Phenotypic Characterization of Extended-Spectrum Beta-Lactamases and Metallo-Beta-Lactamase of Multi Drug Resistant Acinetobacter baumannii Causing Nosocomial Infections in Erbil City

Sakar Bakr Smail, Kamal I. AL-OTRACHI

Abstract


Background: Resistance to broad‑spectrum beta‑lactams, mediated by extended‑spectrum beta‑lactamases, and metallo‑beta‑lactamase enzymes, is an increasing problem worldwide. The main aim is to study phenotypic characterization of extended‑spectrum beta‑lactamases and metallo‑beta‑lactamase multidrug resistant Acinetobacter baumannii in Erbil City. Materials and Methods: A total of 112 Acinetobacter baumannii isolations were collected from patients of all age groups from clinical specimens sputum, blood, pus, wound swab, urine and body fluids (Pleural fluid and cerebrospinal fluid) collected from different medical wards and intensive care unit departments of hospitals in Erbil City for a period of one year from march 2018--march 2019. Isolates were tested for the presence of extended‑spectrum beta‑lactamases and metallo‑beta‑lactamase. Detection of extended‑spectrum beta‑lactamases was done by the combined disk diffusion method according to Clinical and Laboratory Standards Institute guidelines, while metallo‑beta‑lactamase was detected by meropenem and imipenem combined with ethylenediaminetetraacetic acid disk method. Results: 25% (28) Acinetobacter baumannii isolates were positive for extended‑spectrum beta‑lactamases, while 100 % (112) were metallo‑beta‑lactamase producers. Conclusion: Acinetobacter baumannii is becoming a global medical challenge due to the emergence of multi-drug resistance. Newer beta lactamase is a matter of concern as they are developing rapidly and lead to treatment failure. Carbapenems are known to be effective therapeutic agents for Acinetobacter baumannii infections and its resistance limits the use to polymyxins and colistin. Several new medicines are still in research and combination of drug therapy is being currently used in the hospitals together with ours to treat multidrug resistant Acinetobacter baumannii infections.

Keywords


Acinetobacter baumannii, beta‑lactamases, extended‑spectrum beta‑lactamases, metallo‑beta‑lactamase.

Full Text:

PDF

References


Perez F, Hujer AM, Hujer KM, Decker BK, Rather PN, Bonomo RA. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrobial agents and chemotherapy, vol. 51(10), Antimicrobial Agents and Chemotheraphy, 2007, pp. 3471-84. [CrossRef] [PubMed]

Karageorgopoulos DE, Kelesidis T, Kelesidis I, Falagas. Tigecycline for the treatment of multidrug-resistant (including carbapenem-resistant) Acinetobacter infections: a review of the scientific evidence, vol. 62(1), Journal of Antimicrobial Chemotherapy, 2008, pp. 45-55. [CrossRef] [PubMed]

Pfeifer Y, Cullik A, Witte. Resistance to cephalosporins and carbapenems in Gram-negative bacterial pathogens, vol. 300(6), International Journal of medical microbiology, 2010, pp. 371-9. [CrossRef] [PubMed]

Rasmussen BA, Bush. Carbapenem-hydrolyzing beta-lactamases, vol. 41(2), American Society for Microbiology, 1997, pp. 223. [CrossRef] [PubMed]

Walsh TR, Toleman MA, Poirel L, Nordmann. Metallo-β-lactamases: the quiet before the storm?, vol. 18(2), American Society for Microbiology, 2005, pp. 306-25. [CrossRef] [PubMed]

Héritier C, Poirel L, Fournier P-E, Claverie J-M, Raoult D, Nordmann P. Characterization of the naturally occurring oxacillinase of Acinetobacter baumannii. Antimicrobial agents and chemotherapy, vol. 49(10), American Society for Microbiology, 2005, pp. 4174-9. [CrossRef] [PubMed]

Nath H, Barkataki. Prevalence of ESBL and MBL producing Acinetobacter Isolates in Clinical Specimens in Tertiary Care Hospital, Assam, India, vol. 5(11), India: International Journal of Current Microbiology and Applied Sciences, 2016, pp. 515-22. [CrossRef]

Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement, M100-S25, 2015.

Trivedi G, Soni S, Vegad M, Yadav. occurence and detection of extended spectrum [beta]-lactamase and AmpC [beta]-lactamase in clinical isolates Pseudomonas aeruginosa and Acinetobacter baumanii by inhibitor based methods, vol. 4(8), India: International Journal of Microbiology Research, 2012, pp. 299-301. [CrossRef]

Abbo S, Gopher A, Rubin B, Lev-Yadun. On the origin of Near Eastern founder crops and the 'dump-heap hypothesis', vol. 52(5), Genetic Resources and Crop Evolution, 2005, pp. 491-5. [CrossRef]

Moosavian M, Sirous M, Shams. Phenotypic and Genotypic Detection of Extended Spectrum β-lactamase and Carbapenemases Production Including bla TEM, bla PER and bla NDM-1 Genes Among Acinetobacter baumannii Clinical Isolates, vol. 10(12), Ju dishapur Journal of Microbiology, 2017. [CrossRef]

Shahcheraghi F, Abbasalipour M, Feizabadi M, Ebrahimipour G, Akbari N. Isolation and genetic characterization of metallo-β-lactamase and carbapenamase producing strains of Acinetobacter baumannii from patients at Tehran hospitals. vol. 3(2), Iranian journal of microbiology, 2011, pp. 68-74.

Vijayakumar S, Rajenderan S, Laishram S, Anandan S, Balaji V, Biswas. Biofilm formation and motility depend on the nature of the Acinetobacter baumannii clinical isolates, vol. 4, India: Frontiers in Public Health, 2016, pp. 105. [CrossRef] [PubMed]

Peleg AY, Seifert H, Paterson. Acinetobacter baumannii: emergence of a successful pathogen, vol. 21(3), American Society for Microbiology, 2008, pp. 538-82. [CrossRef] [PubMed]

Hans R, Bisht D, Agarwal R, Irfan . Phenotypic detection of MBL, Ampc beta-lactamase and carbapenemases in multi drug resistant isolates of Acinetobacter baumannii, vol. 4(2), India: International Journal of Medical Research & Health Sciences , 2015, pp. 311-6. [CrossRef]

Tsakris A, Ikonomidis A, Poulou A, Spanakis N, Vrizas D, Diomidous M, et al. Clusters of imipenem-resistant Acinetobacter baumannii clones producing different carbapenemases in an intensive care unit, vol. 14(66), Clinical microbiology and Infection, 2008, pp. 588-94. [CrossRef] [PubMed]

Farahani RK, Moniri R, Dastehgoli. Multi-drug resistant Acinetobacter-derived cephalosporinase and OXAsetC genes in clinical specimens of Acinetobacter spp. isolated from teaching hospital, vol. 6(2), Jundishapur Journal of Microbiology, 2013, pp. 181. [CrossRef]

Muthusamy D, Boppe. Phenotypic Methods for the Detection of Various Betalactamases in Carbapenem Resistant Isolates of Acinetobacter baumanii at a Tertiary Care Hospital in South India, vol. 6(6), India: Journal of Clinical & Diagnostic Research, 2012, pp. 970-973.

Jaggi N, Sissodia P, Sharma. Acinetobacter baumannii isolates in a tertiary care hospital: Antimicrobial resistance and clinical significance, vol. 2(2), DergiPark: Journal of Microbiology and Infectious Diseases, 2012, pp. 57-63. [CrossRef]

Sinha M, Srinivasa H, Macaden. Antibiotic resistance profile & extended spectrum beta-lactamase (ESBL) production in Acinetobacter species, vol. 126(1), India: J Med Res, 2007, pp. 63-8.

Safari M, Nejad ASM, Bahador A, Jafari R, Alikhani MY. Prevalence of ESBL and MBL encoding genes in Acinetobacter baumannii strains isolated from patients of intensive care units (ICU), vol. 22(4), Saudi: Journal of Biological Sciences, 2015, pp. 424-9. [CrossRef] [PubMed]

John S, Balagurunathan. Metallo beta lactamase producing Pseudomonas aeruginosa and Acinetobacter baumanni, vol. 29(3), India: Journal of Medical Microbiology 2011, pp. 302-4. [CrossRef] [PubMed]

Noyal M, Menezes G, Harish B, Sujatha S, Parija. Simple screening tests for detection of carbapenemases in clinical isolates of nonfermentative Gram-negative bacteria, vol. 129(6), India: Journal of Medical Research, 2009, pp. 707-712.

Goel V, Hogade SA, Karadesai. Prevalence of extended-spectrum beta-lactamases, AmpC beta-lactamase, and metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii in an intensive care unit in a tertiary care hospital, vol. 40(1), India: Journal of Scientific Science, 2013, pp. 28-31. [CrossRef]

Gupta N, Gandham N, Jadhav S, Mishra. Isolation and identification of Acinetobacter species with special reference to antibiotic resistance, vol. 6(1), J Nat Sci Biol Med, 2015, pp. 159. [CrossRef] [PubMed]




DOI: http://dx.doi.org/10.23851/mjs.v30i4.671

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Al-Mustansiriyah Journal of Science

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


Copyright (c) 2018 by Al-Mustansiriyah Journal of Science
ISSN: 1814-635X (Print), ISSN: 2521-3520 (online)