Occurrence and molecular characterization of metallo-Î²-lactamases (MBLs) among Acinetobacter baumannii isolates from cancer patients
Acinetobacter baumannii cancer patients
Keywords:Acinetobacter baumannii, ESBLs, MBLs, Class 1 Integron, Jordanian cancer patients
Background: During the last decade, the prevalence of carbapenem-resistant infection associated with multidrug resistant (MDR) Acinetobacter baumanniiin patients has been continuously increasing. This prospective study aimed to determine the occurrence and molecular characterization of metallo-Î²-lactamases (MBLs) and carbapenem hydrolyzing oxacillinases among A. baumannii isolates from cancer patients over a period of 6-month.
Methods:Antimicrobial susceptibility profile of 70 randomly collected A. baumannii isolates was first determined using disc diffusion test, and second, the MICs of 45 representative multidrug resistant (MDR) isolates were tested to useful drugs in treatment of their infections using E-test. PCR assays were used to detect the common four types of class D carbapenem hydrolyzing oxacillinases, two types of class A carbapenemases, four types of class B metallo-Î² â€“lactamases, and prevalence of Class 1 Integron among MDR isolates.
Results: All 70 isolates were MDR, including 100% resistance to meropenom, aztreonem, piperacillin/tazobactum and 99% to carbapenem. All isolates carried blaOXA-23 and blaOXA-51, but none carried a blaOXA-24 like or blaOXA-58. The isolates also were positive for NDM-1, NDM, VIM, GES, KPC and SPM at the rates of 29%, 20%, 29%,19%,7% and 2%, respectively. Class 1 Integron was positive in 82% of A. baumanniiisolates.
The clonal relationship of 42 MDR A. baumanniiisolates using ERIC-PCR and constructed dendrogram showed 3 major genotype clusters of genetically related isolates. These include 4 genotype groups, each composed of 2 isolates with 100 % similarity of DNA bands.
Conclusion:This study demonstrates that A. baumannii colonize frequently cancer patients in association with antibiotic treatment. The organism is mostly carrying wide spectrum of antibiotic resistance genetic factors, especially many types of ESBLs and MBLs and Class 1 Integron. This fact should be considered when therapy is selected for treatment of patients infected with MDR A. baumannii.
Key words. Acinetobacter baumannii, ESBLs, MBLs, Class 1 Integron, Jordanian cancer patients.
Wong D, Nielsen TB, Bonomo RA, Pantapalangkoor P, Luna B, et al. Clinical and pathophysiological overview of Acinetobacter infections: a century of challenges. Clin Microbiol Rev 2017;30:409â€“447.
Nazer L, Karabsheh A,Rimawi D, Hawari F. Characteristics and Outcomes of Acinetobacter baumannii Infections in Critically Ill Patients with Cancer: A Matched Caseâ€“Control Study. Microb Drug Resist2015;21(5):556-561
Obeidat N, Jawdat F , Al-Bakr GA , Shehabi AA. Major biological characteristics of Acinetobacter baumannii isolates form hospital environmental and patientsâ€™ respiratory tract sources.American J Infect Control 2014; 42 : 401-404.
Antunes L, Visca P, Towner KJ. Acinetobacter baumannii: evolution of a globalpathogen. Pathog Dis 2014;71: 292â€“301.
Cerqueira GM, Peleg AY. Insights into Acinetobacter baumannii pathogenicity. IUBMB Life2011;63: 1055â€“1060.
Noori M, Karimi A, Fallah F, Hashemi A, Alimehr S,et al. High Prevalence of Metallo-beta-lactamase Producing Acinetobacter baumannii Isolated From Two Hospitals of Tehran, Iran, Arch Pediatr Infect Dis. 2014 ;2(3).
Garcâ€™ia-Garmendia J-L, Ortiz-Leyba C, Garnacho-Montero J, JimÃ©nez-JimÃ©nez F-J, PÃ©rez-Paredes C, et al. Risk factors for Acinetobacter baumannii nosocomial bacteremia in critically ill patients: a cohort study. Clin Infect Dis 2001;33: 939â€“946.
Montefour K, Frieden J, Hurst S, Helmich C, Headley D, et al. Acinetobacter baumannii: an emerging multidrug-resistant pathogen in critical care.Crit Care Nurse 2008; 28: 15â€“25.
Routsi C, Pratikaki M, Platsouka E, Sotiropoulou C, Nanas S, et al. Carbapenem-resistant versus carbapenem-susceptible Acinetobacter baumannii bacteremia in a Greek intensive care unit: risk factors, clinical features and outcomes. Infection 2010;38: 173â€“180.
Luna CM, Aruj PK. Nosocomial Acinetobacter pneumonia. Respirology 2007;12: 787â€“791.
Lei Gao, Yuan Lyu, Yun Li. Trends in Drug Resistance of Acinetobacter baumannii over a 10-year Period: Nationwide Data from the China Surveillance of Antimicrobial Resistance Program.Chin Med J (Engl). 2017;20;130(6): 659â€“664.
Hurley JC. World-wide variation in incidence of Acinetobacter associated ventilatorassociated pneumonia: a meta-regression. BMC Infect Dis 2016; 16: 577
Chang K-C, Lin M-F, Lin N-T, Wu W-J, Kuoet H-Y, al. Clonal spread of multidrug-resistant Acinetobacter baumannii in eastern Taiwan. J MicrobiolImmunol Infect 2012;45: 37â€“42.
Lee C-R, Lee JH, Park M, Park KS, Bae IK, et al. Biology of Acinetobacter baumannii: Pathogenesis, antibiotic resistance mechanisms,and prospective treatment options. Front. Cell Infect Microbiol 2017; 7:1-8.
Clinical Laboratory and Standards Institute (CLSI). Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard â€“ tenth edition. CLSI document M07-A10 Villanova, PA, USA: CLSI, 2016.
Woodford N, Ellington MJ, Coelho JM, Turton JF, Ward ME, et al..Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp.Int J Antimicrob Agents 2006;27(4):351-3.
Poirel L, Walsh TR, Cuvillier V, Nordmann P. Multiplex PCR for detection
of acquired carbapenemase genes. Diagn Microbiol Infect Dis 2011;70(1):119â€“23.
Cicek AC, Saral A, Iraz M, Ceylan A, Duzgun AO, et al. OXA- and GES-type beta-lactamases predominate in extensively drugresistant Acinetobacter baumannii isolates from a Turkish UniversityHospital. Eur J Clin Microbiol Infect Dis 2014; 20(5):410â€“5.
Naas T, Ergani A, Carrer A, Nordmann P. Real-time PCR for detection of
NDM-1 carbapenemase genes from spiked stool samples. AntimicrobAgents Chemother 2011;55(9):4038â€“43.
Hindiyeh M, Smollen G, Grossman Z, Ram D, Davidson Y, et al. Rapid
detection of blaKPCcarbapenemase genes by real-time PCR. J ClinMicrobiol
Ploy MC, Denis F, Courvalin P, Lamber T. Molecular Characterization of Integrons in Acinetobacter baumannii: Description of a Hybrid Class 2 Integron. Antimicrob Agents Chemother 2000; 44(10): 2684â€“2688.
Jeong SH , IL KB , Seung GS , Kwang OP, Young J AN, et al. First Detection of blaIMP-1 in Clinical Isolate Multiresistant Acinetobacter baumannii from Korea. J. Microbiol. Biotechnol 2006; 16(9):1377â€“1383.
Helal S, El Anany M, Ghaith D, RabeeaS . The Role of MDR-Acinetobacter baumannii in Orthopedic Surgical Site Infections. Surg Infect (Larchmt)2015;16: 518â€“522.
Al-Hassan L, El Mehallawy H, Amyes SGB. Diversity in Acinetobacter baumannii isolates from paediatric cancer patients in Egypt. ClinMicrobiol Infect2013;19: 1082â€“1088.
Ghaith DM, Zafer MM, Al-Agamy MH, Alyamani EJ, Booq RY, et al. The emergence of a novel sequence type of MDR Acinetobacter baumannii from the intensive care unit of an Egyptian tertiary care hospital. Ann Clin Microbiol Antimicrob 2017;16: 34.
Gecgel KS, Demircan N. Antibiotic resistance rates among bacterial isolatesfrom infected patients of intensive care unit over the period (2011-2016) in Bursa, Turkey. IAJAA 2017; Vol. 7 No. 2:4.
Anudit C, Kooltheat N, Potup P, Sranujit RP, Usuwanthim K. Nosocomial infection of multidrug-resistant Acinetobacter baumannii in Thailand. Am J Infect Control 2016;44:1161â€“1163.
Al-Dabaibah N, Obeidat NM, Shehabi AA. Epidemiology features of Acinetobacter baumannii colonizing respiratory tracts of ICU patients.IAJAA 2012; 2:1, 1-7.
Peleg AY, de Breij A, Adams MD, Cerqueira GM, Mocali S, et al.The success of Acinetobacter species; genetic, metabolic and virulence attributes. PLoS One 2012;7: e46984.
Spellberg B, Bonomo RA. Combination Therapy for Extreme Drug Resistant (XDR)Acinetobacterbaumannii: Ready for Prime-Time? Crit Care Med 2015; 43: 1332.
Doi Y, Murray GL, Peleg AY . Acinetobacter baumannii: evolution of antimicrobial resistance-treatment options. SeminRespirCrit. Care Med 2015;85â€“98.
Dahdouh E, Hajjar M, Suarez M, Daoud Z . Acinetobacter baumannii Isolated from Lebanese Patients: Phenotypes and Genotypes of Resistance, Clonality, and Determinants of Pathogenicity. Front. Cell. Infect. Microbiol. 2015;6:
Alyamani EJ, Khiyami MA, Booq RY, Alnafjan BM, Altammami MA, et al.. Molecular characterization of extended-spectrum beta-lactamases (ESBLs)produced by clinical isolates of Acinetobacter baumannii in Saudi Arabia. Ann Clin Microbiol Antimicrob 2015;14: 38.
Cicek AC, Saral A, Iraz M, Ceylan A, Duzgun AO, et al. . OXA and GES-type Î²-lactamases predominate in extensively drug-resistant Acinetobacter baumannii isolates from a Turkish University Hospital. Clin Microbiol Infect 2014;20: 410â€“415.
Mathlouthi N, Al-Bayssari C, Bakour S, Rolain JM, Chouchani C. Prevalence and emergence of carbapenemases-producing Gram-negative bacteria in Mediterranean basin.Crit Rev Microbiol. 2017 Feb;43(1):43-61.
Touati M, Diene SM, Racherache A, Dekhil M, Djahoudi A, et al. Emergence of blaOXA-23 and blaOXA-58 carbapenemase-encoding genes in multidrug-resistant Acinetobacter baumannii isolates from University Hospital of Annaba, Algeria.Int J Antimicrob Agents 2012;40: 89â€“91.
Zarrilli R, Pournaras S, Giannouli M, Tsakris A . Global evolution of multidrug resistant Acinetobacter baumannii clonal lineages. Int J Antimicrob Agents 2013;41: 11â€“19.
Mostachio AK, Levin AS, Rizek C, Rossi F, Zerbini J, et al. . High prevalence of OXA-143 and alteration of outer membrane proteins in carbapenem-resistant Acinetobacter spp. isolates in Brazil. Int J Antimicrob Agents 2012;39: 396â€“401.
Qureshi AZ,Hittle EL, Oâ€™Hara AJ , Rivera IJ, Syed A, et al.Colistin-Resistant Acinetobacter baumannii:Beyond Carbapenem Resistance. Clin Infect Dis 2015;60(9):1295â€“303.
Shehabi AA, Odeh JF, Fayyad M . Characterization of antimicrobial resistance andclass 1 integrons found in Escherichia coli isolates from human stools and drinking water sources in Jordan. J Chemother 2006;18: 468â€“472.
Sung JY, Koo SH, Kim S, Kwon KC . Epidemiological characterizations of class 1 integrons from multidrug-resistant Acinetobacter isolates in Daejeon, Korea. Ann Lab Med 2014;34: 293â€“299.
Lin M-F, Lan C-Y. Antimicrobial resistance in Acinetobacter baumannii: From bench to bedside. World J Clin Cases 2014; 2: 787.
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