Widespread dissemination of multidrug-resistant Acinetobacter baumannii producing OXA-23 carbapenemase and ArmA 16S ribosomal RNA methylase in a Bulgarian university hospital

Markova, Boyka; Marteva-Proevska, Yulia; Ivanova, Dobrinka; Mitov, Ivan

doi:10.1016/s1413-8670(12)70333-1

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…This was an expected result in view of that other Bulgarian authors published similar data concerning different University hospitals in the country. [18][19][20] Stoeva et al organized the fi rst detailed study in our country on multi-drug resistant A. baumannii proving the wide spread of OXA-23 among them. OXA-58 and OXA-24 are not that signifi cant for Bulgaria as well as the hyperexpression of the intrinsic OXA-51 due to the upstream situated ISAba1.…”

Section: Discussionmentioning

confidence: 99%

“…This correlates with the results from other Bulgarian hospitals. 18,[20][21][22] The RARD similarity profi les and same clone affi liation of ICU isolates suggests the co-existence of two strains. The slight genetic variability observed among clone isolates could be explained by the high selective antibiotic pressure in the ICU setting and the long period during which this clone was present.…”

Section: Discussionmentioning

confidence: 99%

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Carbapenemase Production of Clinical Isolates Acinetobacter baumannii and Pseudomonas aeruginosa from a Bulgarian University Hospital

Petrova¹,

Stanimirova²,

Ivanov³

et al. 2017

Folia Medica

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Background: Production of Bla OXA-23, OXA-24, OXA-58 and hyperexpression of OXA-51 due to ISAba1 insertion sequence are the leading causes of carbapenem resistance in Acinetobacter baumannii. The loss of OprD transmembrane protein and the overexpression of some effl ux pumps are considered to be the main factors for carbapenem resistance in Pseudomonas aeruginosa whereas metallo-enzymes' production has a secondary role. Aim: Тo examine the carbapenem resistance due to carbapenemase production among clinically signifi cant Gram-negative non-fermenters from St George University hospital, Plovdiv: A. baumannii and P. aeruginosa. Materials and methods: Forty three A. baumannii and 43 P. aeruginosa isolates, resistant or with intermediate resistance to imipenem and/or meropenem were included in the study. They were collected from patients admitted in 14 various hospital wards between 2010 and 2014. Both phenotypic and genetic methods were used for identifi cation and antimicrobial susceptibility testing. Results: All A. baumannii demonstrated carbapenemase production determined by a modifi ed Hodge test whereas P. aeruginosa isolates did not show this phenomenon. OXA-23 genes were determined in 97.7% (42 out of 43) of A. baumannii isolates indistinguishable from the sequence of the classical ARI-1 gene. OXA-24, OXA-58 and overexpression of OXA-51 were not registered in any of the isolates. All P. aeruginosa were negative for blaVIM and blaIMP genes. Conclusion:The leading cause of carbapenem resistance in A. baumannii isolates from our hospital is the carbapenemase production due to the expression of OXA-23 gene, whereas in P. aeruginosa -the loss of transmembrane OprD protein and the effl ux pumps' hyperexpression are suspected to be the main mechanisms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carbapenemase Production of Clinical Isolates Acinetobacter baumannii and Pseudomonas aeruginosa from a Bulgarian University Hospital

Petrova¹,

Stanimirova²,

Ivanov³

et al. 2017

Folia Medica

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“…In 2010-2011, Liakopoulos et al (29) reported that OXA-23-like and OXA-58-like carbapenemases were detected in carbapenem-resistant A. baumannii isolates. Strateva et al (30) reported OXA-23-like carbapenemase in multidrug-resistant A. baumannii isolates in a Bulgarian university hospital. Although OXA 58-like and OXA-24/40-like carbapenemases have been reported in neighboring countries and in Turkey, they were not detected in Edirne.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Metallo Beta Lactamases and Oxacilinases in Carbapenem Resistant Acinetobacter baumannii Strains Isolated from Inpatients

Aksoy¹,

Çavuşlu²,

Tuğrul³

2015

Balkan Med J

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Acinetobacter baumannii strains are non-fermenting aerobic Gram-negative bacteria that play an important role in hospital infections. Difficulties in the treatment and control of this growing threat make this pathogen an important health problem (1).Resistance to beta-lactam antibiotics is widespread among Acinetobacter strains. Plasmid-mediated metallo beta-lactamases Background: Resistance to beta-lactam antibiotics is widespread among Acinetobacter strains. Plasmid-mediated metallo beta lactamases (MBL) are responsible for carbapenem resistance, as are oxacillinases (OXA). In recent years, MBL producing carbapenem-resistant strains have been reported in the world and in Turkey in increasing rates. In our country, besides the OXA 51-like enzyme which is inherent in A. baumannii strains, OXA 58-like and OXA 23-like carbapenemases producing strains have also been widely detected. In addition, Verona Imipenemase (VIM) and (IMP)-type MBL have been reported in some centers. Aims: The aim of our study was to investigate the presence of carbapenemases in Acinetobacter strains isolated from hospitalized patients in Edirne. Study Design: Cross-sectional study. Methods: A total of 52 imipenem-resistant A. baumannii strains isolated between January and March 2013 were investigated. The presence of MBL was described phenotypically by the combined disk diffusion test (CDDT), double disk synergy test (DDST), MBL Etest (only performed in 28 strains) and modified Hodge test. bla IMP , bla VIM , bla GIM , bla SIM , bla SPM genes and bla OXA-23 , bla OXA-51 , bla OXA-40 , bla OXA-58 genes were investigated by multiplex polymerase chain reaction (PCR). The blaNDM-1 gene was determined by PCR. Results: By modified Hodge test, 50 strains (96%) were found to be MBL positive. Positivity of MBL was 21% by both CDDT (0.1 M EDTA) and DDST. Twenty-four of 28 strains (85.7%) were positive by MBL E-test. OXA 23-like and OXA 51-like carbapenemases were detected in all strains, but OXA 58-like and OXA 40-like carbapenemases-producing A. baumannii were not detected. Also, MBL genes were not detected by genotypic methods. Conclusion: Only OXA 23-like carbapenemase was responsible for carbapenem resistance in carbapenemresistant Acinetobacter strains in Edirne. The MBLproducing Acinetobacter strain is not yet a problem in our hospital. MBL resistance was found by phenotyping tests, which must be confirmed by genotypic methods; multiplex PCR tests can be easily used for screening MBL.

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“…Such isolates have been identified in China [274], South Korea [275,276], Vietnam [277], Japan [278], North America [279], Norway [280], Italy [281], Bulgaria [282], Iran [283] and Algeria [136]. The armA gene was always found to be located on a functional composite transposon Tn1548 [279].…”

Section: Acinetobacter Baumanniimentioning

confidence: 99%

“…This highlights the fact that this gene was acquired horizontally from a source that still remains unknown [279]. Noteworthy, the ArmA-encoding gene is often identified among OXA-23-producing A. baumannii strains, however both resistance genes are not physically linked on a single plasmid [280][281][282].…”

Section: Acinetobacter Baumanniimentioning

confidence: 99%

Emerging broad-spectrum resistance in Pseudomonas aeruginosa and Acinetobacter baumannii : Mechanisms and epidemiology

Potron

Poirel

Nordmann

2015

International Journal of Antimicrobial Agents

593

460

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Multidrug resistance is quite common among non-fermenting Gram-negative rods, in particular among clinically relevant species including Pseudomonas aeruginosa and Acinetobacter baumannii. These bacterial species, which are mainly nosocomial pathogens, possess a diversity of resistance mechanisms that may lead to multidrug or even pandrug resistance. Extended-spectrum ␤-lactamases (ESBLs) conferring resistance to broad-spectrum cephalosporins, carbapenemases conferring resistance to carbapenems, and 16S rRNA methylases conferring resistance to all clinically relevant aminoglycosides are the most important causes of concern. Concomitant resistance to fluoroquinolones, polymyxins (colistin) and tigecycline may lead to pandrug resistance. The most important mechanisms of resistance in P. aeruginosa and A. baumannii and their most recent dissemination worldwide are detailed here.

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Widespread dissemination of multidrug-resistant Acinetobacter baumannii producing OXA-23 carbapenemase and ArmA 16S ribosomal RNA methylase in a Bulgarian university hospital

Cited by 16 publications

References 7 publications

Carbapenemase Production of Clinical Isolates Acinetobacter baumannii and Pseudomonas aeruginosa from a Bulgarian University Hospital

Carbapenemase Production of Clinical Isolates Acinetobacter baumannii and Pseudomonas aeruginosa from a Bulgarian University Hospital

Investigation of Metallo Beta Lactamases and Oxacilinases in Carbapenem Resistant Acinetobacter baumannii Strains Isolated from Inpatients

Emerging broad-spectrum resistance in Pseudomonas aeruginosa and Acinetobacter baumannii : Mechanisms and epidemiology

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