Abstract
BACKGROUND Acinetobacter baumannii is a leading cause of nosocomial infections. This species is characterised by the presence of pandemic lineages (International Clones) that present a broad antimicrobial resistance profile.OBJECTIVE To perform the molecular epidemiology of carbapenem-resistant A. baumannii from a clinical setting in the Amazon Basin, and to characterise their antimicrobial resistance determinants.METHODS The genetic relationship of carbapenem-resistant A. baumannii were assessed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Class A, B and D β-lactamase genes were screened by polymerase chain reaction (PCR) and sequencing. The antimicrobial susceptibility profile was obtained by Disc-diffusion method and minimum inhibitory concentration (MIC) determination.FINDINGS All carbapenem-resistant A. baumannii strains belonged to three international clones, IC-1, IC-5 and IC-6, the latter recently reported by the first time in Brazil. The major determinant of carbapenem resistance in IC-1 and IC-5 strains was bla OXA-23, associated with ISAba1 and ISAba3, respectively, while IC-6 harboured the bla OXA-72.CONCLUSIONS The A. baumannii epidemiology in Brazilian Amazon Region was unknown. It was demonstrated that A. baumannii XDR international clones were responsible for nosocomial infections in Boa Vista during 2016-2018, revealing that the epidemiological scenario of A. baumannii infections in Amazon Region resembles those from the cosmopolitan regions worldwide.
Highlights
Acinetobacter baumannii is a leading cause of nosocomial infections
Acinetobacter baumannii has emerged in recent years as a leading cause of nosocomial infections associated with a longer hospital stay and higher mortality, representing a public health problem of major concern worldwide.[1]. A. baumannii presents the long-term ability to survive on inanimate surfaces, and this persistence seems to contribute to its person-to-person transmission, intra- and inter-hospital outbreak spread, and national and international clonal dissemination.[2] this species is characterised by remarkable capabilities for the acquisition of antibiotic resistance genes (ARGs). [3] High-risk pandemic lineages, named international clones (ICs), presenting high capacity to persist in clinical environments and a broad antimicrobial resistance profile have been associated with outbreaks in several cosmopolitan regions around the world.[4,5]
The ST1PAS/ST109OXF (Clone C; n = 9), ST79PAS/ST758OXF (Clone A; n = 12) and ST78PAS/ ST944OXF (Clone B; n = 6), corresponded to the highrisk pandemic International Clone I (IC-1), International Clone V (IC-5) and International Clone VI (IC-6), respectively (Table).(20,26,27,28,29) Previous studies had already reported the dissemination and the high prevalence of multidrug resistant A. baumannii from CC1 (ST1/IC-1), CC15 (ST180) and CC79 (ST79/IC-5) in Brazil.[9,10,11] Here, it was demonstrated that CC1 and CC79 are prevalent in a clinical setting from the Amazon Region (Table)
Summary
Acinetobacter baumannii is a leading cause of nosocomial infections. This species is characterised by the presence of pandemic lineages (International Clones) that present a broad antimicrobial resistance profile. OBJECTIVE To perform the molecular epidemiology of carbapenem-resistant A. baumannii from a clinical setting in the Amazon Basin, and to characterise their antimicrobial resistance determinants.
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