Molecular Characterisation of Carbapenemase-Producing Acinetobacter baumannii isolates from Hospitalised Patients in Iraq

Abstract

Carbapenem-resistant Acinetobacter baumannii has been considered one of the major threats to patients worldwide. To evaluate carbapenemase in several clinical isolates using phenotypic and genotypic approaches. A total of 49 A. baumannii isolates were tested against imipenem and meropenem discs on Muller Hinton agar, then screened phenotypically through the modified Hodge test (MHT), combined disc test (CDT) and modified carbapenem inactivation method (mCIM). The tested isolates have been subjected to polymerase chain reaction (PCR) detection to identify some carbapenemase-encoding genes and one insertion sequence. The carbapenem resistance profile showed 96% and 94% resistance to imipenem and meropenem, respectively. MHT and mCIM were able to produce carbapenemase in 94% and 98% of isolates, respectively, while CDT was able to produce metallo-B-lactamase (MBL) only in 59.2% of isolates. The PCR amplification of blaOXA-51 has been observed in all isolates. We found blaOXA-23 in 98% of isolates. Insertion sequence ISAba1 was present in all positive blaOXA-23 strains (98%). A blaVIM gene encoding MBL was present in 71% of isolates, but none of the isolates has been positive for blaKPC and blaNDM. The high rate of carbapenem resistance in A. baumannii became a serious threat worldwide. Concerning phenotypic tests, mCIM was the most sensitive compared to MHT and CDT. This study established that blaOXA-23 and blaOXA-51 have been the most prevalent among class D carbapenemase, and blaVIM among class B carbapenemase. The present study suggests that there might be silent carbapenemase genes in carbapenem-sensitive strains.