Disruption of the blaOXA-51-like gene by ISAba16 and activation of the blaOXA-58 gene leading to carbapenem resistance in Acinetobacter baumannii Ab244.

OBJECTIVES

This study examines the mechanism of carbapenem resistance in Acinetobacter baumannii isolate Ab244.

METHODS

A multiplex PCR for the detection of the bla(OXA-23-like), bla(OXA-40-like), bla(OXA-51-like) and bla(OXA-58-like) families was performed. MICs of imipenem and meropenem were determined by the agar dilution method. The sequence surrounding the bla(OXA-132) gene was determined by amplification with primer pairs encompassing a part of fxsA and an acetyltransferase gene (GNAT). The sequence upstream of the bla(OXA-58) gene was determined by sequencing. SDS-PAGE and carO PCR were performed to check the integrity of the outer membrane proteins. RT-PCRs for the expression of the bla(OXA-132) gene and the bla(OXA-58) gene were performed.

RESULTS

Isolate Ab244 harboured bla(OXA-132) belonging to the bla(OXA-51-like) gene cluster and a bla(OXA-58) gene. The 4239 bp region between fxsA and GNAT showed an insert of ISAba16 (where IS stands for insertion sequence) after the first 15 nucleotides of the bla(OXA-132) gene, with an 8 bp target site duplication at the 5' and 3' ends of ISAba16. The sequence oriented in the 5'→3' direction caused insertional inactivation of the bla(OXA-132) gene. The bla(OXA-58) gene was highly expressed by the promoters provided by an ISAba3-like structure found upstream of the gene. The isolate was resistant to meropenem and had intermediate resistance to imipenem, and was also positive for ISAba1.

CONCLUSIONS

This is the first report showing ISAba16-mediated inactivation of the bla(OXA-132) gene in strain Ab244. The resistance to carbapenems in strain Ab244 is related to the acquisition of the bla(OXA-58) gene, here governed by an ISAba3-like element.