Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil

Clímaco, Eduardo Carneiro; Oliveira, Milena Locci de; Pitondo-Silva, André; Oliveira, Murilo Gomes; Medeiros, Micheli; Lincopán, Nilton; Darini, Ana Lúcia da Costa

doi:10.1016/j.meegid.2013.06.024

Cited by 47 publications

(36 citation statements)

References 37 publications

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“…It may be that a more recent transfer onto plasmids by this enzyme group has limited its spread to date. In contrast, the bla OXA-143-like enzymes, which are closely related to the bla OXA-40-like enzymes, have been identified only in Brazil (58,61,125). However, this apparent discrepancy may be explained by the close cultural connections between South America, Portugal, and Spain.…”

Section: Geographical Disseminationmentioning

confidence: 99%

“…Subsequent studies have identified isolates carrying bla OXA-23-like genes from all over the world (40,(119)(120)(121)(122)(123). Of all of the acquired OXA-type ␤-lactamases, those of the bla OXA-23-like group currently appear to be the most widespread and are particularly prevalent in Africa (123), South America (120,124,125), and East and Southeast Asia (53,126). 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).…”

Section: Geographical Disseminationmentioning

confidence: 99%

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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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Section: Geographical Disseminationmentioning

confidence: 99%

Section: Geographical Disseminationmentioning

confidence: 99%

OXA β-Lactamases

2014

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“…ST2 (clade B) is part of the IC-II lineage, which is widely prevalent throughout Europe and the United States and is frequently implicated in nosocomial outbreaks (20,74,75). ST406 (clade C) was first reported in an epidemiological study of CRAB clinical isolates from Japan (87) and was subsequently identified in Brazil (88). It is closely related to IC-I strains, which are globally disseminated.…”

Section: Figmentioning

confidence: 99%

Utility of Whole-Genome Sequencing in Characterizing Acinetobacter Epidemiology and Analyzing Hospital Outbreaks

2016

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bAcinetobacter baumannii frequently causes nosocomial infections and outbreaks. Whole-genome sequencing (WGS) is a promising technique for strain typing and outbreak investigations. We compared the performance of conventional methods with WGS for strain typing clinical Acinetobacter isolates and analyzing a carbapenem-resistant A. baumannii (CRAB) outbreak. We performed two band-based typing techniques (pulsed-field gel electrophoresis and repetitive extragenic palindromic-PCR), multilocus sequence type (MLST) analysis, and WGS on 148 Acinetobacter calcoaceticus-A. baumannii complex bloodstream isolates collected from a single hospital from 2005 to 2012. Phylogenetic trees inferred from core-genome single nucleotide polymorphisms (SNPs) confirmed three Acinetobacter species within this collection. Four major A. baumannii clonal lineages (as defined by MLST) circulated during the study, three of which are globally distributed and one of which is novel. WGS indicated that a threshold of 2,500 core SNPs accurately distinguished A. baumannii isolates from different clonal lineages. The bandbased techniques performed poorly in assigning isolates to clonal lineages and exhibited little agreement with sequence-based techniques. After applying WGS to a CRAB outbreak that occurred during the study, we identified a threshold of 2.5 core SNPs that distinguished nonoutbreak from outbreak strains. WGS was more discriminatory than the band-based techniques and was used to construct a more accurate transmission map that resolved many of the plausible transmission routes suggested by epidemiologic links. Our study demonstrates that WGS is superior to conventional techniques for A. baumannii strain typing and outbreak analysis. These findings support the incorporation of WGS into health care infection prevention efforts.A n important role of clinical microbiology is to identify relationships between bacterial isolates. At a broad level, phenotypic and genotypic tests are used to categorize bacterial isolates into the same or different species. Within a bacterial species, techniques are used to group isolates into clonal lineages, which are groups of closely related bacteria that share a recent common ancestor but have spread regionally or globally. At a more local level, infection control practitioners must determine whether a group of isolates constitutes a hospital outbreak by ascertaining whether the isolates have a degree of similarity consistent with a common source within the hospital. Once isolates belonging to a hospital outbreak have been identified, similarities and differences between these isolates can be exploited to generate a transmission map to aid in finding the source of the outbreak and in disrupting ongoing pathways of transmission. For some groups of bacteria, such as Acinetobacter, discernment at each level has medically important consequences and therefore must be accomplished by hospital-associated clinical microbiology laboratories.Within the Acinetobacter genus, the Acinetobacter calcoaceticusAcinetobac...

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“…Until now, this ST was not commonly recovered. Indeed, some A. baumannii isolates belonging to ST113 have been identified in Kuwait in 2013, containing plasmids harboring the bla GES-11 carbapenemase gene alone or coharboring the bla OXA-23 gene (10 (11), emphasizing that the dissemination of this carbapenemase gene is not related to a single clone.…”

mentioning

confidence: 99%

“…CRABs have become increasingly isolated in Brazil, with those carrying bla OXA-23 -like and bla OXA-143 -like genes being most prevalent (11). As opposed to what occurs in the rest of the world, with the predominance of ST92/OXA-23 A. baumannii isolates, it seems that CRABs carrying bla OXA-23 -like and bla OXA-143 -like genes mainly belong to multiple STs and clonal complexes CC104, CC109, and CC113 in Latin American countries.…”

mentioning

confidence: 99%

OXA-253, a Variant of the Carbapenem-Hydrolyzing Class D β - Lactamase OXA-143 in Acinetobacter baumannii

Girlich

Damaceno

Oliveira

et al. 2014

Antimicrob Agents Chemother

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The carbapenem-hydrolyzing class D ␤-lactamase OXA-253 was identified in an Acinetobacter baumannii clinical isolate belonging to sequence type 113 (ST113) in Brazil. OXA-253 shares 93.8% amino acid identity with OXA-143. The bla OXA-253 gene is located on a ca. 20-kb plasmid. The genetic environment of the bla OXA-253 gene shares the highest identity with ubiquitous GR2 group plasmids usually carrying bla OXA-24/-40 genes.A cinetobacter baumannii strains are frequently associated with nosocomial infections, and their resistance to carbapenems has risen in recent decades (1, 2). The main mechanisms of resistance to carbapenems of A. baumannii are efflux pumps, porin mutations, overexpression of the chromosomally encoded OXA-51-like ␤-lactamase, and the biosynthesis of acquired carbapenem-hydrolyzing class D ␤-lactamases (CHDLs) (oxacillinases) (3). To date, five main groups of CHDLs have been identified in A. baumannii, the intrinsic chromosomally encoded OXA-51-like enzyme and the acquired chromosomally encoded and plasmidencoded OXA-23-like, OXA-40-like, OXA-58-like, and OXA-143-like enzymes (3). OXA-143 was first described in 2009 from an A. baumannii strain isolated in Brazil in 2004 (2). In this study, we report an A. baumannii clinical strain producing OXA-253, a variant of OXA-143. The genetic environment of the plasmidborne bla OXA-253 gene is detailed.The clinical isolate A. baumannii 25 was recovered from a perineal swab in the intensive care unit in Minas Gerais Hospital, Brazil. MICs were determined by Etest (bioMérieux, La Balmeles-Grottes, France). Isolate 25 was resistant to all ␤-lactams, including carbapenems, and had reduced susceptibility to cefepime according to the CLSI guidelines (4) ( Table 1). It was also resistant to fluoroquinolones (ciprofloxacin), and susceptible to aminoglycosides (gentamicin, tobramycin, amikacin, and netilmicin), and tetracycline. A modified version of the CarbaNP test (5) and the CarbAcinetoNP test (P. Nordmann, personal communication) was performed and showed a carbapenemase activity. PCR experiments, performed as previously described for screening of bla , bla , bla OXA-58 and bla OXA-143 genes (6), identified a bla OXA-143 -like gene. Further sequencing of the PCR product identified the bla OXA-253 gene (GenBank number KC479324) and showed 95% nucleotide identity with the bla OXA-143 gene. The deduced protein sequence showed 17 amino acid differences between OXA-143 and OXA-253 (93.8% identity) (Fig. 1). Those amino acid changes do not occur in the conserved residues STFK (position 70 to 73) and KSG (position 216 to 218) of class D ␤-lactamases or in the FGN structural element (position 144 to 146) of carbapenem-hydrolyzing class D ␤-lactamases (CHDLs) (Fig. 1).Plasmid extraction from A. baumannii 25 performed by the Kieser technique yielded two plasmids of ca. 70 and 20 kb (7). The gene encoding the OXA-253 determinant from A. baumannii 25 was transferred to Escherichia coli TOP10 by electroporation. The resulting E. coli TOP10 strain harboring the plasmid o...

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Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil

Cited by 47 publications

References 37 publications

OXA β-Lactamases

OXA β-Lactamases

Utility of Whole-Genome Sequencing in Characterizing Acinetobacter Epidemiology and Analyzing Hospital Outbreaks

OXA-253, a Variant of the Carbapenem-Hydrolyzing Class D β - Lactamase OXA-143 in Acinetobacter baumannii

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