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. 2021 May 25:14:1931-1939.
doi: 10.2147/IDR.S310478. eCollection 2021.

Molecular Epidemiology of Extensively-Drug Resistant Acinetobacter baumannii Sequence Type 2 Co-Harboring bla NDM and bla OXA From Clinical Origin

Hasan Ejaz  1 , Mahtab Ahmad  2 , Sonia Younas  3 , Kashaf Junaid  1 , Khalid Omer Abdalla Abosalif  1 , Abualgasim Elgaili Abdalla  1 , Ayman Ali Mohammed Alameen  1 , Mohammed Yagoub Mohammed Elamir  1 , Syed Nasir Abbas Bukhari  4 , Naveed Ahmad  5 , Muhammad Usman Qamar  2
Affiliations

Molecular Epidemiology of Extensively-Drug Resistant Acinetobacter baumannii Sequence Type 2 Co-Harboring bla NDM and bla OXA From Clinical Origin

Hasan Ejaz et al. Infect Drug Resist. .

Abstract

Background: The therapeutic management of carbapenem-resistant Acinetobacter baumannii (CR-AB) represents a serious challenge to the public health sector because these pathogens are resistant to a wide range of antibiotics, resulting in limited treatment options. The present study was planned to investigate the clonal spread of CR-AB in a clinical setting.

Methodology: A total of 174 A. baumannii clinical isolates were collected from a tertiary care hospitals in Lahore, Pakistan. The isolates were confirmed by VITEK 2 compact system and molecular identification of recA and bla OXA-51. Antimicrobial profile and the screening of carbapenem-resistant genes were carried out using VITEK 2 system and PCR, respectively. The molecular typing of the isolates was performed according to the Pasteur scheme.

Results: Of the 174 A. baumannii isolates collected, the majority were isolated from sputum samples (46.5%) and in the intensive care unit (ICU, 75%). Among these, 113/174 (64.9%) were identified as CR-AB, and 49.5% and 24.7% harbored bla OXA-23 and bla NDM-1, respectively. A total of 11 (9.7%) isolates co-harbored bla OXA-51, bla NDM-1, and bla OXA-23. Interestingly, 46.9% of the CR-AB belonged to sequence type 2 (ST2; CC1), whereas 15.9% belonged to ST1 (CC1). All of the CR-AB isolates showed extensive resistance to clinically relevant antibiotics, except colistin.

Conclusion: The study concluded CR-AB ST2 clone harboring bla OXA-23 and bla NDM-1 are widely distributed in Pakistan's clinical settings, which could result in increased mortality. Strict compliance with the National Action Plan on Antimicrobial Resistance is necessary to reduce the impacts of these strains.

Keywords: Acinetobacter baumannii; MIC; MLST; blaNDM; blaOXA.

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Conflict of interest statement

All authors declared no conflicts of interest.

Figures

Figure 1
Figure 1
The hierarchical clustering of carbapenem-resistant Acinetobacter baumannii. The antibiotics are shown on the x-axis, aligned with the bacterial strains on the y-axis. The scale on the y-axis shows bacterial resistance, intermediate resistance, and sensitivity from 1 to 3, respectively. The dendrogram shows the relationship among the different antibacterial drugs.
Figure 2
Figure 2
Carbapenem-resistant A. baumannii shows simultaneous resistance to multiple classes of antibiotics.
Figure 3
Figure 3
Carbapenem-resistant phenotypes. The left photograph shows the DDST for MBL production, and the right photograph displays the MHT for carbapenemase production.
See this image and copyright information in PMC

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