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

Figures & data

Table 1. List of primers used in this study

Genes	Primers	Sequences	Product size (bp)
blaVIM	VIM-F VIM-R	5'-GATGGTGTTTGGTCGCATA-3' 5'-CGAATGCGCAGCACCAG-3'	390-bp
blaIMP	IMP-F IMP-R	5'GGAATAGAGTGGCTTAATTCTC3' 5'-CCAAACCACTACGTTATCT-3'	188-bp
blaGIM	GIM-F GIM-R	5'-TCGACACACCTTGGTCTGAA3' 5'-AACTTCCAACTTTGCCATGC-3'	477-bp
blaSPM	SPM-F SPM-R	5'-AAAATCTGGGTACGCAAA CG-3'5'-ACATTATCCGCTGGAACAGG-3'	271-bp
OXA-51	Forward Reverse	5'-TAATGCTTTGATCGGCCTTG-3' 5' TGGATTGCACTTCATCTTGG-3'	353 bp
OXA-23	Forward Reverse	5'-GATCGGATTGGAGAACCAGA-3' 5'-ATTTCTGACCGCATTTCCAT-3'	501 bp
OXA-143	Forward Reverse	+5'-TGGCACTTTCAGCAGTTCCT-3' 5' TAATCTTGAGGGGGCCAACC-3'	149 bp

Table 2. Prevalence of A. baumannii isolated from different patients in relation to the type of infections

Type of infection	No. of samples	No. of A. baumanii isolates	% of A.baumanii
Wound infections	332	16	4.8
Ear infections	57	-	-
Burns	26	1	3.8
Urinary tract infections	30	-	-
Chest infections	12	-	-
Gastro-enteritis	35	-	-
Patients attended in Intensive care unit(from buccal cavity, skin swab and eye swab)	38	3	7.8
Total	530	20	3.8

Figure 1. Antibiotic resistance pattern of the isolated Acinetobacter baumannii.

Table 3. Distribution of ESBLs and MBL production among A. baumannii strain

		ESBLs		MBL
Type of infection	Resistant A.baumannii to β-lactams	No.	%	No.	%
Wound infections	16	5	31.3	9	56.25
Burns	1	-	-	1	100
Patients reisdent in Intensive care unit(from buccal cavity, skin swab and eye swab)	3	2	66.7	1	33.3
Total	20	7	35	11	55

Table 4. Distribution of the tested genes of ESBLs (CTX-M-15), Class B carbapenemases, Class D carbapenemases among the isolated A. baumannii, their resistance pattern and source of samples

		Class Dβ-lactamases Oxacillinase genes			Class B β-lactamases Carbapenemase genes
Acinetobacter baumannii isolates 2	CTX-M-15	OXA-51	OXA-23	OXA-143	bla-IMP	bla-VIM	bla-GIM	bla-SPM	Resistance pattern	Source of sample
Ac 1	-(ESBLs +)	+	+	+	−	−	−	−	Azetreonam, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic, Gentamicin, Amikacin, Piperacillin, Ceftazidime, Cefoperazone, Colistin sulfate	Wound
Ac 2	−	−	−	−	−	−	−	−	Piperacillin, Azlocillin Ampicillin/sulbactam, Amoxicillin/clavulanic, cefepim, Ceftazidime, Cefoperazone	Wound
Ac 3	−	−	−	−	+	+	+	−	Imipenem, Piperacillin, Azetreonam, Azlocillin Ampicillin/sulbactam, Amoxicillin/clavulanic	Wound
Ac 4	+ (ESBL +)	+	−	+	−	−	−	−	Meropenem, Azetreonam, Azlocillin, piperacillin, Ampicillin/sulbactam Amoxicillin/clavulanic, Ceftazidime, Cefoperazone Cefepime, Levofloxacin, Polymyxin B	ICU
Ac 5	−	−	−	−	+	+	−	−	Pipercillin, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic	Wound
Ac 6	−	−	−	−	−	−	−	−	Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic	Wound
Ac 7	−	+	+	+	+	−	+	+	Meropenem, Imipenem, Azetreonam, Azlocillin Ampicillin/sulbactam,Amoxicillin/clavulanic, Piperacillin, Gentamicin, Amikacin, Ciprofloxacin, Cefoperazone, Cefepime, Levofloxacin,Colistin sulfate	Burn
Ac 8	−	+	+	+	−	−	−	−	Gentamicin, Amikacin, Azetreonam, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic, Piperacillin, Ceftazidime, Tigecycline	Wound
Ac 9	+ (ESBLs)	−	−	−	+	+	+	+	Meropenem, Azlocillin Ampicillin/sulbactam, Amoxicillin/clavulanic, piperacillin	Wound
Ac 10	−	−	−	−	−	−	−	−	Gentamicin, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic, Ceftazidime, Cefoperazone	Wound
Ac 11	+ (ESBL+)	+	+	+	+	+	+	+	Meropenem, Imipenem, Azetreonam, Azlocillin, Ampicillin/sulbactam, cefepim, Amoxicillin/clavulanic, Piperacillin, Polymyxin B, Ceftazidime, Gentamicin, Amikacin, Ciprofloxacin, Levofloxacin, Cefoperazone, carbenicillin, Tobramycin	ICU
Ac 12	−	−	−	−	+	+	+	−	Azlocillin, Azetreonam, Ampicillin/sulbactam, Amoxicillin/clavulanic, piperacillin	Wound
Ac 13	−	+	−	+	+	+	+	−	Meropenem, Azetreonam, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic, Piperacillin, Ceftazidime, Ciprofloxacin	Wound
Ac 14	+ (ESBL+)	+	+	+	+	+	+	−	Meropenem, Azetreonam, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic, Piperacillin, Gentamicin, Amikacin, Ceftazidime, Ciprofloxacin, Cefoperazone, Levofloxacin, Tigecycline, carbenicillin, tobramycin, cefepim	Wound
Ac 15	−	−	−	−	+	+	+	+	Meropenem, Azetreonam, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic	Wound
Ac 16	−	−	−	−	+	+	+	+	Gentamicin, Azetreonam, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic	Wound
Ac 17	+ (ESBLs+)	+	+	+	+	+	+	−	Meropenem, Azetreonam, Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic Ciprofloxacin, Piperacillin, Cefoperazone, Cefepime, Imipenem, Colistin sulfate	Wound
Ac 18	−	−	−	−	−	−	−	−	Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic, Ceftazidime, Cefoperazone, tobramycin, cefepim	Wound
Ac 19	+ (ESBL+)	+	+	+	−	−	−	−	Gentamicin, Amikacin, Azetreonam, Azlocillin, Ampicillin/sulbactam Amoxicillin/clavulanic, Piperacillin, Ceftazidime, Ciprofloxacin Cefoperazone, Cefepime,Tigecycline	ICU
Ac 20	−	−	−	−	−	−	−	−	Azlocillin, Ampicillin/sulbactam, Amoxicillin/clavulanic Ceftazidime, Cefoperazone, tobramycin, cefepim	Wound

Figure 2. PCR amplicons of A. baumannii strains CTX-M-15 gene. Lanes order is as follows: marker (100 bp); isolates number

Figure 3. PCR amplicons of carbapenemases encoding genes in A. baumannii strains

A: IMP gene. B: VIM gene C:SPM gene D:GIM gene

Figure 4. PCR amplicons of Oxa carbapenemase in A. baumannii strains

(a) OXA-143 gene; (B) OXA-51gene.; (c) OXA- 23 gene