Pritsch Michael, Zeynudin Ahmed, Messerer Maxim, Baumer Simon, Liegl Gabriele, Schubert Soeren, Löscher Thomas, Hoelscher Michael, Belachew Tefara, Rachow Andrea, Wieser Andreas
Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802, Munich, Germany.
German Center for Infection Research (DZIF), partner site Munich, Munich, Germany.
BMC Infect Dis. 2017 Mar 1;17(1):180. doi: 10.1186/s12879-017-2289-9.
Multidrug-resistant Gram-negative bacterial infections are recognized as one of the major threats to global health. In this study, we describe for the first time bla gene carrying organisms from Ethiopia consisting of three Acinetobacter baumannii isolates from patients in Jimma.
Besides phenotypic antimicrobial susceptibility testing, molecular strain typing and sequencing was performed to describe the phylogenetic relation of the Ethiopian isolates in detail in relation to published isolates from all over the globe.
Three multi-resistant, bla -positive Acinetobacter baumannii isolates, most likely a local clonal diffusion, were isolated. Two of the three isolates described within this study were untreatable with the locally available antimicrobials and were only susceptible to polymyxin B and amikacin. The genome sequences confirmed the isolates to be distinct from the outbreak strains reported from Kenya, the only other characterized bla positive Acinetobacter baumannii strains in East Africa so far. Up to date, no other bacterial species were found to harbour the gene cassette in Jimma and conjugation to E. coli was not successful under laboratory conditions. However, natural transmission to other bacteria seems likely, given the evident lack of hygienic precautions due to limited resource settings.
The detected isolates could solely be the tip of the iceberg regarding the presence of NDM-1 producing organisms in the region, as only a limited number of bacterial isolates were evaluated so far and until recently, susceptibility testing and isolation of bacteria could hardly be performed in clinical patient care. These multi-drug resistant organisms pose a serious threat to antimicrobial treatments in Jimma, Ethiopia.
耐多药革兰氏阴性菌感染被认为是全球健康面临的主要威胁之一。在本研究中，我们首次描述了来自埃塞俄比亚的携带bla基因的生物体，其中包括来自吉马患者的三株鲍曼不动杆菌分离株。
除了进行表型抗菌药物敏感性测试外，还进行了分子菌株分型和测序，以详细描述埃塞俄比亚分离株与全球已发表的分离株之间的系统发育关系。
分离出三株多重耐药、bla阳性的鲍曼不动杆菌分离株，很可能是局部克隆传播。本研究中描述的三株分离株中有两株对当地可用的抗菌药物无法治疗，仅对多粘菌素B和阿米卡星敏感。基因组序列证实这些分离株与肯尼亚报告的暴发菌株不同，肯尼亚是迄今为止东非唯一其他已鉴定的bla阳性鲍曼不动杆菌菌株。到目前为止，在吉马没有发现其他细菌物种携带该基因盒，并且在实验室条件下与大肠杆菌的接合未成功。然而考虑到资源有限导致明显缺乏卫生预防措施，这些细菌向其他细菌的自然传播似乎很可能发生。
就该地区产NDM-1生物体的存在而言，检测到的分离株可能只是冰山一角，因为到目前为止仅评估了有限数量的细菌分离株，而且直到最近，在临床患者护理中几乎无法进行细菌的药敏试验和分离。这些多重耐药生物体对埃塞俄比亚吉马的抗菌治疗构成严重威胁。
