Prevalence Study of Aminoglycoside-Resistance Genes in Acinetobacter Baumannii Isolated from the Patients in Intensive Care Unit

Document Type : Original Article (s)

Authors

1 Research Assistant, Department of Microbiology, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Assistant Professor, Department of Anesthesiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Associate Professor, Department of Infectious Diseases, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Department of Microbiology, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

Background: Acinetobacter baumanniii is a highly antibiotic-resistant nosocomial opportunistic pathogen possess. This study aimed to assess the antibiotic-resistance pattern and detect the molecular frequency of aphA6 and aadB genes in Acinetobacter baumannii isolated from patients in intensive care unit (ICU).Methods: In this cross-sectional study, 58 Acinetobacter baumannii isolates collected from ICU patients in Imam Reza hospital, Kermanshah, Iran, were confirmed using standard bacteriological tests. Disc diffusion method was deployed for screening resistant isolates. The prevalence of aphA6 and aadB genes was assessed using polymerase chain reaction (PCR) method with specific primers.Findings: The highest antibiotic resistance rates were seen in ticarcilin (87.9%) and ceftazidime (86.2%) and the lowest was of polymyxin B (12.1%). Of 58 Acinetobacter isolates, 36 (62.1%) and 9 (15.5%) harbored aphA6 and aadB genes, respectively. In addition, 5 isolates (8.6%) harbored both genes and 18 isolates (31.3%) were negative for any of those genes.Conclusion: 80% of Acinetobacter isolates showed resistance to aminoglycoside antibiotics. Considering the high rates of antibiotic resistance to this category and other investigated antibiotics in this study, it seems necessary to precise on the use of antibiotics such as polymyxin B to treat the infections caused by this pathogen.

Keywords


  1. Ghajavand H, Havaei A, Nasr Esfahani B, Fazeli H, Moghim S. Frequency of multi drug resistance acinetobacter baumannii isolates in intensive care units (ICU) of Isfahan hospitals, Iran, via molecular method and their antimicrobial resistance patterns. J Isfahan Med Sch 2014; 32(295): 1175-85. [In Persian].
  2. Babay HA, Kambal AM, Al-Anazy AR, Saidu AB, Aziz S. Acinetobacter blood stream infection in a teaching hospital- Riyadh, Saudi Arabia. Kuwait Med J 2003; 35(3): 196-201.
  3. Bendinelli M, Friedman H, Bergogne-Berezin E. Acinetobacter biology and pathogenesis. New York, NY: Springer; 2008. p. 1, 14, 120-4.
  4. Yousefian R, Karbasizade V, Moghim S. Identification and frequency of colistin-resistant Acintobacter baumanii in clinical isolates using polymerase chain reaction. J Isfahan Med Sch 2014; 32(301): 1466-74. [In Persian].
  5. Valentine SC, Contreras D, Tan S, Real LJ, Chu S, Xu HH. Phenotypic and molecular characterization of Acinetobacter baumannii clinical isolates from nosocomial outbreaks in Los Angeles County, California. J Clin Microbiol 2008; 46(8): 2499-507.
  6. Chiu CH, Lee HY, Tseng LY, Chen CL, Chia JH, Su LH, et al. Mechanisms of resistance to ciprofloxacin, ampicillin/sulbactam and imipenem in Acinetobacter baumannii clinical isolates in Taiwan. Int J Antimicrob Agents 2010; 35(4): 382-6.
  7. Hujer KM, Hujer AM, Hulten EA, Bajaksouzian S, Adams JM, Donskey CJ, et al. Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. Antimicrob Agents Chemother 2006; 50(12): 4114-23.
  8. Jafari R, Karbasizade V, Moghim Sh. Frequency and resistance patterns of bacterial isolates from burn wounds infections in Isfahan, Iran. J Isfahan Med Sch 2013; 31(246): 1134-40. [In Persian].
  9. Nemec A. Multidrug resistant Acinetobacter baumannii. Klin Mikrobiol Infekc Lek 2008; 14(5): 162-7. [In Czech].
  10. Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis 2006; 42(5): 692-9.
  11. Poirel L, Nordmann P. Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clin Microbiol Infect 2006; 12(9): 826-36.
  12. Khaledi A, Bahador A, Mansoori NM, Ghazali Bina M, Ghazvini K. Determination of antimicrobial resistance pattern of Acinetobacter baumanii isolated from patients in intensive care unit (ICU). Med J Mashad Univ Med Sci 2015; 58(7): 376-80.
  13. Nemec A, Dolzani L, Brisse S, van den Broek P, Dijkshoorn L. Diversity of aminoglycoside-resistance genes and their association with class 1 integrons among strains of pan-European Acinetobacter baumannii clones. J Med Microbiol 2004; 53(Pt 12): 1233-40.
  14. Aliakbarzade K, Farajnia S, Kariminik A. Prevalence of aminoglycoside resistance genes in acinetobacter baumannii isolates from patients In Tabriz city. Journal of Microbial World 2013; 3(16): 219-27. [In Persian].
  15. Turton JF, Gabriel SN, Valderrey C, Kaufmann ME, Pitt TL. Use of sequence-based typing and multiplex PCR to identify clonal lineages of outbreak strains of Acinetobacter baumannii. Clin Microbiol Infect 2007; 13(8): 807-15.
  16. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial disk susceptibility testing; 20th informational supplement. CLSI/NCCLS M100-S20. Wayne, PA: CLSI; 2010.
  17. Gutierrez O, Juan C, Cercenado E, Navarro F, Bouza E, Coll P, et al. Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa isolates from Spanish hospitals. Antimicrob Agents Chemother 2007; 51(12): 4329-35.
  18. Fazeli H, Vakili B, Khorvash F, Shoaei P, Kariminik A, Yaran M, et al. Identification of mutation in gyrA gene obtained from quinolone resistant clinical isolates of Acinetobacter baumannii. Journal of Microbial World 2014; 7(2): 109-17. [In Persian].
  19. Mohammadtaheri Z, Pourpaki M, Mohammadi F, Namdar R, Masjedi MR. Surveillance of antimicrobial susceptibility among bacterial isolates from intensive care unit patients of a tertiary-care university hospital in Iran: 2006-2009. Chemotherapy 2010; 56(6): 478-84.
  20. Shakibaie MR, Adeli S, Salehi MH. Antibiotic resistance patterns and extended-spectrum beta-lactamase production among Acinetobacter spp. isolated from an intensive care Unit of a hospital in Kerman, Iran. Antimicrob Resist Infect Control 2012; 1(1): 1.
  21. Moniri R, Farahani RK, Shajari G, Shirazi MN, Ghasemi A. Molecular epidemiology of aminoglycosides resistance in acinetobacter spp. With emergence of multidrug-resistant strains. Iran J Public Health 2010; 39(2): 63-8.
  22. Aliakbarzade K, Farajnia S, Karimi NA, Zarei F, Tanomand A. Prevalence of Aminoglycoside Resistance Genes in Acinetobacter baumannii Isolates. Jundishapur J Microbiol 2014; 7(10): e11924.
  23. Khodadadi S, Kiani AH, Pournajafand A, Ardebil A. High prevalence of aminoglycoside resistance among Acinetobacter baumannii isolated from a teaching hospital in Tehran, Iran. International Journal of Development Research 2014; 4(11): 2498-502.
  24. Owlia P, Azimi L, Gholami A, Asghari B, Lari AR. ESBL- and MBL-mediated resistance in Acinetobacter baumannii: a global threat to burn patients. Infez Med 2012; 20(3): 182-7.
  25. Kiani S, Momtaz H, Serajian AA, Tajbakhsh E. Detection of integrons in Acinetobacter baumannii strains isolated from the nosocomial infections of Ahvaz city and their relation with the resistance pattern. International Journal of Medical Laboratory 2016; 3(1): 50-63.
  26. Lin T, Tang CG, Li QH, Ji J, Ge HY, Zhang XY, et al. Identification of aac(2')-I type b aminoglycoside-modifying enzyme genes in resistant Acinetobacter baumannii. Genet Mol Res 2015; 14(1): 1828-35.
  27. Farahani Kheltabadi R, Moniri R, Shajari GR, Nazem Shirazi MH, Musavi SGA, Ghasemi A, et al . Antimicrobial susceptibility patterns and the distribution of resistance genes among Acinetobacter species isolated from patients in Shahid Beheshti hospital, Kashan. Feyz 2009; 12(4): 61-7. [In Persian].