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. 2022 Aug 4;17(8):e0271355.
doi: 10.1371/journal.pone.0271355. eCollection 2022.

Acinetobacter baumannii complex, national laboratory-based surveillance in South Africa, 2017 to 2019

Olga Perovic  1   2 , Adrian Duse  2 , Vindana Chibabhai  2   3 , Marianne Black  2   3 , Mohamed Said  4   5 , Elizabeth Prentice  6 , Jeannette Wadula  2   7 , Yesholata Mahabeer  8   9 , K Swe Swe Han  8   9 , Ruth Mogokotleng  1 , Wilhelmina Strasheim  1 , Michelle Lowe  1 , Sabelle Jallow  1   2 , Husna Ismail  1 ; for GERMS-SA
Affiliations

Acinetobacter baumannii complex, national laboratory-based surveillance in South Africa, 2017 to 2019

Olga Perovic et al. PLoS One. .

Abstract

Objective: We aimed to provide an analysis of A. baumannii complex (ABC) isolated from blood cultures in South Africa.

Materials and methods: ABC surveillance was conducted from 1 April 2017 to 30 September 2019 at 19 hospital sites from blood cultures of any age and sex. Organism identification was performed using the MALDI-TOF MS and antimicrobial susceptibility testing (AST), MicroScan Walkaway System. We confirmed colistin resistance with Sensititre, FRCOL panel, and selected for whole-genome sequencing.

Results: During the study period, we identified 4822 cases of ABC, of which 2152 cases were from 19 enhanced surveillance sites were reported during the enhanced surveillance period (1 August 2018 to 30 September 2019). Males accounted for 54% (2611/4822). Of the cases with known age, 41% (1968/4822) were infants (< 1-year-old). Seventy-eight percent (1688/2152) of cases had a known hospital outcome, of which 36% (602/1688) died. HIV status was known for 69% (1168/1688) of cases, and 14% (238/1688) were positive. Eighty-two percent (1389/1688) received antimicrobial treatment in admission. Three percent (35/1389) of cases received single colistin. Four percent (75/2033) were resistant to colistin. At least 75% of the isolates (1530/2033) can be classified as extensively drug-resistant (XDR), with resistance to most antibiotics except for colistin. The majority, 83% (20/24), of the colistin-resistant isolates were of the sequence type (ST) 1. Resistance genes, both plasmid- and chromosomal- mediated were not observed. Although all isolates had, nine efflux pump genes related to antimicrobial resistance.

Conclusion: Our surveillance data contributed to a better understanding of the natural course of A. baumannii disease, the patient characteristics among infants, and the level of resistance. At least two-thirds of the isolates were extensively drug-resistant, and four percent of isolates were resistant to colistin.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Cases of Acinetobacter baumannii complex (ABC) identified from South Africa from 1 April 2017 to 30 September 2019, N = 4822.
Fig 2
Fig 2. Antimicrobial susceptibility patterns of Acinetobacter baumannii complex (ABC) bloodstream isolates from South Africa from 1 April 2017 to 30 September 2019, n = 2033.
Susceptible (S), Intermediate (I) and resistant (R).
Fig 3
Fig 3. Phylogenetic comparison of colistin-resistant Acinetobacter baumannii bloodstream isolates from South Africa from 1 April 2017 to 30 September 2019, n = 24.
See this image and copyright information in PMC

References

    1. El-Badawy MF, Abou-Elazm FI, Omar MS, El-Naggar ME, Maghrabi IA. The First Saudi Study Investigating the Plasmid-borne Aminoglycoside and Sulfonamide Resistance among Acinetobacter baumannii Clinical Isolates Genotyped by RAPD-PCR: the Declaration of a Novel Allelic Variant Called aac(6’)-SL and Three Novel Mutations in the sul1 Gene in the Acinetobacter Plasmid (s). Infect Drug Resist. 2021;14:4739–56. doi: 10.2147/IDR.S324707 - DOI - PMC - PubMed
    1. Eveillard M, Kempf M, Belmonte O, Pailhories H, Joly-Guillou ML. Reservoirs of Acinetobacter baumannii outside the hospital and potential involvement in emerging human community-acquired infections. Int J Infect Dis. 2013;17(10):e802–5. doi: 10.1016/j.ijid.2013.03.021 - DOI - PubMed
    1. Gramatniece A, Silamikelis I, Zahare I, Urtans V, Zahare I, Dimina E, et al.. Control of Acinetobacter baumannii outbreak in the neonatal intensive care unit in Latvia: whole-genome sequencing powered investigation and closure of the ward. Antimicrob Resist Infect Control. 2019;8:84. doi: 10.1186/s13756-019-0537-z - DOI - PMC - PubMed
    1. Kassamali Z, Jain R, Danziger LH. An update on the arsenal for multidrug-resistant Acinetobacter infections: polymyxin antibiotics. Int J Infect Dis. 2015;30:125–32. doi: 10.1016/j.ijid.2014.10.014 - DOI - PubMed
    1. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al.. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268–81. doi: 10.1111/j.1469-0691.2011.03570.x - DOI - PubMed

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