1887

Abstract

We compared the antibiotic susceptibility, clonal lineages and resistance genes of singleton strains to those of isolates representing repeatedly encountered molecular types in five Abu Dhabi hospitals. One hundred and ten clinically relevant, non-repeat strains were typed by allele sequencing and by PFGE, and selected isolates also by MLST. Resistance was assessed by MIC determinations and by disc diffusion. Genotyping was carried out by PCR, targeting 28 genes. The 80 epidemic strains belonged to worldwide lineages 1, 2 and 7, representing 11 pulsotypes and 9 genotypes, while the 30 sporadic isolates exhibited a high level of genetic variability and, with the exception of a small subgroup, were not associated with any recognized epidemic lineages. All epidemic subtypes carried the ISlinked gene, and harboured the , the and the genes significantly more frequently than their sporadic counterparts. They were all multi-drug resistant, including non-susceptibility to carbepenems, and were often extensively drug resistant, a phenomenon rarely seen among sporadic strains. Epidemic strains represented 78.8 % of intensive care unit isolates, causing more respiratory infections, while sporadic strains were more frequently isolated from wound and soft tissue infections. The study showed that among strains collected at the same time and from the same region, the very heterogeneous, sensitive sporadic strains, with the exception of a few non-susceptible singleton isolates, clearly differed from the highly resistant epidemic ones, which belonged to multiple pulsotypes and genotypes clustered into three worldwide clonal lineages carrying , and , respectively.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.055681-0
2013-04-01
2024-12-14
Loading full text...

Full text loading...

/deliver/fulltext/jmm/62/4/582.html?itemId=/content/journal/jmm/10.1099/jmm.0.055681-0&mimeType=html&fmt=ahah

References

  1. Adams-Haduch J. M., Onuoha E. O., Bogdanovich T., Tian G. B., Marschall J., Urban C. M., Spellberg B. J., Rhee D., Halstead D. C. other authors 2011; Molecular epidemiology of carbapenem-nonsusceptible Acinetobacter baumannii in the United States. J Clin Microbiol 49:3849–3854 [View Article][PubMed]
    [Google Scholar]
  2. Akers K. S., Chaney C., Barsoumian A., Beckius M., Zera W., Yu X., Guymon C., Keen E. F. III, Robinson B. J. other authors 2010; Aminoglycoside resistance and susceptibility testing errors in Acinetobacter baumannii-calcoaceticus complex. J Clin Microbiol 48:1132–1138 [View Article][PubMed]
    [Google Scholar]
  3. Al-Sweih N. A., Al-Hubail M., Rotimi V. O. 2012; Three distinct clones of carbapenem-resistant Acinetobacter baumannii with high diversity of carbapenemases isolated from patients in two hospitals in Kuwait. J Infect Public Health 5:102–108 [View Article][PubMed]
    [Google Scholar]
  4. Bartual S. G., Seifert H., Hippler C., Luzon M. A., Wisplinghoff H., Rodríguez-Valera F. 2005; Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii . J Clin Microbiol 43:4382–4390 [View Article][PubMed]
    [Google Scholar]
  5. Bonnin R. A., Rotimi V. O., Al Hubail M., Gasiorowski E., Al Sweih N., Nordmann P., Poirel L. 2012; Wide dissemination of GES-type carbapenemases in Acinetobacter baumannii in Kuwait. Antimicrob Agents Chemother (Epub ahead of print) [View Article][PubMed]
    [Google Scholar]
  6. Cao V., Lambert T., Nhu D. Q., Loan H. K., Hoang N. K., Arlet G., Courvalin P. 2002; Distribution of extended-spectrum beta-lactamases in clinical isolates of Enterobacteriaceae in Vietnam. Antimicrob Agents Chemother 46:3739–3743 [View Article][PubMed]
    [Google Scholar]
  7. Clark N. C., Olsvik O., Swenson J. M., Spiegel C. A., Tenover F. C. 1999; Detection of a streptomycin/spectinomycin adenylyltransferase gene (aadA) in Enterococcus faecalis . Antimicrob Agents Chemother 43:157–160[PubMed] [CrossRef]
    [Google Scholar]
  8. CLSI 2012; Performance Standards for Antimicrobial Susceptibility Testing; 22nd Informational Supplement, M100-S22. Wayne, PA: Clinical and Laboratory Standards Institute;
  9. Diancourt L., Passet V., Nemec A., Dijkshoorn L., Brisse S. 2010; The population structure of Acinetobacter baumannii: expanding multiresistant clones from an ancestral susceptible genetic pool. PLoS ONE 5:e10034 [View Article][PubMed]
    [Google Scholar]
  10. Dijkshoorn L., Aucken H., Gerner-Smidt P., Janssen P., Kaufmann M. E., Garaizar J., Ursing J., Pitt T. L. 1996; Comparison of outbreak and nonoutbreak Acinetobacter baumannii strains by genotypic and phenotypic methods. J Clin Microbiol 34:1519–1525[PubMed]
    [Google Scholar]
  11. Dijkshoorn L., Nemec A., Seifert H. 2007; An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii . Nat Rev Microbiol 5:939–951 [View Article][PubMed]
    [Google Scholar]
  12. Evans B. A., Hamouda A., Towner K. J., Amyes S. G. 2008; OXA-51-like β-lactamases and their association with particular epidemic lineages of Acinetobacter baumannii . Clin Microbiol Infect 14:268–275 [View Article][PubMed]
    [Google Scholar]
  13. Evans B. A., Hamouda A., Abbasi S. A., Khan F. A., Amyes S. G. 2011; High prevalence of unrelated multidrug-resistant Acinetobacter baumannii isolates in Pakistani military hospitals. Int J Antimicrob Agents 37:580–581 [View Article][PubMed]
    [Google Scholar]
  14. Fritsche T. R., Castanheira M., Miller G. H., Jones R. N., Armstrong E. S. 2008; Detection of methyltransferases conferring high-level resistance to aminoglycosides in Enterobacteriaceae from Europe, North America, and Latin America. Antimicrob Agents Chemother 52:1843–1845 [View Article][PubMed]
    [Google Scholar]
  15. Ghazawi A., Sonnevend A., Bonnin R. A., Poirel L., Nordmann P., Hashmey R., Rizvi T. A., B Hamadeh M., Pál T. 2012; NDM-2 carbapenemase-producing Acinetobacter baumannii in the United Arab Emirates. Clin Microbiol Infect 18:E34–E36 [View Article][PubMed]
    [Google Scholar]
  16. Gordon N. C., Wareham D. W. 2010; Multidrug-resistant Acinetobacter baumannii: mechanisms of virulence and resistance. Int J Antimicrob Agents 35:219–226 [View Article][PubMed]
    [Google Scholar]
  17. Hamouda A., Evans B. A., Towner K. J., Amyes S. G. 2010; Characterization of epidemiologically unrelated Acinetobacter baumannii isolates from four continents by use of multilocus sequence typing, pulsed-field gel electrophoresis, and sequence-based typing of bla OXA-51-like genes. J Clin Microbiol 48:2476–2483 [View Article][PubMed]
    [Google Scholar]
  18. Han H. S., Koh Y. J., Hur J. S., Jung J. S. 2004; Occurrence of the strA-strB streptomycin resistance genes in Pseudomonas species isolated from kiwifruit plants. J Microbiol 42:365–368[PubMed]
    [Google Scholar]
  19. Higgins P. G., Dammhayn C., Hackel M., Seifert H. 2010; Global spread of carbapenem-resistant Acinetobacter baumannii . J Antimicrob Chemother 65:233–238 [View Article][PubMed]
    [Google Scholar]
  20. Jawad A., Seifert H., Snelling A. M., Heritage J., Hawkey P. M. 1998; Survival of Acinetobacter baumannii on dry surfaces: comparison of outbreak and sporadic isolates. J Clin Microbiol 36:1938–1941[PubMed]
    [Google Scholar]
  21. Karah N., Sundsfjord A., Towner K., Samuelsen O. 2012; Insights into the global molecular epidemiology of carbapenem non-susceptible clones of Acinetobacter baumannii . Drug Resist Updat 15:237–247 [View Article][PubMed]
    [Google Scholar]
  22. Landman D., Quale J. M., Mayorga D., Adedeji A., Vangala K., Ravishankar J., Flores C., Brooks S. 2002; Citywide clonal outbreak of multiresistant Acinetobacter baumannii and Pseudomonas aeruginosa in Brooklyn, NY: the preantibiotic era has returned. Arch Intern Med 162:1515–1520 [View Article][PubMed]
    [Google Scholar]
  23. Lee K., Kim M. N., Choi T. Y., Cho S. E., Lee S., Whang D. H., Yong D., Chong Y., Woodford N., Livermore D. M. KONSAR Group 2009; Wide dissemination of OXA-type carbapenemases in clinical Acinetobacter spp. isolates from South Korea. Int J Antimicrob Agents 33:520–524 [View Article][PubMed]
    [Google Scholar]
  24. Libisch B., Poirel L., Lepsanovic Z., Mirovic V., Balogh B., Pászti J., Hunyadi Z., Dobák A., Füzi M., Nordmann P. 2008; Identification of PER-1 extended-spectrum beta-lactamase producing Pseudomonas aeruginosa clinical isolates of the international clonal complex CC11 from Hungary and Serbia. FEMS Immunol Med Microbiol 54:330–338 [View Article][PubMed]
    [Google Scholar]
  25. Magiorakos A. P., Srinivasan A., Carey R. B., Carmeli Y., Falagas M. E., Giske C. G., Harbarth S., Hindler J. F., Kahlmeter G. other authors 2012; Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 18:268–281 [View Article][PubMed]
    [Google Scholar]
  26. Mugnier P., Poirel L., Pitout M., Nordmann P. 2008; Carbapenem-resistant and OXA-23-producing Acinetobacter baumannii isolates in the United Arab Emirates. Clin Microbiol Infect 14:879–882 [View Article][PubMed]
    [Google Scholar]
  27. Mugnier P. D., Poirel L., Naas T., Nordmann P. 2010; Worldwide dissemination of the bla OXA-23 carbapenemase gene of Acinetobacter baumannii . Emerg Infect Dis 16:35–40 [View Article][PubMed]
    [Google Scholar]
  28. Opazo A., Sonnevend A., Lopes B., Hamouda A., Ghazawi A., Pal T., Amyes S. G. 2012; Plasmid-encoded PER-7 β-lactamase responsible for ceftazidime resistance in Acinetobacter baumannii isolated in the United Arab Emirates. J Antimicrob Chemother 67:1619–1622 [View Article][PubMed]
    [Google Scholar]
  29. Peleg A. Y., Seifert H., Paterson D. L. 2008; Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 21:538–582 [View Article][PubMed]
    [Google Scholar]
  30. Peymani A., Higgins P. G., Nahaei M. R., Farajnia S., Seifert H. 2012; Characterisation and clonal dissemination of OXA-23-producing Acinetobacter baumannii in Tabriz, northwest Iran. Int J Antimicrob Agents 39:526–528 [View Article][PubMed]
    [Google Scholar]
  31. Pfeifer Y., Wilharm G., Zander E., Wichelhaus T. A., Göttig S., Hunfeld K. P., Seifert H., Witte W., Higgins P. G. 2011; Molecular characterization of bla NDM-1 in an Acinetobacter baumannii strain isolated in Germany in 2007. J Antimicrob Chemother 66:1998–2001 [View Article][PubMed]
    [Google Scholar]
  32. Rodríguez-Baño J., Cisneros J. M., Fernández-Cuenca F., Ribera A., Vila J., Pascual A., Martínez-Martínez L., Bou G., Pachón J. Grupo de Estudio de Infección Hospitalaria (GEIH) 2004; Clinical features and epidemiology of Acinetobacter baumannii colonization and infection in Spanish hospitals. Infect Control Hosp Epidemiol 25:819–824 [View Article][PubMed]
    [Google Scholar]
  33. Segal H., Garny S., Elisha B. G. 2005; Is ISABA-1 customized for Acinetobacter?. FEMS Microbiol Lett 243:425–429 [View Article][PubMed]
    [Google Scholar]
  34. Seifert H., Schulze A., Baginski R., Pulverer G. 1994; Comparison of four different methods for epidemiologic typing of Acinetobacter baumannii . J Clin Microbiol 32:1816–1819[PubMed]
    [Google Scholar]
  35. Tamura K., Dudley J., Nei M., Kumar S. 2007; mega4: Molecular Evolutionary Genetics Analysis (mega) software version 4.0. Mol Biol Evol 24:1596–1599 [View Article][PubMed]
    [Google Scholar]
  36. Turton J. F., Woodford N., Glover J., Yarde S., Kaufmann M. E., Pitt T. L. 2006; Identification of Acinetobacter baumannii by detection of the bla OXA-51-like carbapenemase gene intrinsic to this species. J Clin Microbiol 44:2974–2976 [View Article][PubMed]
    [Google Scholar]
  37. Weisenberg S. A., Schuetz A. N., Alexander E. A., Eiss B., Behta M., Saiman L., Larone D. H., Jenkins S. G., Rhee K. Y. 2011; Endemic Acinetobacter baumannii in a New York hospital. PLoS ONE 6:e28566 [View Article][PubMed]
    [Google Scholar]
  38. Zander E., Nemec A., Seifert H., Higgins P. G. 2012; Association between β-lactamase-encoding bla OXA-51 variants and DiversiLab rep-PCR-based typing of Acinetobacter baumannii isolates. J Clin Microbiol 50:1900–1904 [View Article][PubMed]
    [Google Scholar]
  39. Zhou H., Zhang T., Yu D., Pi B., Yang Q., Zhou J., Hu S., Yu Y. 2011; Genomic analysis of the multidrug-resistant Acinetobacter baumannii strain MDR-ZJ06 widely spread in China. Antimicrob Agents Chemother 55:4506–4512 [View Article][PubMed]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.055681-0
Loading
/content/journal/jmm/10.1099/jmm.0.055681-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error