Detection ofbla_OXA-23-likeandbla_NDM-1inAcinetobacter baumanniifrom the Eastern Region, Saudi Arabia

Abstract

Acinetobacter baumannii is currently considered as one of the most common successful pathogens in the healthcare system due to its ability to quickly develop resistance. Ten carbapenem-resistant A. calcoaceticus-baumannii complex were isolated from the eastern region, Saudi Arabia in 2014. All isolates were resistant to ciprofloxacin, however, 8 of 10 isolates were tigecycline resistant. Susceptibility test was also carried out for three aminoglycosides, resistance to gentamicin was 80%, amikacin was 90%, and tobramycin was 50%. Colistin susceptibility was seen in all isolates. The 10 isolates harbored bla and ISAba1 and 9 of them also carried bla. Three isolates of 10 harbored bla coding for NDM metallo-β-lactamase (MBL) with coexistence of bla together with either bla or bla or both. Those three isolates exhibited negative Etest MBL screening test. Pulsed-field gel electrophoresis revealed the high clonal variability of the isolates, although two isolates were indistinguishable. The risk of dissemination of carbapenem resistance through presence of ISAba1 upstream of OXA-23-like in all isolates raises the concern about emergence of higher carbapenem prevalence rates in the future in our region. This study also demonstrated the importance of molecular surveillance to provide accurate and reliable data about the resistance rates of A. baumannii. Finally, the high incidence of NDM-1 among our isolates requires a routine surveillance to monitor the future prevalence of this enzyme in the region.

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

“…On the other hand, class D oxacillinase (OXA-23, OXA-24, and OXA-58) predominate in A. baumannii followed by NDM, VIM, and IMP (Alsultan et al, 2013; Elabd et al, 2015; Aly et al, 2016; Al-Agamy et al, 2017; Alhaddad et al, 2018). Clonal diversity revealed by different sequence types as well as PFGE patterns among isolated strains was reported in all the studies (Aly et al, 2014; Lopes et al, 2015; Zowawi et al, 2015; El-Mahdy et al, 2017). In one study, Aljindan et al (2015) found that carbapenem resistant A. baumannii were more resistant to gentamicin, amikacin, ciprofloxacin, and tigecycline compared to the susceptible ones.…”

Prevalence of Acinetobacter baumannii in Saudi Arabia: risk factors, antimicrobial resistance patterns and mechanisms of carbapenem resistance

“…In accordance to these findings, a prospective study of CRAB isolates from patients with different types of infection at King Fahd Hospital in Al-Madinah Al-Monawarah demonstrated the presence of the VIM-1 gene in 61.5% of isolates [55]. Moreover, El-Mahdy et al [61]. found that all of the ten carbapenem-resistant A. calcoaceticus – baumannii complex isolates from the eastern region harbored blaOXA-23-like and ISAba1, and that 9 of them also carried blaADC.…”

“…Another study conducted over a 3-month period from March to May 2014 confirmed these findings. Ten CARB isolates from two tertiary care hospitals were found to be resistant to cefotaxime, ceftazidime, cefepime, and imipenem, meropenem and ciprofloxacin; however, they were all susceptible to colistin [61].…”

Insights into Acinetobacter baumannii: A Review of Microbiological, Virulence, and Resistance Traits in a Threatening Nosocomial Pathogen

“…These are zinc-dependent metallo-β-lactamases (MBLs), that strongly hydrolyze all β-lactams, including carbapenems, but not aztreonam [142], and are inhibited by metal chelators like EDTA and dipicolinic acid [128].The most concerning among MBLs is NDM-1, with carbapenem-resistant A. baumannii producing NDM-1 being identified in 2011 in China [143]. Additional reports of NDM-1 in A. baumannii have accumulated from Tunisia [144], Iran [145], Lebanon [146], and Saudi Arabia [147]. Apart from NDM, VIM [148], GIM [149], SIM [150], and IMP [151,152], including a new allelic variant, IMP-55 [153] were reported.…”