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Abstract
There is mounting evidence that Acinetobacter baumannii has a naturally occurring carbapenemase gene intrinsic in this species. Presence of class 1 integrase gene in Acinetobacter isolates is a useful marker for causing outbreaks in hospitals and for being epidemic strains of A. baumannii. The goal of the present study was to detect the resistance and outbreak marker genes by multiplex polymerase chain reaction (PCR) (blaOXA-51-like gene and class 1 integrase gene). Also to detect the correlation between imipenem susceptibility and detection of blaOXA-51-like gene. For these purposes, 51 consecutive, non-duplicate, A. baumanii strains were isolated from various clinical and environmental specimens from the Intensive Care Units (ICUs) of Assiut University Hospitals, Egypt. All the isolates were identified by conventional standard methods. The antibiotic sensitivity pattern was determined by Kirby Bauer disc diffusion method. For imipenem, the minimum inhibitory concentrations (MICs) were determined using Epsilometer (E test). Multiplex PCR was performed for the detection of the blaOXA-51-like and Class I integrase genes. The blaOXA-51-like gene was detected in (95.8%) and (96.3%) in clinical and environmental isolates, respectively. Class I integrase gene was detected in (75%) and (70.3%) in clinical and environmental isolates, respectively with statistically significant difference (P value of clinical samples = 0.041 and P value of environmental samples =0.011). This means that these strains have metallo-beta-lactamase (MBL) gene (cause outbreak in hospital at any time). Also (67.35%) of A. baumanii isolates are imipenem sensitive and positive for blaOXA-51-like gene and this means that these isolates contain hidden metallo beta lactamase MBL gene. Key words: Acinetobacter baumanii, blaOXA-51-like genes, Class I integrasegene, MBL gene. 
Highlights
Acinetobacter baumannii is an important opportunistic pathogen responsible for severe nosocomial infections, especially in intensive-care-unit patients (Takagi et al., 2009)
The majority of infections are of epidemic origin, and treatment has become difficult because many strains are resistant to a wide range of antibiotics, including broad-spectrum β-lactams, aminoglycosides, and fluoroquinolones (Renu et al, 2010)
Detection of blaoxa-51-like gene and Class I intgrase gene showed that (95.8%) and (96.3%) of A. baumannii isolated from clinical and environmental samples respectively gave positive result for blaoxa-51-like gene while (75%) and (70.3%) of A
Summary
Acinetobacter baumannii is an important opportunistic pathogen responsible for severe nosocomial infections, especially in intensive-care-unit patients (Takagi et al., 2009). Carbapenems are the drugs of choice for A. baumannii infections and are often used as a last resort. There are several carbapenem resistance mechanisms described in Acinetobacter species (Peleg et al, 2008). Many carbapenem hydrolyzing beta- lactamases have been identified, amongst which are the metallo-betalactamases (MBLs). Most of the MBL-encoding genes reside on integrons and plasmids which in turn allows for the widespread dissemination of these genetic elements (Walsh et al, 2005; Perez et al, 2007)
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