneity compared to the non-burn group.
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Affiliation(s)
- Zahra Zanganeh
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, Tehran, IR Iran
| | - Fereshteh Eftekhar
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, Tehran, IR Iran
- Corresponding author: Fereshteh Eftekhar, Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University G. C., Tehran, IR Iran. Tel: +98-2129903208, Fax: +98-2122431664, E-mail:
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Al-Bayssari C, Gupta SK, Dabboussi F, Hamze M, Rolain JM. MUS-2, a novel variant of the chromosome-encoded β-lactamase MUS-1, from Myroides odoratimimus. New Microbes New Infect 2015; 7:67-71. [PMID: 26257915 PMCID: PMC4522612 DOI: 10.1016/j.nmni.2015.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/22/2015] [Indexed: 11/28/2022] Open
Abstract
The aim of the present study was to investigate the molecular mechanism of carbapenem resistance of three imipenem-resistant isolates of Myroides odoratimimus recovered from two livestock farms of cows and pigeons by rectal swab in Lebanon in January 2014. Investigation of imipenem resistance of these isolates using the modified Hodge test, the EDTA test, the modified CarbaNP test and the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry Ultraflex assay showed a carbapenemase activity due to the presence of a chromosome-encoded β-lactamase MUS, verified by PCR. However amplification and sequencing of this chromosomal gene showed a novel variant of it designated MUS-2 by the curators of the Lahey database of β-lactamases (http://www.lahey.org/Studies/webt.asp). Cloning of the blaMUS-2 was performed, followed by protein expression in Escherichia coli TOP 10. Pulsed-field gel electrophoresis clearly showed that the three isolates belonged to the same clone. This study reports a novel variant of the chromosome-encoded blaMUS-1 associated with carbapenem resistance in Myroides odoratimimus and shows that animals may represent a reservoir of bacteria harbouring several variants of resistance genes.
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Affiliation(s)
- C Al-Bayssari
- Laboratoire Microbiologie Santé et Environnement (LMSE), Centre Azm pour la Recherche en Biotechnologie et ses Applications, Ecole Doctorale de Sciences et de Technologie, Université Libanaise, Tripoli, Libya ; Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Marseille, France
| | - S Kumar Gupta
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Marseille, France
| | - F Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Centre Azm pour la Recherche en Biotechnologie et ses Applications, Ecole Doctorale de Sciences et de Technologie, Université Libanaise, Tripoli, Libya
| | - M Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Centre Azm pour la Recherche en Biotechnologie et ses Applications, Ecole Doctorale de Sciences et de Technologie, Université Libanaise, Tripoli, Libya
| | - J-M Rolain
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Marseille, France
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Ghajavand H, Esfahani BN, Havaei SA, Moghim S, Fazeli H. Molecular identification of Acinetobacter baumannii isolated from intensive care units and their antimicrobial resistance patterns. Adv Biomed Res 2015; 4:110. [PMID: 26261812 PMCID: PMC4513333 DOI: 10.4103/2277-9175.157826] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 08/27/2014] [Indexed: 01/28/2023] Open
Abstract
Background: Acinetobacter baumannii is one of the most important pathogens in hospital-acquired infections especially in intensive care units (ICUs). This opportunistic pathogen can be easily isolated from water, soil, and hospital facilities. A. baumannii as a nosocomial opportunistic pathogen is resistant to a wide range of antibiotics and responsible for multiple infections, including bacteremia, pneumonia, meningitis, urinary tract infections, and surgical wounds. The aim of this study was to determine frequency and resistance patterns of A. baumannii isolated in ICUs of Isfahan Hospitals. Materials and Methods: During 1 year period (2012-2013), 350 specimens were collected from ICUs of Isfahan hospitals. The isolates were characterized as A. baumannii by conventional phenotypic, biochemical tests and confirmed by PCR for OXA-51-like gene. Susceptibility of isolates was determined by standard disk diffusion method according to CLSI. Results: From total of 350 specimens, 43 isolates were A. baumannii. The antimicrobial patterns of isolates showed that 53.5% of isolates were resistant to amikacin, 83.7% to tetracyclin, 86% to ceftazidime, 90.7% to Trimethoprim sulfametoxazol, 93% to imipenem, cefepime, meropenem, ampicillin–sulbactam. All isolates were resistant to ciprofloxacin. Conclusion: This study showed a high resistance of A. baumannii to a wide range of antimicrobial agent. It is necessary to adopt appropriate strategies to control the spread of the bacteria in care unit centers and wards.
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Affiliation(s)
- Hasan Ghajavand
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Nasr Esfahani
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sharareh Moghim
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Fazeli
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Kazi M, Nikam C, Shetty A, Rodrigues C. Dual-tubed multiplex-PCR for molecular characterization of carbapenemases isolated among Acinetobacter spp. and Pseudomonas spp. J Appl Microbiol 2015; 118:1096-102. [PMID: 25647446 DOI: 10.1111/jam.12770] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/21/2015] [Accepted: 01/28/2015] [Indexed: 11/30/2022]
Abstract
AIM To molecularly characterize clinical isolates of Acinetobacter spp. and Pseudomonas spp. from various clinical samples so as to identify the carbapenemases mechanisms harboured by them. MATERIALS AND RESULTS A total of 95 carbapenem-resistant, nonduplicate, multi-drug resistant Gram-negative clinical isolates (53 Acinetobacter spp. and 42 Pseudomonas spp.), were collected between July and December 2012. Modified Hodge test (MHT) for the detection of carbapenemases was performed. Inhibitor-based test, EDTA for the detection of metallo-β-lactamases (MBL) and phenyl boronic acid (PBA) for the detection of Klebsiella pneumoniae carbapenemase (KPC), were performed to distinguish between different classes of β-lactamases. Two-tubed multiplex-PCR was performed for genotypic characterization of different classes of carbapenemases ((blaNDM-1 , blaOXA-48 like , blaKPC , blaVIM , blaIMP ), (blaOXA-23 like , blaOXA-24 like , blaOXA-51 like , blaOXA-58 like )). Eighty-five per cent (81/95) isolates were carbapenemase producers. Among these, 56.7% (44) were multiple carbapenemase producers. Furthermore, 48.14% (39) were MBLs, 35.8% (29) were carbapenem hydrolyzing class D β-lactamases (CHDLs), 16% (13) had MBLs as well as CHDLs and 14.7% (14/95) had none of the targeted resistance mechanisms. The overall rate of concordance between phenotypic and genotypic test was 97% and 98% for the detection of carbapenemases and MBL, respectively. CONCLUSION This is the first study from Western India which highlights the presence of multiple carbapenemases in nonfermenters Gram-negative bacilli (NFGNB). Co-existence of multiple carbapenemases along with other resistance mechanisms might result in treatment failure. Molecular characterization of the resistance mechanisms of suspected pathogens would help provide appropriate antimicrobial treatment for good clinical outcome. SIGNIFICANCE AND IMPACT OF THE STUDY Dual-tubed multiplex PCR decreases the time of amplification and thus the turnaround time which is crucial in clinical microbiology; this would be helpful in rapid characterization of CHDLs and MBLs.
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Affiliation(s)
- M Kazi
- Department of Microbiology, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India
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Rajenderan S, Balaji V, Anandan S, Sahni RD, Tansarli GS, Falagas ME. Determination of MIC distribution of arbekacin, cefminox, fosfomycin, biapenem and other antibiotics against gram-negative clinical isolates in South India: a prospective study. PLoS One 2014; 9:e103253. [PMID: 25068396 PMCID: PMC4113358 DOI: 10.1371/journal.pone.0103253] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/29/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To determine the in vitro activity of antibiotics, including arbekacin, cefminox, fosfomycin and biapenem which are all still unavailable in India, against Gram-negative clinical isolates. METHODS We prospectively collected and tested all consecutive isolates of Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa and Acinetobacter spp. from blood, urine and sputum samples between March and November 2012. The minimum inhibition concentration (MIC) of 16 antibiotics was determined by the broth micro-dilution method. RESULTS Overall 925 isolates were included; 211 E. coli, 207 Klebsiella spp., 153 P. aeruginosa, and 354 Acinetobacter spp. The MIC50 and MIC90 were high for cefminox, biapenem and arbekacin for all pathogens but interpretative criteria were not available. The MIC50 was categorized as susceptible for a couple of antibiotics, including piperacillin/tazobactam, carbapenems and amikacin, for E. coli, Klebsiella spp. and P. aeruginosa. However, for Acinetobacter spp., the MIC50 was categorized as susceptible only for colistin. On the other hand, fosfomycin was the only antibiotic that inhibited 90% of E. coli and Klebsiella spp. isolates, while 90% of P. aeruginosa isolates were inhibited only by colistin. Finally, 90% of Acinetobacter spp. isolates were not inhibited by any antibiotic tested. CONCLUSION Fosfomycin and colistin might be promising antibiotics for the treatment of infections due to E. coli or Klebsiella spp. and P. aeruginosa, respectively, in India; however, clinical trials should first corroborate the in vitro findings. The activity of tigecycline should be evaluated, as this is commonly used as last-resort option for the treatment of multidrug-resistant Acinetobacter infections.
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Affiliation(s)
| | | | | | | | | | - Matthew E. Falagas
- Alfa Institute of Biomedical Sciences, Athens, Greece
- Department of Internal Medicine - Infectious Diseases, Iaso General Hospital, Iaso Group, Athens, Greece
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
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Shivaprasad A, Antony B, Shenoy P. Comparative Evaluation of Four Phenotypic Tests for Detection of Metallo-β-Lactamase and Carbapenemase Production in Acinetobacter baumannii. J Clin Diagn Res 2014; 8:DC05-8. [PMID: 24995173 DOI: 10.7860/jcdr/2014/6447.4317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 12/09/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Acinetobacter baumannii is an emerging multi-drug resistant opportunistic pathogen that causes a variety of nosocomial infections. In recent years, carbapenem resistance in A.baumannii has increased due to Ambler class B Metallo β-lactamases or class D OXA Carbapenemases. OBJECTIVE The present study was undertaken to detect and compare the various phenotypic methods for MBL production in nosocomial A.baumannii isolates. MATERIALS AND METHODS One hundred sixty eight A.baumannii isolates were subjected to disc diffusion assay. Imipenem resistant isolates were subjected to 4 different phenotypic tests. MBL screening was done by Imipenem-EDTA double disc synergy test, Imipenem-EDTA combined disc test, Modified Hodge test and MBL E-test. RESULTS Out of 168 A.baumannii isolates, 85 (50.59%) were imipenem resistant. Among these 85 isolates, 57 (67.05%) were MBL positive by DDST, 69 (81.18%) by CDT, 85 (100%) by MHT and all these 85 isolates were confirmed to be MBL positive by MBL E-test method. CONCLUSION Combined disc test, Modified Hodge test & E-test are equally effective to detect MBL production. However, considering the cost constraints of E-test, simple MHT and CDT can be used. They are easy, economical and can be incorporated into routine testing in laboratories to monitor the emergence of MBLs in MDR A.baumannii.
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Affiliation(s)
- Aparna Shivaprasad
- Assisstant Professor, Department of Microbiology, Father Muller Medical College , Mangalore, Karnataka, India
| | - Beena Antony
- Professor, Department of Microbiology, Father Muller Medical College , Mangalore, Karnataka, India
| | - Poornima Shenoy
- Professor, Department of Microbiology, Father Muller Medical College , Mangalore, Karnataka, India
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Guo-xin M, Dan-yang S, Xi-zhou G, Jun-chang C, Rui W, Zhi-gang C, Liang-an C. Laboratory to Clinical Investigation of Carbapenem Resistant Acinetobacter baumannii Outbreak in a General Hospital. Jundishapur J Microbiol 2014; 7:e13120. [PMID: 25147648 PMCID: PMC4138675 DOI: 10.5812/jjm.13120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 10/07/2013] [Accepted: 11/18/2013] [Indexed: 11/17/2022] Open
Abstract
Background: The number of reported cases, infected with carbepenem resistant Acinetobacter baumannii (CRAb) and multi-drug resistant (MDR) Acinetobacter species had gradually increased in most PLA general hospital wards from April to June in 2007. Objectives: We have described the investigation of an outbreak of CRAb and MDR Acinetobacter in PLA general hospital, Beijing. The prospective and retrospective findings were identified and analyzed to study the infection causes. Materials and Methods: A. baumannii samples were collected from the patients and environment in each hospital unit. The onset times were recorded according to their case information. All samples were characterized by genotype and compared using pulsed-field gel electrophoresis (PFGE). The microorganism susceptibility was tested using the in vitro minimal inhibitory concentration (MIC) breakpoints method. Results: A total of 69 A. baumannii strains were successfully isolated from 53 patients. About 89.1% of them were resistant to ampicillin and 89.2% to cefotaxime and 75.4% to all standard antibiotics. PFGE analysis revealed that nine of the isolates had unique clones and the epidemic clone types were A, B and C. Conclusions: The A. baumannii outbreak, was caused by MDR A. baumannii. The strains had widely spread among 12 departments especially in surgical intensive care unit (SICU), emergency intensive care unit (EICU) and the department of respiratory disease. The outbreak was more likely caused by the A. baumannii infected or carrier patients and EICU was its origin.
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Affiliation(s)
- Mo Guo-xin
- Department of Respiratory Disease, Chinese PLA General Hospital, Beijing, China
| | - She Dan-yang
- Department of Respiratory Disease, Chinese PLA General Hospital, Beijing, China
| | - Guan Xi-zhou
- Department of Respiratory Disease, Chinese PLA General Hospital, Beijing, China
| | - Cui Jun-chang
- Department of Respiratory Disease, Chinese PLA General Hospital, Beijing, China
| | - Wang Rui
- Institutes of Clinical Pharmacology Chinese, PLA General Hospital, Beijing, China
| | - Cui Zhi-gang
- State Key Laboratory for Communicable Diseases, Prevention and Control Institute of Communicable Disease Prevention and Control Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Liang-an
- Department of Respiratory Disease, Chinese PLA General Hospital, Beijing, China
- Corresponding author: Chen Liang-an, Department of Respiratory Disease of Chinese, PLA General Hospital, Fuxing road 28, P.O.Box: 100853, Beijing, China. Tel: +86-1068295959, Fax: +86-1068295928, E-mail:
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Gao J, Zhao X, Bao Y, Ma R, Zhou Y, Li X, Chai T, Cai Y. Antibiotic resistance and OXA-type carbapenemases-encoding genes in airborne Acinetobacter baumannii isolated from burn wards. Burns 2013; 40:295-9. [PMID: 23886986 DOI: 10.1016/j.burns.2013.06.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/30/2013] [Accepted: 06/01/2013] [Indexed: 11/18/2022]
Abstract
The study was conducted to investigate drug resistance, OXA-type carbapenemases-encoding genes and genetic diversity in airborne Acinetobacter baumannii (A. baumannii) in burn wards. Airborne A. baumannii were collected in burn wards and their corridors using Andersen 6-stage air sampler from January to June 2011. The isolates susceptibility to 13 commonly used antibiotics was examined according to the CLSI guidelines; OXA-type carbapenemases-encoding genes and molecular diversity of isolates were analyzed, respectively. A total of 16 non-repetitive A. baumannii were isolated, with 10 strains having a resistance rate of greater than 50% against the 13 antibiotics. The resistance rate against ceftriaxone, cyclophosvnamide, ciprofloxacin, and imipenem was 93.75% (15/16), but no isolate observed to be resistant to cefoperazone/sulbactam. Resistance gene analyses showed that all 16 isolates carried OXA-51, and 15 isolates carried OXA-23 except No.15; but OXA-24 and OXA-58 resistance genes not detected. The isolates were classified into 13 genotypes (A-M) according to repetitive extragenic palindromic sequence PCR (REP-PCR) results and only six isolates had a homology ≥90%. In conclusion, airborne A. baumannii in the burn wards had multidrug resistance and complex molecular diversity, and OXA-23 and OXA-51 were dominant mechanisms for resisting carbapenems.
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Affiliation(s)
- Jing Gao
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, China, Sino-German Cooperative Research Centre for Zoonosis of Animal Origin Shandong Province, Tai'an Shandong, China; Tai'an City Central Hospital, Tai'an, China
| | - Xiaonan Zhao
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, China, Sino-German Cooperative Research Centre for Zoonosis of Animal Origin Shandong Province, Tai'an Shandong, China
| | - Ying Bao
- Tai'an City Central Hospital, Tai'an, China
| | - Ruihua Ma
- Affiliated Hospital of the Shandong Agricultural University, Tai'an, China
| | - Yufa Zhou
- Daiyue Husbandry Bureau of Tai'an, Tai'an, China
| | - Xinxian Li
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, China, Sino-German Cooperative Research Centre for Zoonosis of Animal Origin Shandong Province, Tai'an Shandong, China; Tai'an City Central Hospital, Tai'an, China; Affiliated Hospital of the Shandong Agricultural University, Tai'an, China; Daiyue Husbandry Bureau of Tai'an, Tai'an, China
| | - Tongjie Chai
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, China, Sino-German Cooperative Research Centre for Zoonosis of Animal Origin Shandong Province, Tai'an Shandong, China.
| | - Yumei Cai
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, China, Sino-German Cooperative Research Centre for Zoonosis of Animal Origin Shandong Province, Tai'an Shandong, China.
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Niranjan DK, Singh NP, Manchanda V, Rai S, Kaur IR. Multiple carbapenem hydrolyzing genes in clinical isolates of Acinetobacter baumannii. Indian J Med Microbiol 2013; 31:237-41. [DOI: 10.4103/0255-0857.115626] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Purohit M, Mendiratta DK, Deotale VS, Madhan M, Manoharan A, Narang P. Detection of metallo-β-lactamases producing Acinetobacter baumannii using microbiological assay, disc synergy test and PCR. Indian J Med Microbiol 2012. [DOI: 10.4103/0255-0857.103770] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Early insights into the interactions of different β-lactam antibiotics and β-lactamase inhibitors against soluble forms of Acinetobacter baumannii PBP1a and Acinetobacter sp. PBP3. Antimicrob Agents Chemother 2012; 56:5687-92. [PMID: 22908165 DOI: 10.1128/aac.01027-12] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Acinetobacter baumannii is an increasingly problematic pathogen in United States hospitals. Antibiotics that can treat A. baumannii are becoming more limited. Little is known about the contributions of penicillin binding proteins (PBPs), the target of β-lactam antibiotics, to β-lactam-sulbactam susceptibility and β-lactam resistance in A. baumannii. Decreased expression of PBPs as well as loss of binding of β-lactams to PBPs was previously shown to promote β-lactam resistance in A. baumannii. Using an in vitro assay with a reporter β-lactam, Bocillin, we determined that the 50% inhibitory concentrations (IC(50)s) for PBP1a from A. baumannii and PBP3 from Acinetobacter sp. ranged from 1 to 5 μM for a series of β-lactams. In contrast, PBP3 demonstrated a narrower range of IC(50)s against β-lactamase inhibitors than PBP1a (ranges, 4 to 5 versus 8 to 144 μM, respectively). A molecular model with ampicillin and sulbactam positioned in the active site of PBP3 reveals that both compounds interact similarly with residues Thr526, Thr528, and Ser390. Accepting that many interactions with cell wall targets are possible with the ampicillin-sulbactam combination, the low IC(50)s of ampicillin and sulbactam for PBP3 may contribute to understanding why this combination is effective against A. baumannii. Unraveling the contribution of PBPs to β-lactam susceptibility and resistance brings us one step closer to identifying which PBPs are the best targets for novel β-lactams.
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