Abstract
We aimed to identify the virulence and antimicrobial resistance features in Carbapenem Resistant Acinetobacter baumannii (CRAB) strains isolated from hospital settings and compare them with those isolated in the same period of time from community acquired (CA) infections in Bucharest, south of Romania. A total number of 93 A. baumannii strains were isolated in majority from hospitalized patients and from CA infections. The resistance and virulence mechanisms of the strains were characterized by phenotypic and genotypic methods. The antibiotic resistance profiles in H and CA A. baumannii isolates revealed high percentages of carbapenem-resistance in both H and CA isolates. The ciprofloxacin resistance was found very closed in both types of isolates (84%/83.33%). CRAB H and CA isolates revealed the intrinsec carbapenemase OXA-51and the acquired carbapenemases OXA-23, OXA-24, IMP,and VIM-2. The blaOXA-23 gene was identified in different plasmid types (GR2-Aci1, GR6-pACICU2). rep135040, p3S18 and Aci6 in H A. baumannii isolates. The most frequently expressed virulence factor was lipase and DN-ase. OXA-51-like alleles corresponding to the two main sequence groups were identified as blaOXA66 (63.63% of the isolates) and respectively, blaOXA-69 (38.39%) and revealed the corresponding type of ompAand csuE sequence grouping. AphA6 (24%/16.6%), AphA1 (16%/16.6%) and aadB (9.3%/5.5%) genes were responsible for aminoglycosides resistance. Our survey revealed a high drug resistance in A. baumannii isolates. Different plasmid groups containing CRAB isolates may facilitate the blaOXA23 dissemination. Keywords: carbapenem resistance, virulence, community acquired, nosocomial infections
Highlights
Isolates in RomaniaWe aimed to identify the virulence and antimicrobial resistance features in Carbapenem Resistant Acinetobacter baumannii (CRAB) strains isolated from hospital settings and compare them with those isolated in the same period of time from community acquired (CA) infections in Bucharest, south of Romania
Acinetobacter baumannii is recognized as an opportunistic nosocomial pathogen, mainly in immunocompromised patients being frequently associated with therapeutic failures, due to its multi-drug (MDR), extended-drug (XDR) or even pan-drug resistance (PDR) phenotypes
Numerous potential virulence factors have been revealed in A. baumannii strains, including biofilm formation [several factors contribute to biofilm formation such as the Csu pili [11] encoded by csuE gene, the autoinducer synthase AbaI, part of the quorum sensing (QS) system [12], the outer membrane protein A which facilitates the adhesion to host epithelial cells], complement resistance [13], iron acquisition characteristics, capsule, outer membrane protein phospholipases, alteration in penicillin-binding proteins [14]
Summary
We aimed to identify the virulence and antimicrobial resistance features in Carbapenem Resistant Acinetobacter baumannii (CRAB) strains isolated from hospital settings and compare them with those isolated in the same period of time from community acquired (CA) infections in Bucharest, south of Romania. Numerous potential virulence factors have been revealed in A. baumannii strains, including biofilm formation [several factors contribute to biofilm formation such as the Csu pili [11] encoded by csuE gene, the autoinducer synthase AbaI, part of the quorum sensing (QS) system [12], the outer membrane protein A (encoded by OmpA gene) which facilitates the adhesion to host epithelial cells], complement resistance [13], iron acquisition characteristics, capsule, outer membrane protein phospholipases, alteration in penicillin-binding proteins [14]. We are interested in identifying the relationship between virulence and antimicrobial resistance in CRAB strains from both hospital settings and the community, the ARGs, their transfer and dissemination into the community
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