Antimicrobial Resistance Mechanisms and Genetic Diversity of Multidrug-Resistant<i>Acinetobacter baumannii</i>Isolated from a Teaching Hospital in Malaysia

Biglari, Shirin; Hanafiah, Alfizah; Puzi, Shaliawani Mohd; Ramli, Ramliza; Rahman, Md. Mostafizur; Lopes, Bruno Silvester

doi:10.1089/mdr.2016.0130

Cited by 21 publications

(20 citation statements)

References 53 publications

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“…Likewise, A. baumannii isolates collected in 2010 and 2011 from various ward in HSA in the southern state of Johor, displayed resistance rates of 88% for both imipenem and meropenem ( Dhanoa et al, 2015 ). Resistance rates of >70% were also reported for isolates from UKMMC (located south of Kuala Lumpur) in 2010–2011 ( Biglari et al, 2015 , 2017 ) and HSNZ (located in the east coast state of Terengganu) in 2011( Lean et al, 2014 ).…”

Section: Antibiotic Susceptibility Profilesmentioning

confidence: 78%

Acinetobacter spp. Infections in Malaysia: A Review of Antimicrobial Resistance Trends, Mechanisms and Epidemiology

et al. 2017

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Acinetobacter spp. are important nosocomial pathogens, in particular the Acinetobacter baumannii-calcoaceticus complex, which have become a global public health threat due to increasing resistance to carbapenems and almost all other antimicrobial compounds. High rates of resistance have been reported among countries in Southeast Asia, including Malaysia. In this review, we examine the antimicrobial resistance profiles of Acinetobacter spp. hospital isolates from Malaysia over a period of nearly three decades (1987–2016) with data obtained from various peer-reviewed publications as well as the Malaysian National Surveillance on Antibiotic Resistance (NSAR). NSAR data indicated that for most antimicrobial compounds, including carbapenems, the peak resistance rates were reached around 2008–2009 and thereafter, rates have remained fairly constant (e.g., 50–60% for carbapenems). Individual reports from various hospitals in Peninsular Malaysia do not always reflect the nationwide resistance rates and often showed higher rates of resistance. We also reviewed the epidemiology and mechanisms of resistance that have been investigated in Malaysian Acinetobacter spp. isolates, particularly carbapenem resistance and found that blaOXA-23 is the most prevalent acquired carbapenemase-encoding gene. From the very few published reports and whole genome sequences that are available, most of the Acinetobacter spp. isolates from Malaysia belonged to the Global Clone 2 (GC2) CC92 group with ST195 being the predominant sequence type. The quality of data and analysis in the national surveillance reports could be improved and more molecular epidemiology and genomics studies need to be carried out for further in-depth understanding of Malaysian Acinetobacter spp. isolates.

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Section: Antibiotic Susceptibility Profilesmentioning

confidence: 78%

Acinetobacter spp. Infections in Malaysia: A Review of Antimicrobial Resistance Trends, Mechanisms and Epidemiology

et al. 2017

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“…Forty nine Class D (OXA) β-Lactamases have also been described from A. baumannii; 4 of them -(OXA-239, OXA-72, OXA-51, and OXA-253) -were discovered or re-described in the last year [165][166][167][168][169][170].…”

Section: β-Lactamasesmentioning

confidence: 99%

An Overview of Multi-Antibiotic Resistance in Pathogenic Bacteria - From Selected Genetic and Evolutionary Aspects - A Review

Fodor¹,

Ba²,

Deák³

et al. 2018

Preprint

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The challenge posed by multi-drug resistance (MDR) of pathogenic organisms, spectacularly manifested in the 6 “ESKAPE” bacterium (two Gram-positive, four Gram-negative) species, should invoke new comprehensive strategies, and needs cooperation of scientists with medical, veterinary and natural science background. This review is aimed at informing newcomers, coming from the field of biology and genetics, about problems related to rapidly emerging, new multi-drug resistant, pathogenic, bacteria. Unlike persistence, the antibiotic resistance is inherited. A functioning “resistance gene” makes a susceptible organism resistant to a given antibiotic, encoding for polypeptides capable of acting either as decomposing enzymes, or acting as trans-membrane pumps, or membrane structure components capable of modifying the permeability implementing a «by pass» mechanism enabling the antibiotic molecule to reach its cellular target(s). A functioning “sensitivity gene” encode for a polypeptide, capable (directly or indirectly) of transferring toxic molecules into target cells, or of metabolizing non-transferable to transferable, or non-toxic molecules to toxic derivatives. A gene of a normal function could act as a “sensitivity” gene in the presence of antibiotics of chemical structures similar to the natural substrate of the gene product, (enzyme or binding/ trans-membrane protein). The Agrocin 84 story is a good example. Multi-drug resistance is a phenotypic consequence of the sequential accumulation of mutations, and/or up-take of plasmids or genomic islands carrying resistance genes from the environment via horizontal gene transfer, mediated by conjugative plasmid or bacteriophage carrying mobile genetic elements. Both multi-drug resistance and collateral sensitivity are evolutionary products. Some revealed evolutionary process and their Lamarckian and Darwinian interpretations are discussed. Toolkits of comparative full-genome sequencing, genomics, experimental evolution and population genetics may provide perspectives for overcoming the invincibility of multi-drug panresistance. The status of some recently emerging pathogenic bacterium species with zoonic features and of veterinary background is also discussed.

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“…This can be related to the several other studies from the continent of Asia, where a high rate of CR is found to be associated with Acinetobacter spp. [24][25][26][27][28][29] Differences in the proportion of MBLs have been documented from all over the world based on surveys of community-acquired and nosocomial infections. However, we have found no meta-analysis study speci cally on Metallo-β-lactamases.…”

Section: Discussionmentioning

confidence: 99%

Systematic surveillance and meta-analysis on the prevalence of Metallo-β-Lactamase producers among carbapenem resistant clinical isolates in Pakistan

Ain

Abrar

Khan

et al. 2020

Preprint

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Background: Rapid emergence of carbapenem resistance (CR) is a health concern of pertinent importance. Epidemiological surveillance of CR at global and indigenous level (Pakistan) can help to improve infection control strategy and establish pharmacovigilance programs. This study evaluate the prevalence of clinically significant CR isolates, and its genetic variant distribution among different geographical regions of Pakistan. Methods: A meta-analysis was conducted to present the current rate of CR infections and prevalence of Metallo-β-lactamases (MBLs). The proposed subject was researched using robustic electronic databases a) PubMed b) PubMed Central® (PMC), and c) Google Scholar to identify the available literature. Thereafter, relevant data was extracted and statistical analysis was performed using STATA version 14. Result: A total of 110 relevant studies were identified with 19 meeting the inclusion criteria for the meta-analysis of CR, while 22 for MBLs. Pooled rate for carbapenem resistance was determined to be 0.28 (95% CI: 0.26-0.31) with overall significant heterogeneity (I 2 =99.61%, p<0.001) and significant estimated score ES=0 (Z=22.65, p<0.001). In case of Pakistan, the overall pooled proportion of MBL producers was 0.34 (95% CI: 0.29-0.39) with overall heterogeneity significance (I 2 =99.62%, p<0.001) and respective significant ES=0 (Z=13.17, p<0.001). Conclusively, diverse variants of carbapenemases (VIM, IMP, NDM, KPC, GIM, SIM) along with other co-existing β-lactamase variants (OXA, TEM, SHV, CTX-M) have been reported across the country. However, New Delhi Metallo-β-lactamase (NDM)-variants were reported in predominant literature. Conclusion: The prevalence of CR isolates in Pakistan is alarming, associated with MBL production primarily evident from the studies. The study emphasizes the need for regular surveillance, pharmacovigilance and antibiotic stewardship programs to ensure the availability of data to the authorities for preemptive measures of infection control.

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Antimicrobial Resistance Mechanisms and Genetic Diversity of Multidrug-ResistantAcinetobacter baumanniiIsolated from a Teaching Hospital in Malaysia

Cited by 21 publications

References 53 publications

Acinetobacter spp. Infections in Malaysia: A Review of Antimicrobial Resistance Trends, Mechanisms and Epidemiology

Acinetobacter spp. Infections in Malaysia: A Review of Antimicrobial Resistance Trends, Mechanisms and Epidemiology

An Overview of Multi-Antibiotic Resistance in Pathogenic Bacteria - From Selected Genetic and Evolutionary Aspects - A Review

Systematic surveillance and meta-analysis on the prevalence of Metallo-β-Lactamase producers among carbapenem resistant clinical isolates in Pakistan

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