Antimicrobial resistance pattern and molecular epidemiology of ESBL and MBL producing Acinetobacter baumannii isolated from hospitals in Minia, Egypt

ABSTRACT

Introduction: Multidrug resistant (MDR) Acinetobacter baumanii (A. baumannii) strains have emerged as novel nosocomial pathogens threatening patients’ lives, especially in intensive-care units (ICUs). This study aims to determine the prevalence of carbapenemase genes and CTX-M-15 and the resistance pattern of carbapenemase producing isolates.Methods: A total of 530 clinical specimens were collected from patients suffering from different infections, antibiotic susceptibility test was performed using kirby-bauer disk diffusion method. ESβL production was detected phenotypically by double-disc synergy test (DDST). Carbapenemase production was tested by Modified Hodge Test (MHT). Then, these isolates were tested for MBL detection by disc potentiation test. Carbapenemase encoding genes (VIM, IMP, GIM and SPM, OXA-51, OXA-23 and OXA-143) and CTX-M-15 were tested by polymerase chain reaction (PCR).Results: Out of 530 samples, 20 bacterial isolates were identified as A. baumannii from different infectious cases, 35% of isolates were ESBL-producers. Eleven isolates were resistant to imipenem (4 isolates) and meropenem (7 isolates). All carbapenem resistant isolates were MHT positive. Nine (45%) isolates were confirmed as A. baumannii by OXA-51 (all were carbapenem resistant). Distribution of IMP, VIM, GIM and SPM, OXA-23, OXA-143 and CTX-M-15 by PCR were 55, 50, 50, 25, 35, 45 and 33% respectively.Conclusion: The high prevalence of resistance genes and the resistance pattern of the isolates indicate that the detection of ESBLs and MBLs phenotypically and genotypically with the study of the resistance pattern of the isolates is critically important for the surveillance of drug resistance in the hospital environment.

KEYWORDS:

• Multidrug resistant Acinetobacter baumanii
• ESBLs
• MBLs
• carbapenemase gene

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sector

Notes on contributors

Rehab M. Abd El-Baky

Rehab M. Abd El-Baky is a Associate professor of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Mnia, Egypt and the Head of Microbiology and Immunology Department, Faculty of Pharmacy, Deraya University, Minia, Egypt. Specialize in studying the Virulence factors of Bacteria and antimicrobial resistance mechanisms.

Sara M. Farhan

Sara M. Farhan is a Postgraduate students and a demonstrator in the Microbiology and Immunology Department, Faculty of Pharmacy, Deraya University, Minia, Egypt.

Reham A. Ibrahim

Reham A. Ibrahim is a Lecturer of Microbiology and Immunology, Faculty of Pharmacy, Miinia University, Minia, Egypt and specialize in studying the epidemiology of infectious diseases and the mechanisms of antimicrobial resistance.

Khaled M. Mahran

Khaled M. Mahran is a Professor of General Surgery and Laparoscopic surgery, Faculty of Medicine, Minia University, Minia 61519 Egypt

Helal F. Hetta

Helal F. Hetta is a Lecturer of Microbiology and Immunology, Faculty of Pharmacy, Assuit University, Assuit, Egypt and a postdoctoral fellow in the Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA, specialize in Medical Virology and Immunology.