Medical Bacteriology Laboratory, Institut Pasteur of Algeria, Algiers, Algeria.
University Regional Military Hospital of Oran, Oran, Algeria.
J Infect Dev Ctries. 2020 Dec 31;14(12):1395-1401. doi: 10.3855/jidc.12348.
The aim of this study was to investigate the drug-resistance and the molecular characterization of carbapenemases, ESBL, and aminoglycoside-modifying enzymes among Acinetobacter baumannii clinical isolates in Algerian hospitals.
A total of 92 A. baumannii isolates were collected between 2012 and 2016. Antimicrobial susceptibility testings were performed for β-lactams, aminoglycosides, fluoroquinolones, trimethoprim-sulfamethoxazole, rifampicin and colistin. The phenotypic characterization of β-lactamases was investigated. For 30 randomly targeted strains, the carriage of the carbapenemases, ESBL and aminoglycoside-modifying enzymes -encoding genes was determined by PCR. Sequencing was carried out for carbapenemases and ESBL genes.
Most of the 92 isolates studied were recovered from hospitalized patients (93.5%) and were mainly from intensive care units (51.1%) and orthopedics (19.6%). The strains were collected primarily from low respiratory tract (33.7%), wounds (23.9%) and urine (16.3%). Multidrug-resistant A. baumannii strains were prevalent (96.7%). High rates of resistance were observed for almost all antibiotics tested (>70%) excluding rifampicin (7.6%) and colistin (5.4%). For the five colistin-resistant strains, MICs ranged between 4 and 128 µg/mL. Positive MBL (83.7%) and ESBL (23.9%) strains were identified. Regarding β-lactams, the blaNDM and both blaSHV and blaCTX-M1 genes were detected in five and two strains respectively. Sequencing of the genes revealed the presence of blaNDM-1, blaCTX-M-15, and blaSHV-33. For aminoglycosides, aac(6')-Ib, ant(2'')-I and aph(3')-VI genes were detected in three, seven and six strains respectively.
Here, we report the first co-occurrence of extended-spectrum β-lactamases SHV-33 and CTX-M-15, the carbapenemase NDM-1 and the emergence of colistin-resistant A. baumannii in Algerian hospitals.
本研究旨在调查阿尔及利亚医院临床分离的鲍曼不动杆菌对碳青霉烯类、ESBL 和氨基糖苷类修饰酶的耐药性和分子特征。
2012 年至 2016 年共收集 92 株鲍曼不动杆菌。对β-内酰胺类、氨基糖苷类、氟喹诺酮类、复方新诺明、利福平、黏菌素进行了药敏试验。对β-内酰胺酶的表型特征进行了研究。对 30 株随机靶向菌株，通过 PCR 检测碳青霉烯酶、ESBL 和氨基糖苷类修饰酶编码基因的携带情况。对碳青霉烯酶和 ESBL 基因进行测序。
所研究的 92 株分离株主要来自住院患者（93.5%），主要来自重症监护病房（51.1%）和骨科（19.6%）。这些菌株主要从下呼吸道（33.7%）、伤口（23.9%）和尿液（16.3%）中分离出来。多药耐药鲍曼不动杆菌菌株很常见（96.7%）。几乎所有测试的抗生素（>70%）都表现出高耐药率，除利福平（7.6%）和黏菌素（5.4%）外。对于 5 株耐黏菌素的菌株，MIC 值在 4 至 128 µg/mL 之间。鉴定出阳性 MBL（83.7%）和 ESBL（23.9%）菌株。关于β-内酰胺类，在 5 株和 2 株菌中分别检测到 blaNDM 和 blaSHV 和 blaCTX-M1 基因。基因测序显示 blaNDM-1、blaCTX-M-15 和 blaSHV-33 的存在。对于氨基糖苷类，在 3 株、7 株和 6 株菌中分别检测到 aac(6')-Ib、ant(2'')-I 和 aph(3')-VI 基因。
本研究首次报道了在阿尔及利亚医院中，同时存在超广谱β-内酰胺酶 SHV-33 和 CTX-M-15、碳青霉烯酶 NDM-1 和耐黏菌素鲍曼不动杆菌的出现。
