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. 2017 Mar 1;17(1):180.
doi: 10.1186/s12879-017-2289-9.

First report on bla NDM-1-producing Acinetobacter baumannii in three clinical isolates from Ethiopia

Michael Pritsch  1   2 , Ahmed Zeynudin  3   4   5 , Maxim Messerer  5 , Simon Baumer  6 , Gabriele Liegl  5 , Soeren Schubert  5 , Thomas Löscher  7 , Michael Hoelscher  7   8   4 , Tefara Belachew  3 , Andrea Rachow  7   8 , Andreas Wieser  7   8   3   5
Affiliations

First report on bla NDM-1-producing Acinetobacter baumannii in three clinical isolates from Ethiopia

Michael Pritsch et al. BMC Infect Dis. .

Abstract

Background: Multidrug-resistant Gram-negative bacterial infections are recognized as one of the major threats to global health. In this study, we describe for the first time bla NDM-1 gene carrying organisms from Ethiopia consisting of three Acinetobacter baumannii isolates from patients in Jimma.

Methods: Besides phenotypic antimicrobial susceptibility testing, molecular strain typing and sequencing was performed to describe the phylogenetic relation of the Ethiopian isolates in detail in relation to published isolates from all over the globe.

Results and discussion: Three multi-resistant, bla NDM-1-positive Acinetobacter baumannii isolates, most likely a local clonal diffusion, were isolated. Two of the three isolates described within this study were untreatable with the locally available antimicrobials and were only susceptible to polymyxin B and amikacin. The genome sequences confirmed the isolates to be distinct from the outbreak strains reported from Kenya, the only other characterized bla NDM-1 positive Acinetobacter baumannii strains in East Africa so far. Up to date, no other bacterial species were found to harbour the gene cassette in Jimma and conjugation to E. coli was not successful under laboratory conditions. However, natural transmission to other bacteria seems likely, given the evident lack of hygienic precautions due to limited resource settings.

Conclusions: The detected isolates could solely be the tip of the iceberg regarding the presence of NDM-1 producing organisms in the region, as only a limited number of bacterial isolates were evaluated so far and until recently, susceptibility testing and isolation of bacteria could hardly be performed in clinical patient care. These multi-drug resistant organisms pose a serious threat to antimicrobial treatments in Jimma, Ethiopia.

Keywords: Acinetobacter baumannii; Carbapenemase; East-Africa; Ethiopia; NDM-1; New Delhi metallo-beta-lactamase.

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Figures

Fig. 1
Fig. 1
MLST-based phylogenetic tree using the Oxford-scheme. The Sequence Types, countries and years of isolation are indicated when known. Green asterisks indicate the proven presence of an NDM-1-plasmid (Isolate A, Isolate B, Isolate C, 6200, B11911, A1, ZW85-1). The scale-bar represents the number of SNPs per nucleotide
Fig. 2
Fig. 2
Gene-map of the NDM-1 cassette as sequenced in the three isolates from Ethiopia. The sequence was found to be identical to published sequences of NDM-1 in other organisms isolated from multiple places on different continents. There are clearly identifiable transposase genes as well as other antibiotic resistance genes in close proximity of NDM-1; PRAI: phosphoribosylanthranilate isomerase; TAT: twin-arginine translocation pathway
See this image and copyright information in PMC

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