Molecular Characterization of Acinetobacter baumannii Isolated from Ventilator-Associated Pneumonia and Burn Wound Colonization by Random Amplified Polymorphic DNA Polymerase Chain Reaction and the Relationship between Antibiotic Susceptibility and Biofilm Production

Document Type : Original Article

Authors
Mahla Asadian 1
Leila Azimi 2
Faranak Alinejad 3
Yalda Ostadi 4
Abdolaziz Rastegar Lari 5
1 Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran Universitu of Medical Sciences, Tehran, Iran
2 Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
4 Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran
5 Department of Microbiology, Iran University of Medical Sciences, Tehran, Iran
Abstract
Background: Multidrug-resistant Acinetobacter baumannii can cause complications in antibiotic therapy and increase the rate of morbidity and mortality in hospitalized patients. Patients with ventilator and burns are two specific groups at high risk for A. baumannii infections. This study aimed to determine antibiotic susceptibility patterns associated with biofilm production in A. baumannii and to assess its molecular epidemiology by random amplified polymorphic DNA polymerase chain reaction (RAPD PCR) in A. baumannii isolated from ventilator-associated pneumonia and burn wound colonization. Materials and Methods: In this study, 79 isolates of A. baumannii (32 ventilator-associated pneumonia [VAP] 47 burns) were collected in two teaching hospitals in Tehran, Iran, in 2018. Conventional biochemical and microbiological methods were used to identify bacteria. Antibiotic susceptibility was detected by disc diffusion methods according to the Clinical and Laboratory Standards Institute 2018. Tube test was examined for the detection of the biofilm formation rate in collected strains. The most prevalent carbapenemase genes were detected by PCR and molecular typing by RAPD PCR. Results: All of bacteria were extensively drug-resistant (XDR) except for two isolates. The results of tube test indicated that only 36% of XDR strains were in weak rate of biofilm formation group. Two major clonal genetic groups were found in VAP and burn strains. Oxa-23 was the most prevalent carbapenemase in collected A. baumannii. Conclusion: The presence of XDR strains of A. baumannii is considerable significant problem in hospitals. Further, similar genetic clonal identified in them indicated the nosocomial infection origin. Hence, these results are very important for control of nosocomial infection committee in health-care systems.

Keywords

1.
Azimi L, Talebi M, Pourshafie MR, Owlia P, Rastegar Lari A. Characterization of carbapenemases in extensively drug resistance Acinetobacter baumannii in a burn care center in Iran. Int J Mol Cell Med 2015;4:46-53.  Back to cited text no. 1
    
2.
Owlia P, Azimi L, Gholami A, Asghari B, Lari AR. ESBL- and MBL-mediated resistance in Acinetobacter baumannii: A global threat to burn patients. Infez Med 2012;20:182-7.  Back to cited text no. 2
    
3.
Azimi L, Motevallian A, Ebrahimzadeh Namvar A, Asghari B, Lari AR. Nosocomial infections in burned patients in Motahari hospital, Tehran, Iran. Dermatol Res Pract 2011;2011:436952.  Back to cited text no. 3
    
4.
Garnacho-Montero J, Ortiz-Leyba C, Fernández-Hinojosa E, Aldabó-Pallás T, Cayuela A, Marquez-Vácaro JA, et al. Acinetobacter baumannii ventilator-associated pneumonia: Epidemiological and clinical findings. Intensive Care Med 2005;31:649-55.  Back to cited text no. 4
    
5.
Tsakiridou E, Makris D, Daniil Z, Manoulakas E, Chatzipantazi V, Vlachos O, et al. Acinetobacter baumannii infection in prior ICU bed occupants is an independent risk factor for subsequent cases of ventilator-associated pneumonia. Biomed Res Int 2014;2014:193516.  Back to cited text no. 5
    
6.
Bose S, Khodke M, Basak S, Mallick SK. Detection of biofilm producing staphylococci: Need of the hour. J Clin Diagn Res 2009;3:1915-20.  Back to cited text no. 6
    
7.
Babapour E, Haddadi A, Mirnejad R, Angaji SA, Amirmozafari N. Biofilm formation in clinical isolates of nosocomial Acinetobacter baumannii and its relationship with multidrug resistance. Asian Pac J Trop Biomed 2016;6:528-33.  Back to cited text no. 7
    
8.
Liu S, Wang Y, Xu J, Li Y, Guo J, Ke Y, et al. Genome sequence of an OXA23-producing, carbapenem-resistant Acinetobacter baumannii strain of sequence type ST75. J Bacteriol 2012;194:6000-1.  Back to cited text no. 8
    
9.
Mohammadi F, Goudarzi H, Hashemi A, Yousefi Nojookambari N, Khoshnood S, Sabzehali F. Detection of iSabai in Acinetobacter baumannii strains carrying oxa genes isolated from Iranian burn patients. Arch Pediatr Infect Dis 2017;5:e39307.  Back to cited text no. 9
    
10.
Royer S, Faria AL, Seki LM, Chagas TP, Campos PA, Batistão DW, et al. Spread of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa clones in patients with ventilator-associated pneumonia in an adult intensive care unit at a university hospital. Braz J Infect Dis 2015;19:350-7.  Back to cited text no. 10
    
11.
Krzyściak P, Chmielarczyk A, Pobiega M, Romaniszyn D, Wójkowska-Mach J. Acinetobacter baumannii isolated from hospital-acquired infection: Biofilm production and drug susceptibility. APMIS 2017;125:1017-26.  Back to cited text no. 11
    
12.
Clinical Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Nineteenth Informational Supplement M100–S21. Wayne, PA: Clinical Laboratory Standards Institute; 2017.  Back to cited text no. 12
    
13.
Hassan A, Usman J, Kaleem F, Omair M, Khalid A, Iqbal M, Evaluation of different detection methods of biofilm formation in the clinical isolates. Braz J Infect Dis 2011;15:305-11.  Back to cited text no. 13
    
14.
Higgins PG, Lehmann M, Wisplinghoff H, Seifert H. GyrB multiplex PCR to differentiate between Acinetobacter calcoaceticus and Acinetobacter genomic species 3. J Clin Microbiol 2010;48:4592-4.  Back to cited text no. 14
    
15.
Nowak P, Paluchowska P, Budak A. Distribution of blaOXA genes among carbapenem-resistant Acinetobacter baumannii nosocomial strains in Poland. New Microbiol 2012;35:317-25.  Back to cited text no. 15
    
16.
Carr E, Eason H, Feng S, Hoogenraad A, Croome R, Soddell J, et al. RAPD-PCR typing of Acinetobacter isolates from activated sludge systems designed to remove phosphorus microbiologically. J Appl Microbiol 2001;90:309-19.  Back to cited text no. 16
    
Advanced Biomedical Research
Volume 2019, september
September 2019
Pages 1-5