Abstract
BackgroundNosocomial infections and persistence of multidrug resistant biofilm forming Acinetobacter baumannii in hospitals has made it as a serious problem in healthcare settings worldwide.MethodsA total of 100 A. baumannii clinical isolates from immunocompromised patients hospitalized in ICU were investigated for biofilm formation, the presence of biofilm related genes (bap, ompA, csuE, fimH, epsA, blaPER-1, bfmS, ptk, pgaB, csgA, kpsMII), integron characterization and molecular typing based on REP-PCR.ResultsAll isolates were resistant to three or more categories of antibiotics and considered as multidrug resistant (MDR). A total of 32 isolates were resistant to all tested antibiotics and 91% were extensively drug-resistance (XDR). All isolates were able to produce biofilm and 58% of isolates showed strong ability to biofilm formation. All strong biofilm forming A. baumannii isolates were XDR. All A. baumannii isolates carried at least one biofilm related gene. The most prevalent gene was csuE (100%), followed by pgaB (98%), epsA and ptk (95%), bfmS (92%) and ompA (81%). 98% of isolates carried more than 4 biofilm related genes, simultaneously. Class I integron (67%) was more frequent in comparison with class II (10%) (P < 0.05). The REP-PCR patterns were classified as 8 types (A-H) and 21 subtypes. The A1 (23%) and C1 (15%) clusters were the most prevalent among A. baumannii isolates (P < 0.05). According to the REP-PCR patterns, 23% of all isolates had a clonal relatedness.ConclusionOur study revealed the high frequency of biofilm forming XDR A. baumannii in ICU patients, with a high prevalence of biofilm related genes of csuE and pgaB. It seems that the appropriate surveillance and control measures are essential to prevent the emergence and transmission of XDR A. baumannii in our country.
Highlights
Nosocomial infections and persistence of multidrug resistant biofilm forming Acinetobacter baumannii in hospitals has made it as a serious problem in healthcare settings worldwide
The present study aimed to investigate the biofilm related genes, integron characterization and molecular typing based on REP-PCR in multidrug resistant A. baumannii isolated from immunocompromised patients hospitalized in ICU
Characteristics of isolates Out of 100 A. baumannii isolates, 26% were recovered from sputum, 25% from wound swabs, 24% from blood, 15% from urine and 10% from secretions collected from chest tube
Summary
Nosocomial infections and persistence of multidrug resistant biofilm forming Acinetobacter baumannii in hospitals has made it as a serious problem in healthcare settings worldwide. Zeighami et al BMC Infectious Diseases (2019) 19:629 chaperon-usher pilus (Csu), extracellular exopolysaccharide (EPS), two-component system (BfmS/BfmR), poly-β-(1,6)-N-acetyl glucosamine (PNAG) and quorum sensing system [4, 5]. The 38-kDa outer membrane protein OmpA as major porin of A. baumannii plays an important role in attachment and invasion to epithelial cells via interaction with fibronectin. This protein is involved in serum resistance, biofilm formation and persistence, induction of apoptosis and antimicrobial resistance of A. baumannii [1, 4, 8]. The extracellular polysaccharide poly-β-(1,6)-N-acetyl glucosamine (PNAG) is involved in biofilm formation, virulence, immune evasion and antibiotic resistance [9]
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