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Molecular Epidemiology of Extensively-Drug Resistant Acinetobacter baumannii Sequence Type 2 Co-Harboring blaNDM and blaOXA From Clinical Origin
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-05-25 , DOI: 10.2147/idr.s310478 Hasan Ejaz 1 , Mahtab Ahmad 2 , Sonia Younas 3 , Kashaf Junaid 1 , Khalid Omer Abdalla Abosalif 1 , Abualgasim Elgaili Abdalla 1 , Ayman Ali Mohammed Alameen 1 , Mohammed Yagoub Mohammed Elamir 1 , Syed Nasir Abbas Bukhari 4 , Naveed Ahmad 5 , Muhammad Usman Qamar 2
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-05-25 , DOI: 10.2147/idr.s310478 Hasan Ejaz 1 , Mahtab Ahmad 2 , Sonia Younas 3 , Kashaf Junaid 1 , Khalid Omer Abdalla Abosalif 1 , Abualgasim Elgaili Abdalla 1 , Ayman Ali Mohammed Alameen 1 , Mohammed Yagoub Mohammed Elamir 1 , Syed Nasir Abbas Bukhari 4 , Naveed Ahmad 5 , Muhammad Usman Qamar 2
Affiliation
Background: The therapeutic management of carbapenem-resistant Acinetobacter baumannii (CR-AB) represents a serious challenge to the public health sector because these pathogens are resistant to a wide range of antibiotics, resulting in limited treatment options. The present study was planned to investigate the clonal spread of CR-AB in a clinical setting.
Methodology: A total of 174 A. baumannii clinical isolates were collected from a tertiary care hospitals in Lahore, Pakistan. The isolates were confirmed by VITEK 2 compact system and molecular identification of recA and blaOXA-51. Antimicrobial profile and the screening of carbapenem-resistant genes were carried out using VITEK 2 system and PCR, respectively. The molecular typing of the isolates was performed according to the Pasteur scheme.
Results: Of the 174 A. baumannii isolates collected, the majority were isolated from sputum samples (46.5%) and in the intensive care unit (ICU, 75%). Among these, 113/174 (64.9%) were identified as CR-AB, and 49.5% and 24.7% harbored blaOXA-23 and blaNDM-1, respectively. A total of 11 (9.7%) isolates co-harbored blaOXA-51, blaNDM-1, and blaOXA-23. Interestingly, 46.9% of the CR-AB belonged to sequence type 2 (ST2; CC1), whereas 15.9% belonged to ST1 (CC1). All of the CR-AB isolates showed extensive resistance to clinically relevant antibiotics, except colistin.
Conclusion: The study concluded CR-AB ST2 clone harboring blaOXA-23 and blaNDM-1 are widely distributed in Pakistan’s clinical settings, which could result in increased mortality. Strict compliance with the National Action Plan on Antimicrobial Resistance is necessary to reduce the impacts of these strains.
中文翻译：
广泛耐药的鲍曼不动杆菌2型序列的分子流行病学从临床起源上同时带有bla NDM和bla OXA
背景：对碳青霉烯类耐药的鲍曼不动杆菌（CR-AB）的治疗管理对公共卫生部门构成了严峻挑战，因为这些病原体对多种抗生素具有耐药性，导致治疗选择有限。本研究计划在临床环境中研究CR-AB的克隆传播。
方法：从巴基斯坦拉合尔的一家三级医院收集了总共174种鲍曼不动杆菌临床分离株。分离物通过VITEK 2紧凑型系统以及rec A和bla OXA-51的分子鉴定进行了确认。抗菌谱和对碳青霉烯类耐药基因的筛选分别使用VITEK 2系统和PCR进行。分离物的分子分型是根据巴斯德方案进行的。
结果：在收集的174株鲍曼不动杆菌中，大多数是从痰液样本中分离出来的（46.5％），在重症监护病房中也是如此（ICU的比率为75％）。其中113/174（64.9％）被鉴定为CR-AB，分别有bla OXA-23和bla NDM-1占49.5％和24.7％。共有11个（9.7％）分离株共同感染bla OXA-51，bla NDM-1和bla OXA-23。有趣的是，CR-AB的46.9％属于序列类型2（ST2; CC1），而ST-1（CC1）属于15.9％。除粘菌素外，所有CR-AB分离株均表现出对临床相关抗生素的广泛耐药性。
结论：该研究得出结论，带有bla OXA-23和bla NDM-1的CR-AB ST2克隆在巴基斯坦的临床环境中广泛分布，这可能导致死亡率增加。为了减少这些菌株的影响，必须严格遵守《国家抗微生物药物耐药性行动计划》。
更新日期：2021-05-25
Methodology: A total of 174 A. baumannii clinical isolates were collected from a tertiary care hospitals in Lahore, Pakistan. The isolates were confirmed by VITEK 2 compact system and molecular identification of recA and blaOXA-51. Antimicrobial profile and the screening of carbapenem-resistant genes were carried out using VITEK 2 system and PCR, respectively. The molecular typing of the isolates was performed according to the Pasteur scheme.
Results: Of the 174 A. baumannii isolates collected, the majority were isolated from sputum samples (46.5%) and in the intensive care unit (ICU, 75%). Among these, 113/174 (64.9%) were identified as CR-AB, and 49.5% and 24.7% harbored blaOXA-23 and blaNDM-1, respectively. A total of 11 (9.7%) isolates co-harbored blaOXA-51, blaNDM-1, and blaOXA-23. Interestingly, 46.9% of the CR-AB belonged to sequence type 2 (ST2; CC1), whereas 15.9% belonged to ST1 (CC1). All of the CR-AB isolates showed extensive resistance to clinically relevant antibiotics, except colistin.
Conclusion: The study concluded CR-AB ST2 clone harboring blaOXA-23 and blaNDM-1 are widely distributed in Pakistan’s clinical settings, which could result in increased mortality. Strict compliance with the National Action Plan on Antimicrobial Resistance is necessary to reduce the impacts of these strains.
中文翻译：
广泛耐药的鲍曼不动杆菌2型序列的分子流行病学从临床起源上同时带有bla NDM和bla OXA
背景：对碳青霉烯类耐药的鲍曼不动杆菌（CR-AB）的治疗管理对公共卫生部门构成了严峻挑战，因为这些病原体对多种抗生素具有耐药性，导致治疗选择有限。本研究计划在临床环境中研究CR-AB的克隆传播。
方法：从巴基斯坦拉合尔的一家三级医院收集了总共174种鲍曼不动杆菌临床分离株。分离物通过VITEK 2紧凑型系统以及rec A和bla OXA-51的分子鉴定进行了确认。抗菌谱和对碳青霉烯类耐药基因的筛选分别使用VITEK 2系统和PCR进行。分离物的分子分型是根据巴斯德方案进行的。
结果：在收集的174株鲍曼不动杆菌中，大多数是从痰液样本中分离出来的（46.5％），在重症监护病房中也是如此（ICU的比率为75％）。其中113/174（64.9％）被鉴定为CR-AB，分别有bla OXA-23和bla NDM-1占49.5％和24.7％。共有11个（9.7％）分离株共同感染bla OXA-51，bla NDM-1和bla OXA-23。有趣的是，CR-AB的46.9％属于序列类型2（ST2; CC1），而ST-1（CC1）属于15.9％。除粘菌素外，所有CR-AB分离株均表现出对临床相关抗生素的广泛耐药性。
结论：该研究得出结论，带有bla OXA-23和bla NDM-1的CR-AB ST2克隆在巴基斯坦的临床环境中广泛分布，这可能导致死亡率增加。为了减少这些菌株的影响，必须严格遵守《国家抗微生物药物耐药性行动计划》。
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