Prevalence and Characterization of Carbapenem-Hydrolyzing Class D β-Lactamase-Producing Acinetobacter Isolates From Ghana

Ayibieke, Alafate; Kobayashi, Akito; Suzuki, Masato; Sato, Wakana; Mahazu, Samiratu; Prah, Isaac; Mizoguchi, Miyuki; Moriya, Kyoji; Hayashi, T.; Suzuki, Toshihiko; Iwanaga, Shiro; Ablordey, Anthony; Saito, Ryoichi

doi:10.3389/fmicb.2020.587398

Cited by 16 publications

(18 citation statements)

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“…In Ghana specifically, several studies exist on phenotypic and molecular characterization of these priority pathogens mainly with a focus on clinical isolates. Intermediate to high rates of resistance to cephalosporins and carbapenems similar to estimates in the continent and globally were reported in these studies despite limitations of small sample sizes in some cases [ 25 – 33 ]. With regards to surveillance of AMR from hospital environments, research studies exist [ 34 – 37 ] but are inadequate especially for Gram-negative pathogens considering the important role hospital environments can play in transmission.…”

Section: Introductionmentioning

confidence: 55%

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

Acolatse

Portal

Boostrom

et al. 2022

Antimicrob Resist Infect Control

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Background The burden of antibiotic resistant infection is mainly felt in low-to-middle income countries, where the rate of antimicrobial resistance is largely under-surveyed and under huge pressure from unregulated, disparate and often self-guided access to antimicrobials. Nosocomial infections from hospital environments have been shown to be a particularly prevalent source of multi-drug resistant strains, yet surveillance of hospital environmental contamination is often not investigated. Methods The study was prospective, observational and cross-sectional, sampling 231 high and low touch surfaces from 15th March to 13th April 2021, from five wards in the Cape Coast Teaching Hospital, Ghana. Microbial growth in the presence of vancomycin and either meropenem or cefotaxime was examined and bacterial species were identified by MALDI-TOF. The presence of common extended-spectrum β-lactamases (ESBL) and carbapenemase antimicrobial resistance genes (ARG) were identified through PCR screening, which were confirmed by phenotypic antimicrobial susceptibility determination. Isolates positive for carbapenem resistance genes were sequenced using a multi-platform approach. Results We recovered microbial growth from 99% of swabs (n = 229/231) plated on agar in the absence of antimicrobials. Multiple sites were found to be colonised with resistant bacteria throughout the hospital setting. Bacteria with multi-drug resistance and ARG of concern were isolated from high and low touch points with evidence of strain dissemination throughout the environment. A total of 21 differing species of bacteria carrying ARG were isolated. The high prevalence of Acinetobacter baumannii carrying blaNDM-1 observed was further characterised by whole genome sequencing and phylogenetic analysis to determine the relationship between resistant strains found in different wards. Conclusion Evidence of multiple clonal incursions of MDR bacteria of high sepsis risk were found in two separate wards for a regional hospital in Ghana. The prevalence of multiple blaNDM carrying species in combination with combinations of ESBLs was particularly concerning and unexpected in Africa. We also identify strains carrying tet(X3), blaVIM-5 or blaDIM-1 showing a high diversity of carbapenamases present as a reservoir in a hospital setting. Findings of multi-drug resistant bacteria from multiple environmental sites throughout the hospital will inform future IPC practices and aid research prioritisation for AMR in Ghana.

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Section: Introductionmentioning

confidence: 55%

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

Acolatse

Portal

Boostrom

et al. 2022

Antimicrob Resist Infect Control

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“…blaOXA-58 had not previously been reported in Nigeria, and blaOXA-23 has been reported in only two Nigerian studies (15,16). The blaOXA-420 variant of the blaOXA-58 family detected in one isolate has been reported in A. baumannii in only a handful of studies, including two conducted in neighboring Ghana (47)(48)(49). blaNDM-1, which is a less commonly described but highly potent carbapenem resistance gene in A. baumannii, was present in over a third of the isolates, four of which also co-carried blaOXA-23 (50).…”

Section: Discussionmentioning

confidence: 98%

Rectal Colonization and Nosocomial Transmission of Carbapenem-Resistant Acinetobacter baumannii in an Intensive Care Unit, Southwest Nigeria

et al. 2022

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BackgroundAcinetobacter baumannii are of major human health importance because they cause life-threatening nosocomial infections and often are highly resistant to antimicrobials. Specific multidrug-resistant A. baumannii lineages are implicated in hospital outbreaks globally. We retrospectively investigated a suspected outbreak of carbapenem-resistant A. baumannii (CRAB) colonizing patients in an intensive care unit (ICU) of a tertiary hospital in Southwest Nigeria where genomic surveillance of Acinetobacter has hitherto not been conducted.MethodsA prospective observational study was conducted among all patients admitted to the ICU between August 2017 and June 2018. Acinetobacter species were isolated from rectal swabs and verified phenotypically with the Biomerieux Vitek 2 system. Whole genome sequencing (WGS) was performed on the Illumina platform to characterize isolates from a suspected outbreak during the study period. Phylogenetic analysis, multilocus sequence typing, and antimicrobial resistance gene prediction were carried out in silico.ResultsAcinetobacter isolates belonging to the A. baumannii complex were recovered from 20 (18.5%) ICU patients. Single nucleotide polymorphism (SNP) analysis and epidemiological information revealed a putative outbreak clone comprising seven CRAB strains belonging to the globally disseminated international clone (IC) 2. These isolates had ≤2 SNP differences, identical antimicrobial resistance and virulence genes, and were all ST1114/1841.ConclusionWe report a carbapenem-resistant IC2 A. baumannii clone causing an outbreak in an ICU in Nigeria. The study findings underscore the need to strengthen the capacity to detect A. baumannii in human clinical samples in Nigeria and assess which interventions can effectively mitigate CRAB transmission in Nigerian hospital settings.

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“…Carbapenem resistance in Acinetobacter spp. is mainly caused by the production of carbapenem-hydrolyzing class D blactamases (CHDLs) including OXA-23-like, OXA-58-like, and OXA-24-like enzymes (Ayibieke et al, 2020). Acinetobacter pittii, formerly termed genomospecies 3 of the A. calcoaceticus-A.…”

Section: Introductionmentioning

confidence: 99%

“…Carbapenem resistance in Acinetobacter spp. is mainly caused by the production of carbapenem-hydrolyzing class D β-lactamases (CHDLs) including OXA-23-like, OXA-58-like, and OXA-24-like enzymes ( Ayibieke et al., 2020 ). Acinetobacter pittii , formerly termed genomospecies 3 of the A. calcoaceticus - A. baumannii complex, is a close relative of A. baumanii which is increasingly recognized as a significant cause of hospital-acquired infections ( Chusri et al., 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Emergence of ST63 Pandrug-Resistant Acinetobacter pittii Isolated From an AECOPD Patient in China

Yang

Dong

Chen

et al. 2021

Front. Cell. Infect. Microbiol.

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Acinetobacter sp. is among the ESKAPE organisms which represent the major nosocomial pathogens that exhibited a high resistance rate. A. pittii, frequently associated with antimicrobial resistance particularly to carbapenems, is one of the most common Acinetobacter species causing invasive infection. Pandrug resistant A. pittii has rarely been reported. Here, we report the case of a patient with acute exacerbations of chronic obstructive pulmonary disease three years after double lung transplantation and developed severe pneumonia associated with pandrug resistant A. pittii infection. Phenotypic and genomic characteristics of this pandrug resistant isolate (17-84) was identified, and the mechanisms underlying its resistance phenotypes were analyzed. Isolate 17-84 belonged to ST63, carried a non-typable and non-transferable plasmid encoding multiple acquired resistance genes including carbapenemase gene blaOXA-58. Point mutations and acquired resistance genes were identified which were associated with different drug resistance phenotypes. To our knowledge, this is the first detailed phenotypic and genomic characterization of PDR A. pittii causing severe infections in clinical settings. Findings from us and others indicate that A. pittii could serve as a reservoir for carbapenem determinants. The emergence of such a superbug could pose a serious threat to public health. Further surveillance of PDR A. pittii strains and implementation of stricter control measures are needed to prevent this emerging pathogen from further disseminating in hospital settings and the community.

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Prevalence and Characterization of Carbapenem-Hydrolyzing Class D β-Lactamase-Producing Acinetobacter Isolates From Ghana

Cited by 16 publications

References 57 publications

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

Environmental surveillance of ESBL and carbapenemase-producing gram-negative bacteria in a Ghanaian Tertiary Hospital

Rectal Colonization and Nosocomial Transmission of Carbapenem-Resistant Acinetobacter baumannii in an Intensive Care Unit, Southwest Nigeria

Emergence of ST63 Pandrug-Resistant Acinetobacter pittii Isolated From an AECOPD Patient in China

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