Zowawi Hosam M, Sartor Anna L, Sidjabat Hanna E, Balkhy Hanan H, Walsh Timothy R, Al Johani Sameera M, AlJindan Reem Y, Alfaresi Mubarak, Ibrahim Emad, Al-Jardani Amina, Al Salman Jameela, Dashti Ali A, Johani Khalid, Paterson David L
The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia World Health Organization Collaborating Centre for Infection Prevention and Control and Gulf Cooperation Council Center for Infection Control, Riyadh, Saudi Arabia
The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.
J Clin Microbiol. 2015 Mar;53(3):896-903. doi: 10.1128/JCM.02784-14. Epub 2015 Jan 7.
The molecular epidemiology and mechanisms of resistance of carbapenem-resistant Acinetobacter baumannii (CRAB) were determined in hospitals in the states of the Cooperation Council for the Arab States of the Gulf (Gulf Cooperation Council [GCC]), namely, Saudi Arabia, United Arab Emirates, Oman, Qatar, Bahrain, and Kuwait. Isolates were subjected to PCR-based detection of antibiotic resistance genes and repetitive sequence-based PCR (rep-PCR) assessments of clonality. Selected isolates were subjected to multilocus sequence typing (MLST). We investigated 117 isolates resistant to carbapenem antibiotics (either imipenem or meropenem). All isolates were positive for OXA-51. The most common carbapenemases were the OXA-23-type, found in 107 isolates, followed by OXA-40-type (OXA-24-type), found in 5 isolates; 3 isolates carried the ISAba1 element upstream of blaOXA-51-type. No OXA-58-type, NDM-type, VIM-type, or IMP-type producers were detected. Multiple clones were detected with 16 clusters of clonally related CRAB. Some clusters involved hospitals in different states. MLST analysis of 15 representative isolates from different clusters identified seven different sequence types (ST195, ST208, ST229, ST436, ST450, ST452, and ST499), as well as three novel STs. The vast majority (84%) of the isolates in this study were associated with health care exposure. Awareness of multidrug-resistant organisms in GCC states has important implications for optimizing infection control practices; establishing antimicrobial stewardship programs within hospital, community, and agricultural settings; and emphasizing the need for establishing regional active surveillance systems. This will help to control the spread of CRAB in the Middle East and in hospitals accommodating transferred patients from this region.
在海湾阿拉伯国家合作委员会（海湾合作委员会[GCC]）成员国，即沙特阿拉伯、阿拉伯联合酋长国、阿曼、卡塔尔、巴林和科威特的医院中，对耐碳青霉烯类鲍曼不动杆菌（CRAB）的分子流行病学和耐药机制进行了研究。分离株接受基于PCR的抗生素耐药基因检测和基于重复序列的PCR（rep-PCR）克隆性评估。选择的分离株进行多位点序列分型（MLST）。我们调查了117株对碳青霉烯类抗生素（亚胺培南或美罗培南）耐药的分离株。所有分离株的OXA-51均呈阳性。最常见的碳青霉烯酶是OXA-23型，在107株分离株中发现，其次是OXA-40型（OXA-24型），在5株分离株中发现；3株分离株在blaOXA-51型上游携带ISAba1元件。未检测到OXA-58型、NDM型、VIM型或IMP型产生菌。检测到多个克隆，有16个克隆相关的CRAB簇。一些簇涉及不同国家的医院。对来自不同簇的15株代表性分离株进行MLST分析，确定了7种不同的序列类型（ST195、ST208、ST229、ST436、ST450、ST452和ST499），以及3种新的STs。本研究中绝大多数（84%）分离株与医疗保健暴露有关。海湾合作委员会国家对多重耐药菌的认识对于优化感染控制措施、在医院、社区和农业环境中建立抗菌药物管理计划以及强调建立区域主动监测系统的必要性具有重要意义。这将有助于控制CRAB在中东地区以及接收该地区转诊患者的医院中的传播。
