Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important pathogenic bacterium that can cause nosocomial infection in hospitalized patients with various manifestations. The purposes of this recent study were to determine the prevalence, antimicrobial susceptibility profiles, carbapenemase-producing phenotypic and genotypic of CRAB in two tertiary care hospitals in Indonesia. Methods: A. baumannii isolates collected from patient’s clinical cultures in two tertiary care hospitals in Malang and Manado were included. Identifications of meropenem-resistant A. baumannii isolates with the vitek2® system results, followed by a sensitivity test using 10 µg imipenem antibiotic disc according to CLSI guidelines to fulfill the criteria as CRAB isolates. We assessed carbapenemase-production using mCIM and eCIM, and determined the presence of blaKPC, blaNDM, blaOXA-23 carbapenemase resistance genes using simplex PCR. Results: 73 CRAB were collected from hospitalized patients, of which 30 CRAB from Manado and 43 CRAB from Malang. The largest number of samples came from sputum and indicates that XDR has also occurred in all CRAB isolates. Carbapenemase-production test using mCIM obtained positive results on 29 samples (96.7%) and 42 samples (97.7%) in Manado and Malang, respectively. The eCIM showed metallo-β-lactamase was dominant in two tertiary care hospitals. The prevalence of carbapenemase resistance genes was obtained blaOXA-23 and blaNDM ranged between 60% - 90.7% and 3.3% - 4.6%, respectively. blaKPC gene was not detected. Conclusions: We showed that CRAB isolates positive result of carbapenemase-production and carbapenemase resistance genes of blaOXA-23 seem to be dominant in two tertiary care hospitals in Malang and Manado, Indonesia. A national prevention and surveillance system should be prepared to reduce and limiting transmission of CRAB isolates.
Carbapenem-resistant Acinetobacter baumannii (A. baumannii)-calcoaceticus complex (CRAb-cc) is an important pathogen causing nosocomial infections worldwide; however, molecular epidemiology of the A. baumannii-calcoaceticus complex in Indonesian hospitals is scarce. This study aimed to determine the clonal relatedness of CRAb-cc in two tertiary care hospitals in Malang and Manado in Indonesia. The CRAb-cc isolates from routine clinical cultures in two tertiary care hospitals in Malang and Manado were identified using the Vitek2® system (bioMérieux, Lyon, France). Multi-locus variable-number tandem-repeat analysis (MLVA) typing, multi-locus sequence typing (MLST), clonal complex (CC), and phylogenetic tree analysis were conducted for a subset of isolates. Seventy-three CRAb-cc isolates were collected. The CRAb-cc isolates were frequently found among lower-respiratory-tract specimens. We detected the MLVA type (MT) 1, MT3, and MT4 CRAB-cc isolates belonging to the sequence type (ST) 642, and CC1 was the predominant clone in this study. In conclusion, we identified the clonal relatedness of A. baumannii-calcoaceticus complex isolates in two tertiary care hospitals in Malang and Manado in Indonesia. Further study is required to investigate the clinical importance and distribution of ST642 in Indonesian hospitals for developing prevention and control measures.
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