Volume 11, Issue 1 (2025)
IEM 2025, 11(1): 13-22 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Motamedi S, Najafikhah A, Hakemi Vala M. Frequency of Carbapenemase Genes in Acinetobacter baumannii complex Isolates from Burn Wounds in Motahari Hospital, Tehran, Iran. IEM 2025; 11 (1) :13-22
URL: http://iem.modares.ac.ir/article-4-76666-en.html
URL: http://iem.modares.ac.ir/article-4-76666-en.html
1- School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
2- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
3- Professor of department of Microbiology, School of Medicine, Shahid Beheshti University of Medical sciences (SBMU), Tehran, Iran ,m.hakemi@sbmu.ac.ir
2- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
3- Professor of department of Microbiology, School of Medicine, Shahid Beheshti University of Medical sciences (SBMU), Tehran, Iran ,
Abstract: (426 Views)
Aims: Acinetobacter baumannii complex (Acb complex) are opportunistic Gram-negative bacteria responsible for a diverse array of nosocomial infections. In recent years, carbapenem-resistant Acb complex has become a global concern. Carbapenemases are one of the most important mechanisms of resistance to carbapenems. This study aimed to measure the prevalence of carbapenemase genes in Acb complex isolates from burn wounds in a burn center in Iran.
Materials & Methods: During six months, 50 Acb complex isolates were collected from the wounds of burn patients admitted to Motahari hospital in Tehran (2020-2021). Antimicrobial susceptibility testing was performed for the isolates using Kirby-Bauer disc diffusion method based on the Clinical and Laboratory Standards Institute 2020 guidelines. DNA extraction was done by boiling method. The existence of blaOXA-51, blaOXA-23, blaIMP, blaNDM-1, and blaKPC genes was evaluated by PCR and gel electrophoresis.
Findings: All isolated bacteria were confirmed as Acb complex based on positive PCR results for the presence of the blaOXA-51 gene. According to the antibiotic susceptibility testing results, the isolates showed 100% resistance to ceftazidime, 98% to ciprofloxacin, amikacin, and imipenem, and 94% to gentamicin and piperacillin-tazobactam. The most prevalent carbapenemase genes among the isolates were blaOXA-51 and blaOXA-23 (100%), followed by blaIMP (26%), blaNDM-1 (14%), and blaKPC (4%).
Conclusion: Carbapenem resistance and the prevalence of carbapenemase genes among Acb complex isolates has reached an alarming rate. Collaborative global efforts are crucial to safeguard antibiotic effectiveness and enhance patient care amidst escalating antimicrobial resistance challenges.
Materials & Methods: During six months, 50 Acb complex isolates were collected from the wounds of burn patients admitted to Motahari hospital in Tehran (2020-2021). Antimicrobial susceptibility testing was performed for the isolates using Kirby-Bauer disc diffusion method based on the Clinical and Laboratory Standards Institute 2020 guidelines. DNA extraction was done by boiling method. The existence of blaOXA-51, blaOXA-23, blaIMP, blaNDM-1, and blaKPC genes was evaluated by PCR and gel electrophoresis.
Findings: All isolated bacteria were confirmed as Acb complex based on positive PCR results for the presence of the blaOXA-51 gene. According to the antibiotic susceptibility testing results, the isolates showed 100% resistance to ceftazidime, 98% to ciprofloxacin, amikacin, and imipenem, and 94% to gentamicin and piperacillin-tazobactam. The most prevalent carbapenemase genes among the isolates were blaOXA-51 and blaOXA-23 (100%), followed by blaIMP (26%), blaNDM-1 (14%), and blaKPC (4%).
Conclusion: Carbapenem resistance and the prevalence of carbapenemase genes among Acb complex isolates has reached an alarming rate. Collaborative global efforts are crucial to safeguard antibiotic effectiveness and enhance patient care amidst escalating antimicrobial resistance challenges.
Article Type: Original Research |
Subject:
Bacteriology
Received: 2024/08/21 | Accepted: 2025/01/2 | Published: 2025/02/22
Received: 2024/08/21 | Accepted: 2025/01/2 | Published: 2025/02/22
References
1. Kyriakidis I, Vasileiou E, Pana ZD, Tragiannidis A. Acinetobacter baumannii Antibiotic Resistance Mechanisms. Pathogens. 2021;10(3). [DOI:10.3390/pathogens10030373] [PMID] []
2. Hassan RM, Salem ST, Hassan SIM, Hegab AS, Elkholy YS. Molecular characterization of carbapenem-resistant Acinetobacter baumannii clinical isolates from Egyptian patients. PLoS One. 2021;16(6):e0251508. [DOI:10.1371/journal.pone.0251508] [PMID] []
3. Azimi L, Fallah F, Karimi A, Shirdoust M, Azimi T, Sedighi I, et al. Survey of various carbapenem-resistant mechanisms of Acinetobacter baumannii and Pseudomonas aeruginosa isolated from clinical samples in Iran. Iranian journal of basic medical sciences. 2020;23(11):1396-400.
4. Wasfi R, Rasslan F, Hassan SS, Ashour HM, Abd El-Rahman OA. Co-Existence of Carbapenemase-Encoding Genes in Acinetobacter baumannii from Cancer Patients. Infect Dis Ther. 2021;10(1):291-305. [DOI:10.1007/s40121-020-00369-4] [PMID] []
5. Nasiri MJ, Zamani S, Fardsanei F, Arshadi M, Bigverdi R, Hajikhani B, et al. Prevalence and Mechanisms of Carbapenem Resistance in Acinetobacter baumannii: A Comprehensive Systematic Review of Cross-Sectional Studies from Iran. Microb Drug Resist. 2020;26(3):270-83. [DOI:10.1089/mdr.2018.0435] [PMID]
6. Nguyen M, Joshi SG. Carbapenem resistance in Acinetobacter baumannii, and their importance in hospital-acquired infections: a scientific review. J Appl Microbiol. 2021;131(6):2715-38. [DOI:10.1111/jam.15130] [PMID]
7. Beigverdi R, Sattari-Maraji A, Emaneini M, Jabalameli F. Status of carbapenem-resistant Acinetobacter baumannii harboring carbapenemase: First systematic review and meta-analysis from Iran. Infect Genet Evol. 2019;73:433-43. [DOI:10.1016/j.meegid.2019.06.008] [PMID]
8. Nordmann P, Poirel L. Epidemiology and Diagnostics of Carbapenem Resistance in Gram-negative Bacteria. Clinical Infectious Diseases. 2019;69(Supplement_7):S521-S8. [DOI:10.1093/cid/ciz824] [PMID] []
9. Vijayakumar S, Wattal C, J KO, Bhattacharya S, Vasudevan K, Anandan S, et al. Insights into the complete genomes of carbapenem-resistant Acinetobacter baumannii harbouring bla OXA-23, bla OXA-420 and bla NDM-1 genes using a hybrid-assembly approach. Access Microbiol. 2020;2(8):acmi000140. [DOI:10.1099/acmi.0.000140] [PMID] []
10. CLSI. Performance standards for Antimicrobial Susceptibility testing. 30th ed. CLSI suppelemnt M100. Wayne,PA: Clinical and Laboratory Standards Institute; 2020.
11. Gholami M, Hashemi A, Hakemi-Vala M, Goudarzi H, Hallajzadeh M. Efflux Pump Inhibitor Phenylalanine-Arginine Β-Naphthylamide Effect on the Minimum Inhibitory Concentration of Imipenem in Acinetobacter baumannii Strains Isolated From Hospitalized Patients in Shahid Motahari Burn Hospital, Tehran, Iran. Jundishapur J Microbiol. 2015;8(10):e19048. [DOI:10.5812/jjm.19048]
12. Hou C, Yang F. Drug-resistant gene of blaOXA-23, blaOXA-24, blaOXA-51 and blaOXA-58 in Acinetobacter baumannii. Int J Clin Exp Med. 2015;8(8):13859-63.
13. Poirel L, Walsh TR, Cuvillier V, Nordmann P. Multiplex PCR for detection of acquired carbapenemase genes. Diagn Microbiol Infect Dis. 2011;70(1):119-23. [DOI:10.1016/j.diagmicrobio.2010.12.002] [PMID]
14. Khosravi AD, Mihani F. Detection of metallo-beta-lactamase-producing Pseudomonas aeruginosa strains isolated from burn patients in Ahwaz, Iran. Diagn Microbiol Infect Dis. 2008;60(1):125-8. [DOI:10.1016/j.diagmicrobio.2007.08.003] [PMID]
15. Woodford N, Ellington MJ, Coelho JM, Turton JF, Ward ME, Brown S, et al. Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int J Antimicrob Agents. 2006;27(4):351-3. [DOI:10.1016/j.ijantimicag.2006.01.004] [PMID]
16. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, 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]
17. Pournajaf A, Rajabnia R, Razavi S, Solgi S, Ardebili A, Yaghoubi S, et al. Molecular characterization of carbapenem-resistant Acinetobacter baumannii isolated from pediatric burns patients in an Iranian hospital. Tropical Journal of Pharmaceutical Research. 2018;17 (1):135-41. [DOI:10.4314/tjpr.v17i1.19]
18. Salehi B, Goudarzi H, Nikmanesh B, Houri H, Alavi-Moghaddam M, Ghalavand Z. Emergence and characterization of nosocomial multidrug-resistant and extensively drug-resistant Acinetobacter baumannii isolates in Tehran, Iran. J Infect Chemother. 2018;24(7):515-23. [DOI:10.1016/j.jiac.2018.02.009] [PMID]
19. Lukovic B, Gajic I, Dimkic I, Kekic D, Zornic S, Pozder T, et al. The first nationwide multicenter study of Acinetobacter baumannii recovered in Serbia: emergence of OXA-72, OXA-23 and NDM-1-producing isolates. Antimicrob Resist Infect Control. 2020;9(1):101. [DOI:10.1186/s13756-020-00769-8] [PMID] []
20. El-Badawy MF, Abdelwahab SF, Alghamdi SA, Shohayeb MM. Characterization of phenotypic and genotypic traits of carbapenem-resistant Acinetobacter baumannii clinical isolates recovered from a tertiary care hospital in Taif, Saudi Arabia. Infect Drug Resist. 2019;12:3113-24. [DOI:10.2147/IDR.S206691] [PMID] []
21. Khodaei H, Eftekhar F. Detection of kpc-type carbapenemases in clinical isolates of acinetobacter Baumannii. Journal of Krishna Institute of Medical Sciences University. 2017;6:64-70.
22. Khalid F, Saleem S, Ahmad I. High prevalence of carbapenem-resistant Acinetobacter baumannii associated respiratory tract infections in Pakistani hospitals. JPMA The Journal of the Pakistan Medical Association. 2020;70(9):1630-2. [DOI:10.5455/JPMA.35384] [PMID]
23. AlAmri AM, AlQurayan AM, Sebastian T, AlNimr AM. Molecular Surveillance of Multidrug-Resistant Acinetobacter baumannii. Curr Microbiol. 2020;77(3):335-42. [DOI:10.1007/s00284-019-01836-z] [PMID]
24. Gupta N, Angadi K, Jadhav S. Molecular Characterization of Carbapenem-Resistant Acinetobacter baumannii with Special Reference to Carbapenemases: A Systematic Review. Infect Drug Resist. 2022;15:7631-50. [DOI:10.2147/IDR.S386641] [PMID] []
25. Farshadzadeh Z, Hashemi FB, Rahimi S, Pourakbari B, Esmaeili D, Haghighi MA, et al. Wide distribution of carbapenem resistant Acinetobacter baumannii in burns patients in Iran. Front Microbiol. 2015;6:1146. [DOI:10.3389/fmicb.2015.01146] [PMID] []
26. Azimi L, Talebi M, Pourshafie MR, Owlia P, Rastegar Lari A. Characterization of Carbapenemases in Extensively Drug Resistance Acinetobacter baumannii in a Burn Care Center in Iran. Int J Mol Cell Med. 2015;4(1):46-53.
27. Elshamy AA, Aboshanab KM. A review on bacterial resistance to carbapenems: epidemiology, detection and treatment options. Future Sci OA. 2020;6(3):FSO438. [DOI:10.2144/fsoa-2019-0098] [PMID] []
28. Hakemi vala M, Hallajzadeh M, Hashemi A, Goudarzi H, Tarhani M, Tabrizi M, et al. Detection of ambler class A, B and D β-Lactamases among Pseudomonas Aeruginosa and Acinetobacter Baumannii clinical isolates from burn patients. Annals of burns and fire disasters. 2014;27:8-13.
29. Hsu LY, Apisarnthanarak A, Khan E, Suwantarat N, Ghafur A, Tambyah PA. Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia. Clin Microbiol Rev. 2017;30(1):1-22. [DOI:10.1128/CMR.00042-16] [PMID] []
30. Aruhomukama D, Najjuka CF, Kajumbula H, Okee M, Mboowa G, Sserwadda I, et al. bla(VIM)- and bla(OXA)-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda. BMC Infect Dis. 2019;19(1):853. [DOI:10.1186/s12879-019-4510-5] [PMID] []
31. Zhao Y, Hu K, Zhang J, Guo Y, Fan X, Wang Y, et al. Outbreak of carbapenem-resistant Acinetobacter baumannii carrying the carbapenemase OXA-23 in ICU of the eastern Heilongjiang Province, China. BMC Infect Dis. 2019;19(1):452.
https://doi.org/10.1186/s12879-019-4073-5 [DOI:10.1186/s12879-019-4224-8] [PMID] []
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |