Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain UCLouvain, Brussels, Belgium.
Laboratoire de Référence des Mycobactéries (LRM), Cotonou, Benin.
Ann Clin Microbiol Antimicrob. 2021 Jan 6;20(1):5. doi: 10.1186/s12941-020-00411-w.
Carbapenem-resistant Acinetobacter baumannii is considered a top priority pathogen by the World Health Organization for combatting increasing antibiotic resistance and development of new drugs. Since it was originally reported in Klebsiella pneumoniae in 2009, the quick spread of the bla gene encoding a New-Delhi metallo-beta-lactamase-1 (NDM-1) is increasingly recognized as a serious threat. This gene is usually carried by large plasmids and has already been documented in diverse bacterial species, including A. baumannii. Here, we report the first detection of a NDM-1-producing A. baumannii strain isolated in Benin.
A 31-year-old woman was admitted to a surgical unit with a diagnosis of post-cesarean hematoma. An extensively-drug resistant A. baumannii strain solely susceptible to amikacin, colistin and ciprofloxacin, and resistant to several other antibiotics including ceftazidime, imipenem, meropenem, gentamicin, tobramycin, ceftazidime/avibactam, and sulfamethoxazole-trimethoprim, was isolated from the wound. Production of NDM-1 was demonstrated by immunochromatographic testing. Whole genome sequencing of the isolate confirmed the presence of bla, but also antibiotic resistance genes against multiple beta-lactamases and other classes of antibiotics, in addition to several virulence genes. Moreover, the bla gene was found to be present in a Tn125 transposon integrated on a plasmid.
The discovery of this extensively-drug resistant A. baumannii strain carrying bla in Benin is worrying, especially because of its high potential risk of horizontal gene transfer due to being integrated into a transposon located on a plasmid. Strict control and prevention measures should be taken, once NDM-1 positive A. baumannii has been identified to prevent transfer of this resistance gene to other Enterobacterales. Capacity building is required by governmental agencies to provide suitable antibiotic treatment options and strategies, in combination with strengthening laboratory services for detection and surveillance of this pathogen.
耐碳青霉烯类鲍曼不动杆菌被世界卫生组织视为对抗日益增加的抗生素耐药性和开发新药物的首要病原体。自 2009 年首次在肺炎克雷伯菌中报道以来，编码一种新德里金属β-内酰胺酶-1（NDM-1）的 bla 基因的快速传播已被越来越多地认为是一个严重威胁。该基因通常由大型质粒携带，并且已经在包括鲍曼不动杆菌在内的多种细菌物种中得到证实。在这里，我们报告了在贝宁首次检测到产 NDM-1 的鲍曼不动杆菌菌株。
一名 31 岁女性因剖宫产血肿被收入外科病房。从伤口中分离出一株对阿米卡星、黏菌素和环丙沙星敏感，对头孢他啶、亚胺培南、美罗培南、庆大霉素、妥布霉素、头孢他啶/阿维巴坦和磺胺甲噁唑-甲氧苄啶等其他几种抗生素耐药的广泛耐药鲍曼不动杆菌。通过免疫层析试验证实了 NDM-1 的产生。该分离株的全基因组测序证实了 bla 的存在，但也证实了对多种β-内酰胺酶和其他类抗生素的抗生素耐药基因，以及几种毒力基因。此外，bla 基因存在于整合在质粒上的 Tn125 转座子中。
在贝宁发现携带 bla 的这种广泛耐药的鲍曼不动杆菌菌株令人担忧，尤其是因为它整合到位于质粒上的转座子中，具有很高的水平基因转移的潜在风险。一旦发现 NDM-1 阳性的鲍曼不动杆菌，应采取严格的控制和预防措施，以防止该耐药基因转移到其他肠杆菌科。政府机构需要加强能力建设，提供合适的抗生素治疗选择和策略，并结合加强实验室服务，以检测和监测这种病原体。
