Diversity of multi-drug resistant Acinetobacter baumannii population in a major hospital in Kuwait

Abstract

Acinetobacter baumannii is one of the most important opportunistic pathogens that causes serious health care associated complications in critically ill patients. In the current study we report on the diversity of the clinical multi-drug resistant (MDR) A. baumannii in Kuwait by molecular characterization. One hundred A. baumannii were isolated from one of the largest governmental hospitals in Kuwait. Following the identification of the isolates by molecular methods, the amplified blaOXA-51-like gene product of one isolate (KO-12) recovered from blood showed the insertion of the ISAba19 at position 379 in blaOXA-78. Of the 33 MDR isolates, 28 (85%) contained blaOXA-23, 2 (6%) blaOXA-24 and 6 (18%) blaPER-1 gene. We did not detect blaOXA-58, blaVIM, blaIMP, blaGES, blaVEB, and blaNDM genes in any of the tested isolates. In three blaPER-1 positive isolates the genetic environment of blaPER-1 consisted of two copies of ISPa12 (tnpiA1) surrounding the blaPER-1 gene on a highly stable plasmid of ca. 140-kb. Multilocus-sequence typing (MLST) analysis of the 33 A. baumannii isolates identified 20 different STs, of which six (ST-607, ST-608, ST-609, ST-610, ST-611, and ST-612) were novel. Emerging STs such as ST15 (identified for the first time in the Middle East), ST78 and ST25 were also detected. The predominant clonal complex was CC2. Pulsed-field gel electrophoresis and MLST defined the MDR isolates as multi-clonal with diverse lineages. Our results lead us to believe that A. baumannii is diverse in clonal origins and/or is undergoing clonal expansion continuously while multiple lineages of MDR A. baumannii circulate in hospital ward simultaneously.

Identification of a Novel Plasmid Carrying mcr-4.3 in an Acinetobacter baumannii Strain in China

“…KT346360]) identified in clinical A. baumannii isolates recovered prior to 2010 in Australia (26), was excluded. ISAba19 is an A. baumannii-original insertion sequence with a length of 1,309 bp, which was found inserted into the bla OXA-78 gene in clinical A. baumannii isolates (27). Additionally, pRCH52-1 harbors a tetA(39)-tetR(39) unit (1,895 bp); the original study showed that tetA(39) was located on a plasmid from A. baumannii isolated in 1997, but only a 3,727-bp fragment was sequenced (28,29).…”

High prevalence of TEM, VIM, and OXA-2 beta-lactamases and clonal diversity among Acinetobacter baumannii isolates in Turkey

“…In this study, we found that all the isolated strains were susceptible to tigecycline and colistin. However, there have been many reports of tigecycline and colistin resistance, which range from 0.6% to 45.8% [18][19][20][21] and 0 to 30.6%, respectively, around the world [22][23][24][25]. Furthermore, colistin resistance was reported to be of 4% in the EARS-Net 2016 report [26].…”

Molecular epidemiology and antimicrobial resistance features of Acinetobacter baumannii clinical isolates from Pakistan

“…ST158 isolates were also reported in Lebanon between 2011 and 2013 [42]. The recognition of Ab-Pak-cluster-7 in Pakistan has then expanded the geographic distribution of ST158 beyond the Middle East [43][44][45][46].…”