Prevalence of High-Risk Antibiotic Resistant Acinetobacter baumannii in the Holy Cities of Makkah and Al-Madinah

Abdulrahman A Al-Sultan

doi:10.2174/1874285802115010145

Abstract

Background: Acinetobacter baumannii strains resistant to carbapenems are a global public health problem. Objectives: The aim of the present study is to evaluate the prevalence of genetic fingerprints associated with Metallo β-lactamases in A. baumannii in addition to the clonal diversity of A. baumannii in Makkah and Al-Madinah regions of Saudi Arabia, which receive a high number of international visitors. Methods: Multi-antibiotic resistant A. baumannii isolates were investigated. Bacterial isolation was conducted employing a basic bacteriological technique after confirming the ID of isolates. The antimicrobial susceptibility test was carried out using the Vitek 2 compact system. The molecular clonal diversity of the isolates was determined by Pulse Field Gel Electrophoresis (PFGE). Clusters were analyzed with BioNumerics software version 6.5. Dice coefficient was used for calculating the similarities. Results: The results indicated resistance in 82.5% of A. baumannii isolates against the carbapenems. All the isolates were found to be sensitive to colistin, while 5% of isolates were resistant to tigecycline. The screening of carbapenem-resistant A. baumannii isolates showed that the dissemination of imipenem and meropenem resistance was 81 and 84%, respectively, while the majority of the strains were susceptible to tigecycline and colistin. The blaOXA and blaVIM were the most encountered genes in A. baumannii isolates, while ISAba1 was the prominent insertion sequence. The genetic fingerprinting results (PFGE) revealed two types of epidemic clones: monoclonal and polyclonal models of 17 clusters. Conclusion: The current investigation indicates the diversity in genetic fingerprints of carbapenem-resistant A. baumannii in Makkah and Al-Madinah region of Saudi Arabia, and that two types of epidemic clones are present. It has also been demonstrated that such clones create serious infection dissemination to other parts of the world as heavy pilgrimage traffic is received throughout the year in Makkah and Al-Madinah, especially in the Haj season.

Highlights

Infections resulting from Acinetobacter baumannii continue to receive global attention by researchers, more so as such infections have become extremely difficult to treat
The current investigation indicates the diversity in genetic fingerprints of carbapenem-resistant A. baumannii in Makkah and Al-Madinah region of Saudi Arabia, and that two types of epidemic clones are present
The significant difference in resistance to both imipenem and meropenem by isolates indicates that the isolates are of different strains, and that A. baumannii isolates in circulation carry different genes having multi-antibiotics resistance to the carbapenems

Summary

Introduction

Infections resulting from Acinetobacter baumannii continue to receive global attention by researchers, more so as such infections have become extremely difficult to treat. These infectios have led to an increase in the literature available glob-. Multi-antibiotic resistance includes resistance to the carbapenems, as reported globally by researchers [4 - 6]. The available literature attributes antimicrobial resistance exhibited by this bacterium to a diverse number of genetic determinants, of which OXA-23, OXA-40 and OXA-51 β-lactamases are the most commonly reported genes [1]. There are different types of integrons, with class 1 reported to be the most commonly associated with the spread and emergence of multiantibiotic resistance [18]. Acinetobacter baumannii strains resistant to carbapenems are a global public health problem

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