Advanced Biomedical Research

Molecular identification of Acinetobacter baumannii isolated from intensive care units and their antimicrobial resistance patterns

Authors

Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Acinetobacter baumannii is one of the most important pathogens in hospital-acquired infections especially in intensive care units (ICUs). This opportunistic pathogen can be easily isolated from water, soil, and hospital facilities. A. baumannii as a nosocomial opportunistic pathogen is resistant to a wide range of antibiotics and responsible for multiple infections, including bacteremia, pneumonia, meningitis, urinary tract infections, and surgical wounds. The aim of this study was to determine frequency and resistance patterns of A. baumannii isolated in ICUs of Isfahan Hospitals.
Materials and Methods: During 1 year period (2012-2013), 350 specimens were collected from ICUs of Isfahan hospitals. The isolates were characterized as A. baumannii by conventional phenotypic, biochemical tests and confirmed by PCR for OXA-51-like gene. Susceptibility of isolates was determined by standard disk diffusion method according to CLSI.
Results : From total of 350 specimens, 43 isolates were A. baumannii. The antimicrobial patterns of isolates showed that 53.5% of isolates were resistant to amikacin, 83.7% to tetracyclin, 86% to ceftazidime, 90.7% to Trimethoprim sulfametoxazol, 93% to imipenem, cefepime, meropenem, ampicillin-sulbactam. All isolates were resistant to ciprofloxacin.
Conclusion: This study showed a high resistance of A. baumannii to a wide range of antimicrobial agent. It is necessary to adopt appropriate strategies to control the spread of the bacteria in care unit centers and wards.

Keywords

1.
Perez F, Hujer AM, Hujer KM, Decker BK, Rather PN, Bonomo RA. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2007;51:3471-84.  Back to cited text no. 1
    
2.
Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: Emergence of a successful pathogen. Clin Microbiol Rev 2008;21:538-82.  Back to cited text no. 2
    
3.
Fagon JY, Chastere J, Domart Y, Trouillet JL, Gibert C. Mortality due to ventilator-associated pneumonia or colonization with Pseudomonas or Acinetobacter species: Assessment by quantitative culture of samples obtained by a protected specimen brush. Clin Infect Dis 1996;23:538-42.  Back to cited text no. 3
    
4.
Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH. Manual of Clinical Microbiology. 7 th ed. Washington, DC: ASM Press; 1999. p. 517- 25.  Back to cited text no. 4
    
5.
Jawad A, Seifert H, Snelling AM, Heritage J, Hawkey PM. Survival of Acinetobacter baumannii on dry surfaces: Comparison of outbreak and sporadic isolates. J Clin Microbiol 1998;36:1938-41.  Back to cited text no. 5
    
6.
Diomedi A. Acinetobacter baumannii pandrug-resistant: Update in epidemiological and antimicrobial managing issues. Rev Chilena Infectol 2005;2:298-320.  Back to cited text no. 6
    
7.
Dijkshoorn L, Van Vianen W, Degener JE, Michel MF. Typing of Acinetobacter calcoaceticus strains isolated from hospital patients by cell envelope protein profiles. Epidemiol Infect 1987;99:659-67.  Back to cited text no. 7
    
8.
Joly-Guillou ML. Clinical impact and pathogenicity of Acinetobacter. Clin Microbiol Infect 2005;11:868-73.  Back to cited text no. 8
    
9.
Diancourt L, Passet V, Nemec A, Dijkshoorn L, Brisse S. The population structure of Acinetobacter baumannii: Expanding multiresistant clones from an ancestral susceptible genetic pool. PLoS One 2010;5:e10034.  Back to cited text no. 9
    
10.
Shahcheraghi F, Abbasalipour M, Feizabadi M, Ebrahimipour G, Akbari N. Isolation and genetic characterization of metallo-β-lactamase and carbapenamase producing strains of Acinetobacter baumannii from patients at Tehran hospitals. Iran J Microbiol 2011;3:68-74.  Back to cited text no. 10
    
11.
Barbolla RE, Centrón D, Maimone S, Rospide F, Salgueila C Altclas J, et al. Molecular epidemiology of Acinetobacter baumannii spread in an adult intensive care unit under an endemic setting. Am J Infect Control 2008;36:444-52.  Back to cited text no. 11
    
12.
Mihu MR, Martinez LR. Novel therapies for treatment of multi-drug resistant Acinetobacter baumannii skin infections. Virulence 2011;2:97-102.  Back to cited text no. 12
    
13.
Lee K, Lee WG, Uh Y, Ha GY, Cho J, Chong Y; Korean Nationwide Surveillance of Antimicrobial Resistance Group. VIM- and IMP-type metallo-beta-lactamase-producing Pseudomonas spp. and Acinetobacter spp. in Korean hospitals. Emerg Infect Dis 2003;9:868-71.  Back to cited text no. 13
    
14.
Lee K, Yum JH, Yong D, Lee HM, Kim HD, Docquier JD, et al. Novel acquired metallo-beta-lactamase gene, bla (SIM-1), in a class 1 integron from Acinetobacter baumannii clinical isolates from Korea. Antimicrob Agents Chemother 2005;49:4485-91.  Back to cited text no. 14
    
15.
Bou G, Cerveró G, Domínguez MA, Quereda C, Martínez-Beltrán J. Characterization of a nosocomial outbreak caused by a multiresistant Acinetobacter baumannii strain with a carbapenem-hydrolyzing enzyme: High-level carbapenem resistance in A. baumannii is not due solely to the presence of beta-lactamases. J Clin Microbiol 2000;38:3299-305.  Back to cited text no. 15
    
16.
Luna CM, Aruj PK. Nosocomial Acinetobacter pneumonia. Respirology 2007;12:787-91.  Back to cited text no. 16
    
17.
Bassetti M, Righi E, Esposito S, Petrosillo N, Nicolini L. Drug treatment for multidrug-resistant Acinetobacter baumannii infections. Future Microbiol 2008;3:649-60.  Back to cited text no. 17
    
18.
Seward RJ. Detection of integrons in worldwide nosocomial isolates of Acinetobacter spp. Clin Microbiol Infect 1999;5:308-18.  Back to cited text no. 18
    
19.
Yum JH, Yi K, Lee H, Yong D, Lee K, Kim JM, et al. Molecular characterization of metallo-beta-lactamase-producing Acinetobacte rbaumannii andAcinetobacter genomospecies 3 from Korea: Identification of two new integrons carrying the bla (VIM-2) gene cassettes. J Antimicrob Chemother 2002;49:837-40.  Back to cited text no. 19
    
20.
Peleg AY, Franklin C, Bell JM, Spelman DW. Dissemination of the metallo-beta-lactamase gene blaIMP-4 among gram-negative pathogens in a clinical setting in Australia. Clin Infect Dis 2005;41:1549-56.  Back to cited text no. 20
    
21.
Zarrilli R, Crispino M, Bagattini M, Barretta E, Popolo AD, Triassi M, et al. Molecular epidemiology of sequential outbreaks of Acinetobacter baumannii in an intensive care unit shows the emergence of carbapenem resistance. J Clin Microbiol 2004;42:946-53.  Back to cited text no. 21
    
22.
Brown S, Young HK, Amyes SG. Characterisation of OXA-51, a novel class D carbapenemase found in genetically unrelated clinical strains of Acinetobacter baumannii from Argentina. Clin Microbiol Infect 2005;11:15-23.  Back to cited text no. 22
    
23.
Woodford N, Ellington MJ, Coelho JM, Turton JF, Ward ME, Brown S, et al. Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int J Antimicrob Agents 2006;27:351-3.  Back to cited text no. 23
    
24.
Taherikalani M, Fatolahzadeh B, Emaneini M, Soroush S, Feizabadi MM. Distribution of different carbapenem resistant clones of Acinetobacter baumannii in Tehran Hospitals. New Microbiol 2009;32:265-71.  Back to cited text no. 24
    
25.
Clinical Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 20 th Informational Supplement: M100-S20. Wayne, PA, USA: Clinical Laboratory Standards Institute; 2012.  Back to cited text no. 25
    
26.
Ayan M, Durmaz R, Aktas E, Durmaz B. Bacteriological, clinical and epidemiological characteristics of hospital-acquired Acinetobacter baumannii infection in a teaching hospital. J Hosp Infect 2003;54:39-45.  Back to cited text no. 26
    
27.
Farivar AS, Nowroozi J, Emami M. The prevalence of Acinetobacter in sergical ICU in Rasoul Akram hospital in 2004-2005. Journal of Rafsanjan university of medical Sciences 2005;4:342-7.  Back to cited text no. 27
    
28.
Rit K, Saha R. Niger Med J. Multidrug-resistant Acinetobacter infection and their susceptibility patterns in a tertiary care hospital. Niger Med J 2012;53:126-8.  Back to cited text no. 28
[PUBMED]  Medknow Journal  
29.
Sadeghifard N, Ranjbar R, Zaeimi J. Antimicrobial susceptibility, plasmid profiles, and RAPD-PCR typing of Acinetobacter bacteria. Asian Biomed (Res Rev News) 2010;4:901-11.  Back to cited text no. 29
    
30.
Wang SH, Sheng WH, Chang YY, Wang LH, Lin HC, Chen ML, et al. Healthcare-associated outbreak due to pan-drug resistant Acinetobacter baumanii in a surgical intensive care unit. J Hosp Infect 2003;53:97-102.  Back to cited text no. 30
    
31.
Gopinath P, Geethapriya S, Jayakeerthana KH, Srivani R. Detection of certain virulence attributes and antimicrobial resistance pattern among clinical isolates of Acinetobacter baumannii.IJPBS2011;2:501-7.  Back to cited text no. 31
    
32.
Koh TH, Sng LH, Wang GC, Hsu LY, Zhao Y. IMP-4 and OXA beta-lactamases in Acinetobacter baumannii from Singapore. J Antimicrob Chemother 2007;59:627-32.  Back to cited text no. 32
    
33.
Hujer KM, Hujer AM, Hulten EA, Bajaksouzian S, Adams JM, Donskey CJ, et al. Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. Antimicrob Agents Chemother 2006;50:4114-23.  Back to cited text no. 33
    
34.
Le Hello S, Falcot V, Lacassin F, Mikulski M, Baumann F. Risk factors for carbapenem-resistant Acinetobacter baumannii infections at a tertiary care hospital in New Caledonia, South Pacific. Scand J Infect Dis 2010;42:821-6.  Back to cited text no. 34
    
35.
Kwon KT, Oh WS, Song JH, Chang HH, Jung SI, Kim SW, et al. Impact of imipenem resistance on mortality in patients with Acinetobacter bacteraemia. J Antimicrob Chemother 2007;59:525-30.  Back to cited text no. 35
    
36.
Tsakris A, Ikonomidis A, Poulou A, Spanakis N, Vrizas D, Diomidous M, et al. Clusters of imipenem-resistant Acinetobacter baumannii clones producing different carbapenemases in an intensive care unit. Clin Microbiol Infect 2008;14:588-94.  Back to cited text no. 36
    
37.
Amudhan SM, Sekar U, Arunagiri K, Sekar B. OXA beta-lactamase-mediated carbapenem resistance in Acinetobacter baumannii. Indian J Med Microbiol 2011;29:269-74.  Back to cited text no. 37
[PUBMED]  Medknow Journal  
38.
Martins AF, Kuchenbecker R, Sukiennik T, Boff R, Reiter KC, Lutz L, et al. Carbapenem-Resistant Acinetobacter baumannii producing the OXA-23 enzyme: Dissemination in southern Brazil. Infection 2009;37:474-6.  Back to cited text no. 38
    
39.
Mammina C, Palma DM, Bonura C, Aleo A, Fasciana T, Sodano C, et al. Epidemiology and clonality of carbapenem-resistant Acinetobacter baumannii from an intensive care unit in Palermo, Italy. BMC Res Notes 2012;5:365.  Back to cited text no. 39
    
40.
Saeed NK, Kambal AM, El-Khizzi NA. Antimicrobial-resistant bacteria in a general intensive care unit in Saudi Arabia. Saudi Med J 2010;31:1341-9.  Back to cited text no. 40
    
41.
Zolldann D, Haefner H, Poetter C, Buzello S, Sohr D, Luetticken R, et al. Assessment of a selective surveillance method for detecting nosocomial infections in patients in the intensive care department. Am J Infect Control 2003;31:261-5.  Back to cited text no. 41
    
42.
Jeong SH, Bae IK, Kwon SB, Lee K, Yong D, Woo GJ, et al. Investigation of a nosocomial outbreak of Acinetobacter baumanii producing PER-1 extended-spectrum beta-lactamase in an intensive care unit. J Hosp Infect 2005;59:242-8.  Back to cited text no. 42
Advanced Biomedical Research
Volume 2015, May
May 2015
Pages 1-5