Phenotypic Detection of Metallo-Beta-Lactamases in Carbapenem Resistant<i>Acinetobacter baumannii</i>Isolated from Pediatric Patients in Pakistan

Anwar, Muneeza; Ejaz, Hassan; Zafar, Ali; Hamid, Hamdan

doi:10.1155/2016/8603964

Cited by 36 publications

(30 citation statements)

References 20 publications

(23 reference statements)

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“…All the isolates were resistant to ≥ 3 classes of antibiotics and were accordingly defined as multidrug-resistant [27]. The results were in line with previous studies describing extensive occurrence of multidrug-resistant strains of A. baumannii in Pakistan [28][29][30]. However, our results could be partially biased by the predominance of few genetically related clusters of isolates, as described in the next paragraph.…”

Section: Antimicrobial Resistance Patternssupporting

confidence: 91%

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

Karah

Khalid

Wai

et al. 2020

Ann Clin Microbiol Antimicrob

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Background: Acinetobacter baumannii is a Gram-negative opportunistic pathogen with a notorious reputation of being resistant to antimicrobial agents. The capability of A. baumannii to persist and disseminate between healthcare settings has raised a major concern worldwide. Methods: Our study investigated the antibiotic resistance features and molecular epidemiology of 52 clinical isolates of A. baumannii collected in Pakistan between 2013 and 2015. Antimicrobial susceptibility patterns were determined by the agar disc diffusion method. Comparative sequence analyses of the ampC and bla OXA-51-like alleles were used to assign the isolates into clusters. The whole genomes of 25 representative isolates were sequenced using the MiSeq Desktop Sequencer. Free online applications were used to determine the phylogeny of genomic sequences, retrieve the multilocus sequence types (ST), and detect acquired antimicrobial resistance genes.Results: Overall, the isolates were grouped into 7 clusters and 3 sporadic isolates. The largest cluster, Ab-Pak-cluster-1 (bla OXA-66 and ISAba1-ampC-19) included 24 isolates, belonged to ST2 and International clone (IC) II, and was distributed between two geographical far-off cities, Lahore and Peshawar. Ab-Pak-clusters-2 (bla OXA-66 , ISAba1-ampC-2), and -3 (bla OXA-66 , ISAba1-ampC-20) and the individual isolate Ab-Pak-Lah-01 (ISAba1-bla OXA-66 , ISAba1-ampC-2) were also assigned to ST2 and IC II. On the other hand, Ab-Pak-clusters-4 (bla OXA-69 , ampC-1), -5 (bla OXA-69 , ISAba1-ampC-78), and -6A (bla OXA-371 , ISAba1-ampC-3) belonged to ST1, while Ab-Pak-cluster-6B (bla OXA-371 , ISAba1-ampC-8) belonged to ST1106, with both ST1 and ST1106 being members of IC I. Five isolates belonged to Ab-Pak-cluster-7 (bla . This cluster corresponded to ST158, showed a well-delineated position on the genomic phylogenetic tree, and was equipped with several antimicrobial resistance genes including bla OXA-23 and bla . Conclusions:Our study detected the occurrence of 7 clusters of A. baumannii in Pakistan. Altogether, 6/7 of the clusters and 45/52 (86.5%) of the isolates belonged to IC I (n = 9) or II (n = 36), making Pakistan no exception to the global domination of these two clones. The onset of ST158 in Pakistan marked a geographical dispersal of this clone beyond the Middle East and brought up the need for a detailed characterization.

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Section: Antimicrobial Resistance Patternssupporting

confidence: 91%

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

Karah

Khalid

Wai

et al. 2020

Ann Clin Microbiol Antimicrob

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“…Carbapenem resistance in A.baumannii has been reported in various studies, ranging from 40-98.7% (5, [21][22][23][24]. We found 86.9% carbapenem resistance in A. baumannii which is similar to 85% resistance reported by Rynga D et al (2015) from Delhi (25).…”

Section: Discussionsupporting

confidence: 80%

Molecular Epidemiology of Metallo Beta Lactamases in Acinetobacter Baumannii at a Tertiary Care Hospital

Mohammed¹,

Singh²

2019

IJMBS

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Background: Carbapenem resistance mediated by metallo beta lactamases (MBL) in Acinetobacter baumannii is a global challenge due to its rapid spread and limited therapeutic options. Objective: To determine the prevalence of MBL in A. baumannii isolates in hospitalized patients by both phenotypic and genotypic methods. Materials and Methods: The clinical samples were collected from inpatients and subcultured on routine culture media for growth. Identification of bacteria along with antimicrobial sensitivity testing was done by VITEK -2 Compact (bioMerieux). Antibiotics that were not tested by VITEK-2 were tested manually by Kirby-Bauer disk diffusion method according to CLSI 2017 and EUCAST 2016 guidelines. The isolates which were resistant to carbapenem (imipenem and/ or meropenem) were tested by phenotypic (imipenem-EDTA combined disk method) and genotypic method for presence of common metallo beta lactamases genes (blaIMP, blaNDM, blaGIM, blaVIM, blaSPM and blaSIM). Results: 84 non duplicate A.baumannii were isolated out of 947 pathogenic gram negative isolates. Majority (47.6%) of isolates were obtained from tracheostomy/endotracheal/bronchoalveolar lavage (TT/ET/BAL) followed by sputum (21.4%). None of the isolates were found to be resistant to colistin and tigecycline. 73 (86.9%) isolates were found to be carbapenem resistant, among these 60 (82.2%) were found to be MBL positive by phenotypic and 32 (43.2%) by genotypic method. MBL genes detected were blaNDM (39.7%), blaGIM (2.7%) and blaVIM (1.4%). None of the isolates were positive for blaIMP, blaSPM and blaSIM. Conclusion: The prevalence of MBL in carbapenem resistant isolates of A.baumannii was 87.7%. blaNDM was the most common gene detected. No significant difference was found in the ability of phenotypic and genotypic methods for MBL detection. The resistance rate of the A.baumannii is high for most antibiotics except for polymyxins (E&B) and tigecycline. Key words: Metallo beta Lactamases, Acinetobacter baumannii, Carbapenem.

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“…A wide range of nosocomial infections encompassing meningitis, septicemia, pneumonia, and skin and wound infections are caused by A. baumannii and are considered as a major challenge in the patient healthcare [23]. Carbapenems such as imipenem, doripenem, meropenem, and ertapenem are considered as the last resort antibiotics in the treatment of severe and complicated infections established by multidrug-resistant A. baumannii [24]. In recent decades, resistance to carbapenems is highly reported [25].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of VIM- and GIM-producing Acinetobacter baumannii from patients with severe urinary tract infection

Girija¹,

Priyadharsini

Arumugam

2018

AMicr

117

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Carbapenems are administered as the final drug of choice for treating complicated nosocomial infections caused by multidrug-resistant Acinetobacter baumannii strains. It is currently a worldwide issue that metallo-β-lactamases (MBLs) as carbapenem-hydrolyzing enzymes are one of the major drug resistance mechanisms. This investigation is thus aimed to assess the prevalence and characterize the MBL-producing strains of A. baumannii both by phenotypic assays and by genotypic characterization. A total of 73 isolates of A. baumannii were phenotypically and genotypically characterized from patients (N = 1,000) with severe urinary tract infection. Tested strains were subjected to double disc synergy testing (DDST) by Kirby-Bauer disc diffusion method with imipenem (IMP) and IMP/EDTA combination discs. Plasmid DNA was molecularly screened for MBL-encoding bla IMP , bla VIM , bla GIM , and bla NDM genes by PCR for the genetic relatedness of the MBL genes with carbapenem resistance. Carbapenem resistance profile showed 100%, 45%, and 49% non-susceptibility against imipenem, doripenem, and meropenem, respectively. Altogether 42.46% (n = 31) of the isolates showed MBL production upon double disc phenotypic test with IMP and IMP/EDTA discs. The bla VIM and bla GIM were detected in 34.24% (n = 25) and 16.43% (n = 12) of the isolates, respectively, while the co-occurrence of bla VIM and bla GIM was 2.73% among the isolates. DDST-positive isolates showed 21.19% and 9.58% strains positive for bla VIM and bla GIM , respectively, whereas 1.36% of the strains for both genes. None of the strains yielded bla IMP and bla NDM genes. The findings of this study showed prevalence of carbapenem resistance among A. baumannii from urine samples and the frequency of bla VIM and bla GIM.

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Phenotypic Detection of Metallo-Beta-Lactamases in Carbapenem ResistantAcinetobacter baumanniiIsolated from Pediatric Patients in Pakistan

Cited by 36 publications

References 20 publications

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

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

Molecular Epidemiology of Metallo Beta Lactamases in Acinetobacter Baumannii at a Tertiary Care Hospital

Prevalence of VIM- and GIM-producing Acinetobacter baumannii from patients with severe urinary tract infection

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