Volume 30, Issue 143 (November & December 2022)                   J Adv Med Biomed Res 2022, 30(143): 544-552 | Back to browse issues page

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Osanloo L, Zeighami H, Haghi F, Shapouri R, Shokri R. Multidrug-Resistant Strains of Acinetobacter baumannii from Intensive Care Unit Patients Show Genetic Diversity and Distribution of Genes Associated with Aminoglycoside Resistance. J Adv Med Biomed Res 2022; 30 (143) :544-552
URL: http://journal.zums.ac.ir/article-1-6637-en.html
Multidrug-Resistant Strains of Acinetobacter baumannii from Intensive Care Unit Patients Show Genetic Diversity and Distribution of Genes Associated with Aminoglycoside Resistance
Leili Osanloo1 , Habib Zeighami *2 , Fakhri Haghi3 , Reza Shapouri1 , Rasoul Shokri1
1- Dept. of Microbiology, Zanjan Branch, Islamic Azad University, Zanjan, Iran
2- Dept. of Microbiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran , Zeighami@zums.ac.ir
3- Dept. of Microbiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Abstract:   (30647 Views)

Background and Objective: As a significant cause of nosocomial infections, Acinetobacter baumannii has been linked to opportunistic infections. The assessment of clonal relatedness of A. baumannii isolates using typing methods like ERIC-PCR is beneficial for controlling conditions due to these resistant isolates. This research aims to study Acinetobacter baumannii resistant isolates to multidrug using typing methods like ERIC-PCR in clinics of Zanjan city.
Materials and Methods: In all, one hundred immunocompromised patients in ICU were included in the study and isolates of A. baumannii were extracted from their samples, and molecular typing using ERIC-PCR was performed on patients who were positive for aminoglycoside resistance-related genes (aph(2'')-Id, ant(4'')-Ia, ant(3'')-I, aac(6'')-Ib, aac(3)-I, aph(3'')-I, aph(2'')-Ib and aph (2'')-Ic).
Results: 67% of isolates had gentamicin resistance, and 63% had tobramycin resistance. The isolates tested positive for multidrug resistance (MDR) were all labeled as MDR strains. Furthermore, all antibiotics tested were ineffective against 32% of the isolates, while 91% could be deemed extensively drug-resistant (XDR). The aminoglycoside resistance gene aac(6′)-Ib accounted for 79% of the cases, followed by ant(3'')-I and aph(2'')-Id (47%). Sixty-four percent of the isolates carried three or more aminoglycoside resistance genes simultaneously. A total of six types and 20 subtypes of patterns were obtained from ERIC-PCR.
Conclusion: In this study, aminoglycoside-resistant A. baumannii was found in a high percentage of ICU patients, mainly with the enzyme-modified aminoglycosides like aac(6′)-Ib, aph(2'')-Id and ant(3'')-I. ERIC-PCR has also shown an increased level of diversity in A. baumannii isolates. Therefore, genetic diversity or clonal relatedness of A. baumannii isolates in clinical settings can be assessed using ERIC-PCR.

Keywords: Acinetobacter baumannii, Molecular typing, Antibiotic resistance, ERIC PCR
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✅ In this study, aminoglycoside-resistant A. baumannii was found in a high percentage of ICU patients, mainly with the enzyme-modified aminoglycosides like aac(6′)-Ib, aph(2'')-Id and ant(3'')-I. ERIC-PCR has also shown an increased level of diversity in A. baumannii isolates. Therefore, genetic diversity or clonal relatedness of A. baumannii isolates in clinical settings can be assessed using ERIC-PCR.


Type of Study: Original Research Article | Subject: Epidemiologic Studies
Received: 2021/07/25 | Accepted: 2022/04/6 | Published: 2022/10/10
References
1. Lee CR, Lee JH, Park M, et al. Biology of Acinetobacter baumannii: pathogenesis, antibiotic resistance mechanisms, and prospective treatment options. Front Cell Infect Microbiol. 2017;7:55. [DOI:10.3389/fcimb.2017.00055] [PMID] [PMCID]
2. Shirmohammadlou N, Zeighami H, Haghi F, Kashefieh M. Resistance pattern and distribution of carbapenemase and antiseptic resistance genes among multidrug-resistant Acinetobacter baumannii isolated from intensive care unit patients. J Med Microbiol. 2018;67(10):1467-73. [DOI:10.1099/jmm.0.000826] [PMID]
3. Safari M, Saidijam M, Bahador A, Jafari R, Alikhani MY. High prevalence of multidrug resistance and metallo-beta-lactamase (MbetaL) producing Acinetobacter baumannii isolated from patients in ICU wards, Hamadan, Iran. J Res Health Sci. 2013;13(2):162-7.
4. Ghasemi E, Ghalavand Z, Goudarzi H, et al. Phenotypic and genotypic investigation of biofilm formation in clinical and environmental isolates of Acinetobacter baumannii. 2018;13(4):e12914. [DOI:10.5812/archcid.12914]
5. Chen F, Wang L, Wang M, et al. Genetic characterization and in vitro activity of antimicrobial combinations of multidrug-resistant Acinetobacter baumannii from a general hospital in China. Oncol Lett. 2018;15(2):2305-15. [DOI:10.3892/ol.2017.7600]
6. Zhao WS, Liu GY, Mi ZH, Zhang F. Coexistence of blaOXA-23 with armA and novel gyrA mutation in a pandrug-resistant Acinetobacter baumannii isolate from the blood of a patient with haematological disease in China. J Hosp Infect. 2011;77(3):278-9. [DOI:10.1016/j.jhin.2010.11.006] [PMID]
7. Khoshnood S, Eslami G, Hashemi A, et al. Distribution of Aminoglycoside resistance genes among Acinetobacter baumannii strains isolated from burn patients in Tehran, Iran. 2017;5(3):e57263. [DOI:10.5812/pedinfect.57263]
8. Nie L, Lv Y, Yuan M, et al. Genetic basis of high level aminoglycoside resistance in Acinetobacter baumannii from Beijing, China. Acta Pharm Sin B. 2014;4(4):295-300. [DOI:10.1016/j.apsb.2014.06.004] [PMID] [PMCID]
9. Cho YJ, Moon DC, Jin JS, Choi CH, Lee YC, Lee JC. Genetic basis of resistance to aminoglycosides in Acinetobacter spp. and spread of armA in Acinetobacter baumannii sequence group 1 in Korean hospitals. Diagn Microbiol Infect Dis. 2009;64(2):185-90. [DOI:10.1016/j.diagmicrobio.2009.02.010] [PMID]
10. Gholami M, Haghshenas M, Moshiri M, et al. Frequency of 16S rRNA methylase and aminoglycoside-modifying enzyme genes among clinical isolates of Acinetobacter baumannii in Iran. Iran J Pathol. 2017;12(4):329-38. [DOI:10.30699/ijp.2017.27989] [PMID] [PMCID]
11. Viana GF, dos Santos Saalfeld SM, et al. Evolution of antimicrobial resistance of Acinetobacter baumannii in a university hospital. Lett Appl Microbiol. 2011;53(3):374-8. [DOI:10.1111/j.1472-765X.2011.03109.x] [PMID]
12. Codjoe FS, Brown CA, Smith TJ, Miller K, Donkor ES. Genetic relatedness in carbapenem-resistant isolates from clinical specimens in Ghana using ERIC-PCR technique. PLOS ONE. 2019;14(9):e0222168. [DOI:10.1371/journal.pone.0222168] [PMID] [PMCID]
13. M100-S27: Clinical and Laboratory Standards Institute, Performance standards for antimicrobial susceptibility testing; 23th informational supplement. 2017.
14. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268-81. [DOI:10.1111/j.1469-0691.2011.03570.x] [PMID]
15. Vila J, Marcos MA, Jimenez de Anta MT. A comparative study of different PCR-based DNA fingerprinting techniques for typing of the Acinetobacter calcoaceticus-A. baumannii complex. J Med Microbiol. 1996;44(6):482-9. [DOI:10.1099/00222615-44-6-482] [PMID]
16. Xiao-Min X, You-Fen F, Wei-Yun F, Zu-Huang M, Xing-Bei W. Antibiotic resistance determinants of a group of multidrug-resistant Acinetobacter baumannii in China. J Antibiot (Tokyo). 2014;67(6):439-44. [DOI:10.1038/ja.2014.18] [PMID]
17. Direkel Ş, Uzunoğlu E, Keleş S, Yapar K. Antibiotic resistance rates of Acinetobacter baumannii strains isolated from various clinical samples in Giresun Prof. Dr. Atilla ilhan Ozdemir State Hospital. Gazi Med J. 2015.
18. Saba Shamim MAaMHQ. Prevalence of multidrug resistant Acinetobacter baumannii in hospitalized patients in Lahore, Pakistan. Pakistan J Mol Med. 2015;2(1):6.
19. Vahdani P, Yaghoubi T, Aminzadeh Z. Hospital acquired antibiotic-resistant Acinetobacter baumannii infections in a 400-bed hospital in Tehran, Iran. Int J Prev Med. 2011;2(3):127-30.
20. Saffari F, Monsen T, Karmostaji A, Azimabad FB, Widerstrom M. Significant spread of extensively drug-resistant Acinetobacter baumannii genotypes of clonal complex 92 among intensive care unit patients in a university hospital in southern Iran. J Med Microbiol. 2017;66(11):1656-62. [DOI:10.1099/jmm.0.000619] [PMID]
21. Helmy OM, Kashef MT. Different phenotypic and molecular mechanisms associated with multidrug resistance in Gram-negative clinical isolates from Egypt. Infect Drug Resist. 2017;10:479-98. [DOI:10.2147/IDR.S147192] [PMID] [PMCID]
22. Wen JT, Zhou Y, Yang L, Xu Y. Multidrug-resistant genes of aminoglycoside-modifying enzymes and 16S rRNA methylases in Acinetobacter baumannii strains. Genet Mol Res. 2014;13(2):3842-9. [DOI:10.4238/2014.May.16.9] [PMID]
23. Haldorsen BC, Simonsen GS, Sundsfjord A, Samuelsen O. Increased prevalence of aminoglycoside resistance in clinical isolates of Escherichia coli and Klebsiella spp. in Norway is associated with the acquisition of AAC(3)-II and AAC(6')-Ib. Diagn Microbiol Infect Dis. 2014;78(1):66-9. [DOI:10.1016/j.diagmicrobio.2013.10.001] [PMID]
24. Ramirez MS, Nikolaidis N, Tolmasky ME. Rise and dissemination of aminoglycoside resistance: the aac(6')-Ib paradigm. Front. microbiol. 2013;4:121. [DOI:10.3389/fmicb.2013.00121] [PMID] [PMCID]
25. Falah F, Shokoohizadeh L, Adabi M. Molecular identification and genotyping of Acinetobacter baumannii isolated from burn patients by PCR and ERIC-PCR. Scars, burns & healing. 2019;5:2059513119831369. [DOI:10.1177/2059513119831369] [PMID] [PMCID]
26. Ece G, Erac B, Yurday Cetin H, Ece C, Baysak A. Antimicrobial susceptibility and clonal relation between Acinetobacter baumannii strains at a tertiary care center in Turkey. Jundishapur J Microbiol. 2015;8(2):e15612-e. [DOI:10.5812/jjm.15612] [PMID] [PMCID]
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