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. 2018 Oct 11:7:123.
doi: 10.1186/s13756-018-0410-5. eCollection 2018.

Prevalence of different carbapenemase genes among carbapenem-resistant Acinetobacter baumannii blood isolates in Taiwan

Teng-Ho Wang  1   2   3 , Yi-Shing Leu  4   5 , Nai-Yu Wang  6 , Chang-Pan Liu  5   6   7   8   9 , Tsong-Rong Yan  2
Affiliations

Prevalence of different carbapenemase genes among carbapenem-resistant Acinetobacter baumannii blood isolates in Taiwan

Teng-Ho Wang et al. Antimicrob Resist Infect Control. .

Abstract

Background: Although the prevalence of the carbapenem-resistant A. baumannii (CRAB) has increased in Taiwan, few studies have elucidated the prevalence of different carbapenemase genes in Taiwan. The first objective of this study was to identify the types and prevalence of different carbapenemase genes, and the second objective was to determine the carbapenem antimicrobial susceptibility of carbapenemase producing isolates.

Methods: In total, 269 CRAB blood isolates from four medical centres in Taiwan from 1/1/2009 to 31/12/2013 were analysed. Antimicrobial susceptibilities were determined using the Vitek 2 system. Carbapenemase genes were identified by polymerase chain reaction (PCR) and sequencing. Pulsed-field gel electrophoresis (PFGE) was used to identify the different pulsotypes.

Results: All 269 CRAB isolates had the blaOXA-51-like gene, while 237 (88.1%) had the blaOXA-23-like gene, and 11 (4.09%) had the blaOXA-24-like gene. Twenty-one CRAB isolates (7.81%) contained only the blaOXA-51-like gene. None of the isolates had the blaOXA-58-like gene or the metallo-β-lactamases (MBL)-encoding genes. In 28.69% of isolates with the blaOXA-23-like gene and 90.91% of isolates with the blaOXA-24-like gene, the minimum inhibitory concentrations (MICs) for imipenem were 64 mg/L or more. In 37.55% of isolates with the blaOXA-23-like gene and 100% of isolates with the blaOXA-24-like gene, meropenem MICs were 64 mg/L or more. PFGE analyses indicated that six highly similar genomes which harbored the blaOXA-24-like gene came from three different medical centres.

Conclusion: Our study determined the prevalence of CRAB, the types and prevalence of carbapenemase genes, carbapenem susceptibility among CRAB isolates, and documented that the blaOXA-24-like gene had greater resistance to carbapenem than the blaOXA-23-like gene. We also demonstrated inter-hospital transmission of the highly resistant blaOXA-24-like gene.

Keywords: Acinetobacter calcoaceticus-Acinetobacter baumannii (ACB) complex; Carbapenem-resistant Acinetobacter baumannii (CRAB); blaOXA-23-like; blaOXA-24-like; blaOXA-51-like.

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Conflict of interest statement

This study was approved by Institutional Review Board, MacKay Memorial Hospital, Taipei, Taiwan. Protocol no. 14MMHIS125.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Distribution of imipenem MICs in 269 CRAB blood isolates with the blaOXA-23-like and blaOXA-24-like genes
Fig. 2
Fig. 2
Distribution of meropenem MICs in 269 CRAB blood isolates with the blaOXA-23-like and blaOXA-24-like genes
Fig. 3
Fig. 3
Pulsed-field gel electrophoresis results of A. baumannii isolates that had the blaOXA-24-like and blaOXA-51-like genes. There were 11 distinct genospecies and 3 PFGE dominant types. The scale indicates the percentage of overall genetic similarity. Isolates with the same letter were from the same hospital. M1, M2, M3, C5, C6, and V1 with the same gene cluster came from 3 different hospitals. Letter C: Changhua Christian Hospital. Letter M: MacKay Memorial Hospital. Letter V: Taipei Veterans General Hospital
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