:: Volume 20, Issue 1 (Bimonthly 2016) ::
Feyz 2016, 20(1): 49-56 Back to browse issues page
Emergence of multidrug resistant, extended-spectrum β-lactamase and metallo-β-lactamase strain of Acinetobacter baumannii in ICU ward of Kashan Beheshti Hospital during 2013-14
Sareh Bagheri-Josheghani , Rezvan Moniri , Farzaneh Firoozeh , Mojtaba Sehhat , Elham Ghenaat Ghamsari
Kashan University of Medical Sciences , moniri@kaums.ac.ir
Abstract:   (5388 Views)

Background: Acinetobacter baumannii (A .baumannii) is a nosocomial opportunistic pathogen especially in intensive care unit (ICU) patients with innate resistance to many antibiotics. The aims of this study were to determine the antibiotic resistance patterns, the frequency of extended-spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) enzymes among the A. baumannii isolated from tracheal tubes of hospitalized patients in ICU ward of Beheshti hospital (Kashan, Iran) during 2013-2014.

Materials and Methods: A descriptive cross-sectional study was performed on 40 isolates of A .baumannii. Antibiotic susceptibility test for seventeen antimicrobial agents was performed according to the CLSIs guidelines. ESBL and MBL producing isolates were confirmed by double-disk diffusion test. The presence of blaOXA51 gene was investigated using PCR.

Results: All of A. baumannii isolates were resistant to Piperacillin, Piperacillin-Tazo­bactam, Ceftazidime, Cefepime, Cefotaxime, Ceftriaxone, Meropenem, Imipenem, Ciprofloxacin, Levofloxacin, and Trimethoprim-Sulfamethoxazole; 100% of the isolates were multi-drug resistant (MDR). Two (5%) and 26 (65%) strains were ESBL- and MBL-positive, respectively. All isolates were positive for blaOXA-51 gene.

Conclusions: The study emphasizes the high frequency of MDR in Kashan Shahid Beheshti hospital. Since the resistance genes are located on mobile elements, to prevent further spread of the infection, rapid identification of the mentioned strains is essential.
Keywords: Acinetobacter baumannii, Extended-spectrum beta-lactamase, Metallo-β-lactamase, Multidrug resistant
Full-Text [PDF 324 kb]   (3100 Downloads)    
Type of Study: Research | Subject: General
Received: 2016/04/13 | Revised: 2017/08/2 | Accepted: 2016/04/13 | Published: 2016/04/13
References
1. ‌‍‍Vincent JL. Nosocomial infections in adult intensive-care units. Lancet 2003; 361(9374): 2068-77.
2. Aybar Türkoğlu M, Topeli Iskit A. Ventilator-associated pneumonia caused by high risk microorganisms: a matched case-control study. Tuberk Toraks 2008; 56(2): 139-49.
3. Lambiase A, Rossano F, Piazza O, Del Pezzo M, Catania MR, Tufano R. Typing of Pseudomonas aeruginosa isolated from patients with VAP in an intensive care unit. New Microbiol 2009; 32(3): 277-83.
4. Kluytmans-Vandenbergh MF, Kluytmans JA, Voss A. Dutch guideline for preventing nosocomial transmission of highly resistant microorganisms (HRMO). Infection 2005; 33(5-6): 309-13.
5. Perez F, Hujer AM, Hujer KM, Decker BK, Rather PN, Bonomo RA. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2007; 51(10): 3471-84.
6. Zarrilli R, Casillo R, Di Popolo A, Tripodi MF, Bagattini M, Cuccurullo S, et al. Molecular epidemiology of a clonal outbreak of multi‌drug‐resistant Acinetobacter baumannii in a university hospital in Italy. Clin Microbiol Infect 2007; 13(5): 481-9.
7. Roberts MC. Multidrug-resistant genes are associated with an 86-kb island in Acinetobacter baumannii. Trends Microbiol 2006; 14(9): 375-8.
8. BazarganiA, Hashemizadeh Z. Bacteremia due to multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL) producing Acinetobacter baumannii. Afr J Microbiol Res 2011; 5(21): 3483-6.
9. Farahani RK, Moniri R, Dastehgoli K. Multi-Drug Resistant Acinetobacter-Derived Cephalos‌porinase and OXAs-etC Genes in Clinical Specimens of Acinetobacter spp. Isolated From Teach-ing Hospital. Jundishapur J Microbiol 2013; 6(2): 181-5.
10. Zarrilli R, Pournaras S, Giannouli M, Tsakris A. Global evolution of multidrug-resistant Acinetobacter baumannii clonal lineages. Int J Antimicrob Agents 2013; 41(1): 11-9.
11. Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 2001; 14(4): 933-51.
12. Evans BA, Hamouda A, Towner KJ, Amyes SG. OXA‐51‐like β‐lactamases and their association with particular epidemic lineages of Acinetobacter baumannii. Clin Microbiol Infect 2008; 14(3): 268-75.
13. Turton JF, Woodford N, Glover J, Yarde S, Kaufmann ME, Pitt TL. Identification of Acineto‌bacter baumannii by detection of the blaOXA-51-like carbapenemase gene intrinsic to this species. J Clin Microbiol 2006; 44(8): 2974-6.
14. Jorgensen JH, Hindler JF. New consensus guidelines from the Clinical and Laboratory Standards Institute for antimicrobial susceptibility testing of infrequently isolated or fastidious bacteria. Clin Infect Dis 2007; 44(2): 280-6.
15. 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(3): 182-7.
16. Feizabadi MM, Fathollahzadeh B, Taherikalani M, Rasoolinejad M, Sadeghifard N, Aligholi M, et al. Antimicrobial susceptibility patterns and distribution of blaOXA genes among Acinetobacter spp. isolated from patientsat Tehran hospitals. Jpn J Infect Dis 2008; 61(4): 274-8.
17. ] Mirnejad R, Mostofi S, Masjedian F. Antibiotic resistance and carriage class 1 and 2 integrons in clinical isolates of Acinetobacter baumannii from Tehran, Iran. Asian Pac J Trop Biomed 2013; 3(2): 140-5.
18. Moniri R, Farahani RK, Shajari G, Shirazi MN, Ghasemi A. Molecular epidemiology of aminoglycosides resistance in acinetobacter spp. With emergence of multidrug-resistant strains. Iran J Public Health 2010; 39(2): 63-8.
19. Khosrishahi N, Sharifi M. Isolation of carbapenem resistant acinetobacter baumannii (crab) strains from patients and equipments of intensive care units (icus) at qazvin between 2005-2006. Iran J Med Microbiol 2007; 1(3): 33-8. [in Persian]
20. Mohajeri P, Farahani A, Feizabadi MM, Ketabi H, Abiri R, Najafi F. Antimicrobial Susceptibility Profiling and Genomic Diversity of Acinetobacter baumannii isolates: A study in western Iran. Iran J Microbiol 2013; 5(3): 195-202.
21. Safari M, Saidijam M, Bahador A, Jafari R, Alikhani MY. High Prevalence of Multidrug Resistance and Metallo-beta-lactamase (MβL) producing Acinetobacter Baumannii Isolated from Patients in ICU Wards, Hamadan, Iran. J Res Health Sci 2013; 13(2): 162-7.
22. Jafari R, Karbasizade V. Frequency and Antimicrobial Susceptibility of Acinetobacter baumannii in Burn infections in Isfahan, Iran. Adv Biores 2014; 5(2): 148-52.
23. Amini M, Davati A, Golestanifard M. Frequency of Nosocomial Infections with Antibiotic Resistant Strains of Acinetobacter spp. in ICU Patients. Iran J Pathol 2012; 7(4): 241-5.
24. Japoni S, Japoni A, Farshad S, Ali AA, Jamalidoust M. Association between existence of integrons and multi-drug resistance in Acinetobacter isolated from patients in southern Iran. Pol J Microbiol 2011; 60(2): 163-8.
25. Talebi-Taher M, Latifnia M, Javad-Moosavai SA, Adabi M, Rastgar Lari A, Fatahi Abdizadeh M, et al. Risk factors and antimicrobial susceptibility in ventilator associated pneumonia: a brief report. Tehran Univ Med J 2012; 70(9): 577-82.
26. 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(12): 4114-23.
27. Al-Agamy MH, Khalaf NG, Tawfick MM, Shibl AM, Kholy AE. Molecular characterization of carbapenem-insensitive Acinetobacter baumannii in Egypt. Int J Infect Dis 2014; 22: 49-54.
28. Al Johani SM, Akhter J, Balkhy H, El-Saed A, Younan M, Memish Z. Prevalence of antimicrobial resistance among gram-negative isolates in an adult intensive care unit at a tertiary care center in Saudi Arabia. Ann Saudi Med 2010; 30(5): 364-9.
29. Mordi RM, Erah PO. Susceptibility of common urinary isolates to the commonly usedantibiotics in a tertiary hospital in southern Nigeria. Afr J Biotechnol 2006; 5(11): 1067-71.
30. Al-Agamy MH, Khalaf NG, Tawfick MM, Shibl AM, El KholyA. Molecular characterization of carbapenem-insensitive Acinetobacte rbaumannii in Egypt. Int J Infect Dis 2014; 22: 49-54.
31. Shahcheraghi F, Akbari Shahmirzadi N, Abbas Alipour Bashash M, Jabbari H, Amir Mozafari N. Detection of blaCTX, blaTEM beta-lactamase genes in clinical isolates of acinetobacter spp. from selected Tehran hospitals. Iran J Med Microbiol 2009; 3(1): 1-9. [in Persian]
32. Peymani A, Farajnia S, Mohammad R, Nasrollah sohrabi L, Abbasi KA, Azhari F. Prevalence of class 1 integron among multidrug-resistant Acinetobacter baumannii in Tabriz, Northwest of Iran. Pol J Microbiol 2012; 61(1): 57-60.
33. Anwar S, Amin R. Phenotype detection of metallo – beta – lactamase among the imipenem resistant psudomonas and asintobacter in the tertiary care hospitals of Dhaka city. BMC proc 2011; 5 Suppl 1: 92
34. Walsh TR. Emerging carbapenemases: a global perspective. Int J Antimicrob Agents 2010; 36 Suppl 3: S8-14.
35. Zavacski AP, Carvalhaes CG, Picao RC, Gales AC. Multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii: resistance mechanisms and implications for therapy. Expert Rev Anti Infect Ther 2010; 8(1): 71-93.
36. 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(3): 265.
37. Sohrabi N, Farajnia S, Akhi MT, Nahaei MR, Naghili B, Peymani A, et al. Prevalence of OXA-Type β-Lactamases Among Acinetobacter baumannii Isolates from Northwest of Iran. Microb Drug Resist 2012; 18(4): 385-9

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