We investigated the distribution of resistance genes and the clonal relationships among carbapenem-resistant Acinetobacter baumannii isolates from the intensive care unit wards of two hospitals in Guangzhou, China. From 2012 to 2013, 57 A. baumannii isolates were obtained from blood cultures from two hospitals in Guangzhou. The antibiotic resistance profiles were determined by using the Vitek2 system and Etest strips. PCR was used to detect the genes encoding OXA-type carbapenemases and metallo-β-lactamases and the presence of ISAba1 upstream of the blaOXA-51-like gene and the blaOXA-23-like gene. Multilocus sequence typing (MLST) and sequence-based typing of blaOXA-51-like genes (SBT-blaOXA-51-like genes) were performed to analyze the genetic relationship of the isolates. Among the 57 isolates, 46 were carbapenem-resistant A. baumannii (CRAB) isolates. The blaOXA-51-like gene was identified in all 57 isolates, while the blaOXA-23-like gene was present in all 46 CRAB isolates. The MLST analysis grouped the A. baumannii isolates into five existing sequence types (STs) and five new STs. Fifty-two isolates belonged to the worldwide spread of clonal complex 92 (CC92), among which ST195 and ST365 were the most common STs. The MLST data and SBT-blaOXA-51-like genes showed that all isolates harboring the major blaOXA-51-like alleles, such as blaOXA-66, belonged to CC92.
Get full access to this article
View all access options for this article.
References
1.
AlyM., TayebH.T., Al JohaniS.M., AlyamaniE.J., AldughaishemF., AlabdulkarimI., and BalkhyH.H.2014. Genetic diversity of OXA-51-like genes among multidrug-resistant Acinetobacter baumannii in Riyadh, Saudi Arabia. Eur. J. Clin. Microbiol. Infect. Dis., 33:1223–1228.
2.
BartualS.G., SeifertH., HipplerC., LuzonM.A., WisplinghoffH., and Rodriguez-ValeraF.2005. Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii. J. Clin. Microbiol., 43:4382–4390.
3.
ChangH.C., WeiY.F., DijkshoornL., VaneechoutteM., TangC.T., and ChangT.C.2005. Species-level identification of isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex by sequence analysis of the 16S-23S rRNA gene spacer region. J. Clin. Microbiol., 43:1632–1639.
4.
Clinical and Laboratory Standards Institute (CLSI). 2013. Performance Standards for Antimicrobial Susceptebility Testing: Twenty-Third Informational Supplement, M100-S23, Wayne, PA.
5.
DengM., ZhuM.H., LiJ.J., BiS., ShengZ.K., HuF.S., ZhangJ.J., ChenW., XueX.W., ShengJ.F., and LiL.J.2014. Molecular epidemiology and mechanisms of tigecycline resistance in clinical isolates of Acinetobacter baumannii from a Chinese university hospital. Antimicrob. Agents Chemother., 58:297–303.
6.
DijkshoornL., NemecA., and SeifertH.2007. An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii. Nat. Rev. Microbiol., 5:939–951.
7.
EllingtonM.J., KistlerJ., LivermoreD.M., and WoodfordN.2007. Multiplex PCR for rapid detection of genes encoding acquired metallo-beta-lactamases. J. Antimicrob. Chemother., 59:321–322.
8.
EvansB.A., HamoudaA., TownerK.J., and AmyesS.G.2008. OXA-51-like beta-lactamases and their association with particular epidemic lineages of Acinetobacter baumannii. Clin. Microbiol. Infect., 14:268–275.
9.
FeilE.J., LiB.C., AanensenD.M., HanageW.P., and SprattB.G.2004. eBURST: inferring patterns of evolutionary descent among clusters of related bacterial genotypes from multilocus sequence typing data. J. Bacteriol., 186:1518–1530.
10.
FuY., ZhouJ., ZhouH., YangQ., WeiZ., YuY., and LiL.2010. Wide dissemination of OXA-23-producing carbapenem-resistant Acinetobacter baumannii clonal complex 22 in multiple cities of China. J. Antimicrob. Chemother., 65:644–650.
11.
HamoudaA., EvansB.A., TownerK.J., and AmyesS.G.2010. Characterization of epidemiologically unrelated Acinetobacter baumannii isolates from four continents by use of multilocus sequence typing, pulsed-field gel electrophoresis, and sequence-based typing of bla(OXA-51-like) genes. J. Clin. Microbiol., 48:2476–2483.
12.
HeC., XieY., ZhangL., KangM., TaoC., ChenZ., LuX., GuoL., XiaoY., DuoL., and FanH.2011. Increasing imipenem resistance and dissemination of the ISAba1-associated blaOXA-23 gene among Acinetobacter baumannii isolates in an intensive care unit. J. Med. Microbiol., 60:337–341.
13.
HuangL., SunL., and YanY.2013. Clonal spread of carbapenem resistant Acinetobacter baumannii ST92 in a Chinese Hospital during a 6-year period. J. Microbiol., 51:113–117.
14.
KimD.H., ChoiJ.Y., KimH.W., KimS.H., ChungD.R., PeckK.R., ThamlikitkulV., SoT.M., YasinR.M., HsuehP.R., CarlosC.C., HsuL.Y., BuntaranL., LalithaM.K., SongJ.H., and KoK.S.2013. Spread of carbapenem-resistant Acinetobacter baumannii global clone 2 in Asia and AbaR-type resistance islands. Antimicrob. Agents Chemother., 57:5239–5246.
15.
LiY., PanC., ZhaoZ., ZhaoZ., ChenH., and LuW.2013. Effects of a combination of amlodipine and imipenem on 42 clinical isolates of Acinetobacter baumannii obtained from a teaching hospital in Guangzhou, China. BMC Infect. Dis., 13:548–556.
16.
ManageiroV., Jones-DiasD., FerreiraE., LouroD., and CanicaM.2012. Genetic diversity and clonal evolution of carbapenem-resistant Acinetobacter baumannii isolates from Portugal and the dissemination of ST118. Int. J. Antimicrob. Agents., 40:398–403.
17.
PournarasS., GogouV., GiannouliM., DimitrouliaE., DafopoulouK., TsakrisA., and ZarrilliR.2014. Single-locus-sequence-based typing of blaOXA-51-like genes for rapid assignment of Acinetobacter baumannii clinical isolates to international clonal lineages. J. Clin. Microbiol., 52:1653–1657.
18.
RuanZ., ChenY., JiangY., ZhouH., ZhouZ., FuY., WangH., WangY., and YuY.2013. Wide distribution of CC92 carbapenem-resistant and OXA-23-producing Acinetobacter baumannii in multiple provinces of China. Int. J. Antimicrob. Agents., 42:322–328.
19.
TadaT., Miyoshi-AkiyamaT., KatoY., OhmagariN., TakeshitaN., HungN.V., PhuongD.M., ThuT.A., BinhN.G., AnhN.Q., NgaT.T., TruongP.H., XuanP.T., ThuL.T., SonN.T., and KirikaeT.2013. Emergence of 16S rRNA methylase-producing Acinetobacter baumannii and Pseudomonas aeruginosa isolates in hospitals in Vietnam. BMC Infect. Dis., 13:251–256.
20.
TadaT., Miyoshi-AkiyamaT., ShimadaK., ShimojimaM., and KirikaeT.2014. Dissemination of 16S rRNA methylase ArmA-producing Acinetobacter baumannii and emergence of OXA-72 carbapenemase coproducers in Japan. Antimicrob. Agents Chemother., 58:2916–2920.
21.
TurtonJ.F., WardM.E., WoodfordN., KaufmannM.E., PikeR., LivermoreD.M., and PittT.L.2006. The role of ISAba1 in expression of OXA carbapenemase genes in Acinetobacter baumannii. FEMS Microbiol. Lett., 258:72–77.
22.
ViscaP., SeifertH., and TownerK.J.2011. Acinetobacter infection-an emerging threat to human health. IUBMB Life, 63:1048–1054.
23.
Vranić-LadavacM., BedenićB., MinandriF., IštokM., BošnjakZ., Frančula-ZaninovićS., LadavacR., and ViscaP.2013. Carbapenem resistance and acquired class D beta-lactamases in Acinetobacter baumannii from Croatia 2009–2010. Eur. J. Clin. Microbiol. Infect. Dis., 33:471–478.
24.
Walther-RasmussenJ., and HoibyN.2006. OXA-type carbapenemases. J. Antimicrob. Chemother., 57:373–383.
25.
WangH., GuoP., SunH., WangH., YangQ., ChenM., XuY., and ZhuY.2007. Molecular epidemiology of clinical isolates of carbapenem-resistant Acinetobacter spp. from Chinese hospitals. Antimicrob. Agents Chemother., 51:4022–4028.
26.
WangX., QiaoF., YuR., GaoY., and ZongZ.2013. Clonal diversity of Acinetobacter baumannii clinical isolates revealed by a snapshot study. BMC Microbiol., 13:234–241.
27.
WangY., and XuY.C.2007. CHINET surveillance of antimicrobial resistance among A. baumannii isolates in China during 2004–2005. Chin. J. Infect. Chemother., 7:279–282.
28.
WoodfordN., EllingtonM.J., CoelhoJ.M., TurtonJ.F., WardM.E., BrownS., AmyesS.G., and LivermoreD.M.2006. Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int. J. Antimicrob. Agents., 27:351–353.
29.
ZanderE., NemecA., SeifertH., and HigginsP.G.2012. Association between beta-lactamase-encoding bla(OXA-51) variants and DiversiLab rep-PCR-based typing of Acinetobacter baumannii isolates. J. Clin. Microbiol., 50:1900–1904.
30.
ZhangH., ZhangX.J., and XUY.C.2013. CHINET 2011 surveillance of antibiotic resistance in A. baumannii isolates in China. Chin. J. Infect. Chemother., 13:342–348.
31.
ZhangJ.P., ZhuW., TianS.F., ChuY.Z., and ChenB.Y.2010. Molecular characteristics and resistant mechanisms of imipenem-resistant Acinetobacter baumannii isolates in Shenyang, China. J. Microbiol., 48:689–694.
32.
ZhongQ., XuW., WuY., and XuH.2012. Clonal spread of carbapenem non-susceptible Acinetobacter baumannii in an intensive care unit in a teaching hospital in China. Ann. Lab. Med., 32:413–419.
