Abstract
It has previously been shown that carbapenem-resistant Acinetobacter baumannii are frequently detected in Saudi Arabia. The present study aimed to identify the epidemiology and distribution of antibiotic resistance determinants in these bacteria. A total of 83 A. baumannii isolates were typed by pulsed-field gel electrophoresis (PFGE), and screened by PCR for carbapenemase genes and insertion sequences. Antibiotic sensitivity to imipenem, meropenem, tigecycline, and colistin were determined. Eight different PFGE groups were identified, and were spread across multiple hospitals. Many of the PFGE groups contained isolates belonging to World-wide clone 2. Carbapenem resistance or intermediate resistance was detected in 69% of isolates. The blaVIM gene was detected in 94% of isolates, while blaOXA–23–like genes were detected in 58%. The data demonstrate the co-existence and wide distribution of a number of clones of carbapenem-resistant A. baumannii carrying multiple carbapenem-resistance determinants within hospitals in the Eastern Region of Saudi Arabia.
Highlights
A number of recent studies have identified high levels of carbapenem resistance in isolates of Acinetobacter baumannii from Saudi Arabia (Alsultan et al, 2013; Abdalhamid et al, 2014; Aly et al, 2014)
There was a significant difference in the diabetic status of the patients between the individual pulsed-field gel electrophoresis (PFGE) groups (Kruskal Wallis, χ2 = 26.32, d.f. = 7, p = 0.0024 following correction), with isolates from diabetic patients being in the majority in PFGE groups B, D, and H (Figure 1)
A. baumannii isolates from hospitals in the Eastern District of Saudi Arabia were examined to identify their mechanisms of resistance to the carbapenems and their local epidemiology, both within the hospitals and the District
Summary
A number of recent studies have identified high levels of carbapenem resistance in isolates of Acinetobacter baumannii from Saudi Arabia (Alsultan et al, 2013; Abdalhamid et al, 2014; Aly et al, 2014). These studies have demonstrated that a large number of different genetic lineages within a hospital are resistant to the carbapenems, rather than there being the predominance of a single epidemic clone (Abdalhamid et al, 2014; Aly et al, 2014) These isolates often belong to widespread clonal lineages (Zarrilli et al, 2013). A recent study carried out in Abu Dhabi, United Arab Emirates, that borders Saudi Arabia, identified a diverse range of isolates, with even the epidemic isolates belonging to multiple PFGE pulsotypes and genotypes (Sonnevend et al, 2013)
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