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Cited by 68Antibiotic Resistance in BacteriaInfections and bacterial resistanceAntimicrobial Resistance in Staphylococcus

High prevalence of oxacillinases in clinical multidrug-resistant Acinetobacter baumannii isolates from the Tshwane region, South Africa—an update

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Lowings, Michelle, Ehlers, Marthie Magdaleen, Dreyer, Andries William, Kock, Marleen Magdalena·2015·BMC Infectious Diseases
DOI 10.1186/s12879-015-1246-8PMC PMC4647659
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Abstract

BACKGROUND: Acinetobacter baumannii is an important hospital-acquired pathogen in healthcare facilities that frequently causes bacteraemia and ventilator-associated pneumonia in intensive care units. Acinetobacter baumannii can be isolated from various sites in the hospital environment like medical equipment, bed linen, medical personnel and indwelling catheters. It is difficult to treat A. baumannii infections because of their highly resistant antimicrobial profiles. The purpose of this study was to determine the prevalence of β-lactamase genes in multidrug-resistant (MDR) clinical A. baumannii isolates using Multiplex-PCR (M-PCR) assays. METHODS: One hundred MDR A. baumannii isolates were collected from the diagnostic division of the Department of Medical Microbiology after routine analysis of the submitted specimens. All collected isolates were identified and tested for susceptibility using the VITEK 2® system (bioMérieux, France). Six isolates were excluded from this study because the isolates were incorrectly identified as A. baumannii with the VITEK 2® system (bioMérieux, France). Molecular tests, namely M-PCR assays, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed. MLST analyses were performed on representative isolates from the four major pulsotypes (≥5 isolates with 80 % similarity) and selective isolates from each minor pulsotype. RESULTS: All the A. baumannii isolates showed 100 % resistance to ampicillin, amoxicillin, cefuroxime, cefuroximine axetil, cefoxitin, cefotaxime and nitrofurantoin. Seven percent of the isolates were resistant to amikacin. Two percent of the isolates were classified as having intermediate susceptibility to tigecycline. A. baumannii isolates showed an antibiotic resistance profile of 67 % and higher to antibiotics, such as ceftazidime, cefepime, imipenem, meropenem, gentamicin, ciprofloxacin and trimethoprim/sulfamethoxazole. None of the isolates were resistant to colistin. The M-PCR assays showed that 99 % of the isolates contained the OXA-51 gene and 77 % contained the OXA-23 gene. None of the isolates contained the GES, GIM, IMP, KPC, NDM, OXA-24, OXA-58, PER, SIM, SPM, VEB and VIM genes. Representative A. baumannii isolates were grouped into five existing sequence types (ST): ST106, ST258, ST339, ST502, ST758 and ST848. Isolates belonging to the pan-European clonal lineages I and II (EUI and EUII) were identified. CONCLUSION: The high prevalence of MDR A. baumannii isolates has a severe impact on available treatment choices and this in return impacts on treatment outcomes in the studied healthcare facilities. The most dominant ST among the collected isolates was ST758, member of the EUI group. The presence of the OXA-23 gene was not restricted to a specific ST. Continuous research and surveillance is necessary to monitor the circulating β-lactamase genes in clinical settings to guide infection control policies in order to try and curb the spread of this bacterium.

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  • Mounting evidence demonstrates the emergence of Acinetobacter as a cause of hospital-associated and occasionally community-acquired infection in resource-limited settings.

    “mounting evidence demonstrates the emergence of this pathogen as a cause of hospital-associated and occasionally community-acquired infection in resource-limited settings.[5, 16–20]”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [18]

    The Background describes A. baumannii as an emerging pathogen associated with outbreaks in healthcare facilities, and the paper studies isolates from hospitals in South Africa. Our copy does not describe community-acquired infections, so it does not support that part of the claim. (LLM, conf=0.86)

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Authors
Lowings, M., Ehlers, M. M., Dreyer, A. W., & Kock, M. M.
Affiliations
  • University of Pretoria (ZA)
  • National Health Laboratory Service (ZA)
  • National Institute for Communicable Diseases (ZA)
Corresponding author
Lowings, Michelle
ORCID
Venue
BMC Infectious Diseases
Publisher
Springer Science and Business Media LLC
Published
2015-11-14
Volume
15
Issue
1
Pages
521-521
ISSN
1471-2334 (ISSN-L)
DOI
10.1186/s12879-015-1246-8
PMC
PMC4647659
OpenAlex
W2183501693
Cited by
68
References
49
Citations by year
2026: 4 · 2025: 6 · 2024: 4 · 2023: 10 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 9 · 2016: 1
FWCI
2.22
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Infectious Diseases (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UpSpace Institutional Repository (University of Pretoria) (submittedVersion, cc-by)
Funders
Marleen Magdalena Kock
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Infections and bacterial resistance
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
Keywords
Acinetobacter baumannii, multidrug resistance, OXA-51, OXA-23, Ge, metallo-beta-lactamase, beta-lactamase genes, antimicrobial resistance, Tshwane, nosocomial infections, molecular epidemiology, pulsed-field gel electrophoresis, multilocus sequence typing
MeSH terms
Acinetobacter Infections, Adolescent, Adult, Aged, Anti-Bacterial Agents, beta-Lactamases, Child, Child, Preschool, Colistin, Humans, Infant, Infant, Newborn, Intensive Care Units, Middle Aged, South Africa, Bacteremia, Electrophoresis, Gel, Pulsed-Field, beta-Lactam Resistance, Drug Resistance, Multiple, Bacterial, Acinetobacter baumannii, Young Adult, Multilocus Sequence Typing, Multiplex Polymerase Chain Reaction

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