Distribution of bla OXA-23, IS Aba , Aminoglycosides resistant genes among burned & ICU patients in Tehran and Sari, Iran

Abstract

BackgroundMultidrug resistant strains of Acinetobacter baumannii (MDR-AB) have emerged as alarming nosocomial pathogens among patients admitted to Intensive Care Unit and burned patients. The aim of this study was to determine the susceptibility of A. baumannii isolates, the carbapenems resistance patterns bla OXA-23 and also ISAba elements of A. baumannii isolates among burned and ICU patients in Tehran and Sari, Iran.MethodsIn this study, 100 A. baumannii isolates from burned and ICU patients in Tehran and Sari (Iran) during 2013 were tested for determination of antimicrobials susceptibility by the disc-diffusion method on Mueller Hinton agar recommended by the guidelines of Clinical and Laboratory Standards Institute (CLSI), and frequency blaOXA-23 carbapenemase genes, and insertion elements ISAba genes were studied by PCR method.ResultsThe highest rates of susceptibility were observed with Colistin (88.7%), Tigecycline (82.2%), Imipenem (67%) and ISAba (32.2%). The extensively drug-resistance and pan drug-resistance were observed in 37.1% and 8.1% isolates, respectively.Results indicated among isolates resistant to Aminoglycoside and Carbapenem, the highest resistance was observed to Streptomycin (90%) ‚ and the most sensitivity was to Imipenem (67%).ConclusionsThis is the most study that attempted to detect Acinetobacter baumanii the insertion elements ISAba, bla OXA-23 and aminoglycosides resistance in MDR-AB isolates from burned and ICU patients in Iran. In a timely manner, antimicrobial resistance surveillance and strict infection control strategies are still lacking in burn ward and ICU in Iran, despite the alarming emergence of MDR-AB strains, particularly among those isolates that are not susceptible to Colistin. The results of this study are consistent with a recent report in which a number of combinations exhibited potent activity against Multidrug resistant strains of A. baumannii (MDR-AB).

Limited genetic diversity and extensive antimicrobial resistance in clinical isolates of Acinetobacter baumannii in north-east Iran

“…These figures were higher than the findings of Feizabadi et al (2008), who reported a 25% prevalence of the bla OXA-23 gene and a 17% prevalence of the bla OXA-24 gene in clinical isolates of A. baumannii. Moreover, a study conducted on isolates recovered from burn ward and ICU patients in Tehran reported a low rate of ISAba1 (32.2%) and an median rate of bla OXA-23 (67%), which differs from the results of the present study (Nasrolahei et al, 2014). We also found that 64% of isolates were VIM-family MBL producers; however, there were non-MBL carrier isolates in the samples which were imipenem-resistant.…”

The Study of the Inhibition Effects of Satureja khuzestaniea Essence on the Gene Expression of bla-OXA-23 in Multidrug-Resistant Strains of Acinetobacter baumannii

“…The increasing prevalence of XDR and PDR A. baumannii strains and the limited treatment options have prompted the use of antibiotic combinations such as Tigecycline and Colistin as therapeutic regimens (15,16). Resistant strains of bacterial pathogens are a major source of high morbidity, mortality, and increased cost, making their treatment much more difficult (11). Traditionally, plants have played an important role in the treatment of diseases; as such, they may be considered sources of drug therapies that could be used instead of carbapenem.…”

“…Antibiogram testing was performed on white amikacin (30 µg), Oxacillin (30 µg), Kanamycin (30 µg), Gentamicin (10 µg), Neomycin (30 µg), and imipenem (10 µg). The antimicrobial activity of Acinetobacter baumannii in Satureja khuzestaniea essence was studied using a disk diffusion method (11). Here, 10 µL from essence was dissolved in 90 µL DMSO.…”

“…Since then, several cases have been reported around the world (10). An acquired resistance to carbapenems is mediated by Ambler class D beta-lactamases or OXA-type carbapenamases, as well as Ambler class B metallo-beta-lactamases that are encoded by transmissible genes, which account for most of the resistance to carbapenems (5,11). The use of medicinal herbaceous drugs in treatments has been recommended since ancient times.…”

An Investigation of Antibacterial Resistance Patterns Among Acinetobacter baumannii and Pseudomonas aeruginosa Isolates Collected from Intensive Care Units of a University-Affiliated Hospital in Ahvaz, Iran

“…In the past, most A. baumannii isolates were sensitive to carbapenems (7), but in the last two decades, due to the widespread use of these antibiotics, MDR and extensively drug-resistant (XDR) strains of A. baumannii have been increasingly reported and have emerged as a critical problem worldwide (8, 9). Members of the genus Acinetobacter have been implicated as the cause of many serious infectious diseases, such as respiratory infections, bacteremia, urinary tract infections, meningitis, and endocarditis, mostly engaging critically ill or immunocompromised patients (1, 8). The incidence of A. baumannii infections has increased over the last few decades (10) and this has been recognized as the third most common causative agent of infections in ICU patients, with mortality rates of 26% - 68% (7).…”