Characterisation of carbapenem-resistant Acinetobacter baumannii outbreak strains producing OXA-58 in Turkey

Külah, Canan; Mooij, Marlies J.; Cömert, Füsun; Aktaş, Elif; Çelebi, Güven; Özlü, Nagihan; Rijnsburger, Martine; Savelkoul, Paul H. M.

doi:10.1016/j.ijantimicag.2010.03.017

Cited by 50 publications

(46 citation statements)

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“…Our results support previous reports indicating the worldwide spread of the bla OXA-58 gene and highlight its importance in conferring carbapenem resistance among A. baumannii isolates from Latin America Higgins et al, 2010a;Kulah et al, 2010;Marqué et al, 2005;McCracken et al, 2009;Mendes et al, 2009;Papa et al, 2009). …”

Section: E Sevillano and Others 82supporting

confidence: 91%

Emergence and clonal dissemination of carbapenem-hydrolysing OXA-58-producing Acinetobacter baumannii isolates in Bolivia

Sevillano

Fernández

Bustamante

et al. 2012

Journal of Medical Microbiology

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and the presence of carbapenemases as a mechanism of resistance to imipenem. Isolates were obtained from 46 patients (one isolate per patient; 30 males,16 females) with an age range of 1 day to 84 years, and were collected from different sample types, the majority from respiratory tract infections (17) and wounds (13). Resistance to imipenem was detected in 15 isolates collected from different hospitals of the city. These isolates grouped into the same genotype, named A, and were resistant to all antibiotics tested including imipenem, with susceptibility only to colistin. Experiments to detect carbapenemases revealed the presence of the OXA-58 carbapenemase. Further analysis revealed the location of the bla OXA-58 gene on a 40 kb plasmid. To our knowledge, this is the first report of carbapenem resistance in A. baumannii isolates from Bolivia that is conferred by the OXA-58 carbapenemase. The presence of this gene in a multidrug-resistant clone and its location within a plasmid is of great concern with regard to the spread of carbapenem-resistant A. baumannii in the hospital environment in Bolivia. INTRODUCTIONAcinetobacter baumannii is a nosocomial pathogen responsible for severe infections often diagnosed in patients attending hospitals worldwide. Carbapemens are considered the drugs of choice for treating these infections, but they are not always efficient due to the occurrence of multidrug-resistant strains of this bacterium (Canduela et al., 2006;Coelho et al., 2006;Higgins et al., 2010a;Mendes et al., 2009;Poirel et al., 2010). Mechanisms enabling the development of carbapenem resistance include an induced decrease in membrane permeability, efflux pump overexpression and the production of carbapenemases. Among these mechanisms, the production of carbapenemases plays a major role in carbapenem resistance in most Gram-negative bacilli, including A. baumannii clinical isolates (Canduela et al., 2006;Coelho et al., 2006;Poirel et al., 2010;Queenan & Bush, 2007;Walsh, 2010). The most common type of enzyme occurring in A. baumannii is represented by the carbapenem-hydrolysing class D b-lactamases, which are divided into five phylogenetic groups: OXA-23-like, OXA-24-like, OXA-58-like, OXA-51-like, which is intrinsic to A. baumannii, and the recently described OXA-143-like enzymes (Higgins et al., 2009;Queenan & Bush, 2007).Although A. baumannii is considered an emerging pathogen and much research has been carried out on it, there have been only a few studies concerning the mechanisms conferring carbapenem resistance of this bacterium in Latin American countries (Celenza et al., 2006;Coelho et al., 2006;Sader et al., 2004;Sgambatti et al., 2010). In addition, there are no previous publications regarding the resistance of A. baumannii to imipenem or the occurrence of carbapenemases in A. baumannii isolates in Bolivia.In this study, we analysed the antibiotic resistance, in particular to imipenem, of clinical isolates of A. baumannii obtained from several hospitals in Cochabamba, Bolivia, and the presence of carbape...

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Section: E Sevillano and Others 82supporting

confidence: 91%

Emergence and clonal dissemination of carbapenem-hydrolysing OXA-58-producing Acinetobacter baumannii isolates in Bolivia

Sevillano

Fernández

Bustamante

et al. 2012

Journal of Medical Microbiology

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“…While not as prevalent as the bla OXA-23-like genes, the bla OXA-58-like genes are also globally distributed (53,(126)(127)(128)(129). However, they are detected at very high frequencies in southern European Mediterranean countries such as Italy (130), Greece (131), and Turkey (132). Until recently, the bla OXA-40-like genes appeared to be restricted largely to the Iberian Peninsula, where they have been the predominant acquired OXA-type ␤-lactamase (133)(134)(135).…”

Section: Geographical Disseminationmentioning

confidence: 99%

OXA β-Lactamases

2014

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SUMMARY The OXA β-lactamases were among the earliest β-lactamases detected; however, these molecular class D β-lactamases were originally relatively rare and always plasmid mediated. They had a substrate profile limited to the penicillins, but some became able to confer resistance to cephalosporins. From the 1980s onwards, isolates of Acinetobacter baumannii that were resistant to the carbapenems emerged, manifested by plasmid-encoded β-lactamases (OXA-23, OXA-40, and OXA-58) categorized as OXA enzymes because of their sequence similarity to earlier OXA β-lactamases. It was soon found that every A. baumannii strain possessed a chromosomally encoded OXA β-lactamase (OXA-51-like), some of which could confer resistance to carbapenems when the genetic environment around the gene promoted its expression. Similarly, Acinetobacter species closely related to A. baumannii also possessed their own chromosomally encoded OXA β-lactamases; some could be transferred to A. baumannii , and they formed the basis of transferable carbapenem resistance in this species. In some cases, the carbapenem-resistant OXA β-lactamases (OXA-48) have migrated into the Enterobacteriaceae and are becoming a significant cause of carbapenem resistance. The emergence of OXA enzymes that can confer resistance to carbapenems, particularly in A. baumannii , has transformed these β-lactamases from a minor hindrance into a major problem set to demote the clinical efficacy of the carbapenems.

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“…Acinetobacter have the ability to develop resistance rapidly, and this has been observed particularly for carbapenems in different parts of the world. [23][24][25] A number of antimicrobial resistance mechanisms not for citation purposes Antibiotic resistance of A. baumannii in blood Al -Mously et al…”

Section: %) Invasivementioning

confidence: 99%

Acinetobacter baumannii bloodstream infections in a tertiary hospital: Antimicrobial resistance surveillance

Al-Mously¹

2013

Int. j. infect. control

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Nosocomial bacteremia caused by Acinetobacter baumannii is of increasing concern in critically ill patients. there is a world-wide increase in the emergence of multidrug-resistant (MDR) A. baumannii to antimicrobials. therefore we conducted this study to evaluate the resistance pattern of A. baumannii in patients with bacteremia. this is a retrospective study conducted in a tertiary hospital in Saudi Arabia. During the period from April 2006 till April 2010, data for A. baumannii isolated from blood were collected. Multidrug resistant A. baumannii was defined as resistance to three or more classes of antibiotics.We found 191 isolates of A. baumannii from blood. the majority of cases were reported in surgical ICU (40.8%). the highest resistance rates to antimicrobials were reported for cefepime (73.8%) and piperacillin / tazobactam (72.3%), followed by ciprofloxacin (68%), and gentamicin (66%). Resistance rates were also high to imipenem (61.3%) and meropenem (60.7%). low rates of resistance to colistin (0.5%) and to tigecycline (3.9%) were observed. MDR was observed in 132 (69%) of the A. baumannii isolates and 104 (78.8%) of these MDR strains showed sensitivity only to colistin and tigecycline.Bacteremia due to A. baumannii was the highest in surgical ICU. the emergence of MDR A. baumannii is increasing and the resistance rates to carbapenems are alarming. Urgent measures are in need to slow the development of MDR AB. We recommend encouraging clinicians for strict adherence to infection control Corresponding Author

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Characterisation of carbapenem-resistant Acinetobacter baumannii outbreak strains producing OXA-58 in Turkey

Cited by 50 publications

References 21 publications

Emergence and clonal dissemination of carbapenem-hydrolysing OXA-58-producing Acinetobacter baumannii isolates in Bolivia

Emergence and clonal dissemination of carbapenem-hydrolysing OXA-58-producing Acinetobacter baumannii isolates in Bolivia

OXA β-Lactamases

Acinetobacter baumannii bloodstream infections in a tertiary hospital: Antimicrobial resistance surveillance

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