Molecular epidemiology of multidrug-resistant Acinetobacter baumannii in a single institution over a 10-year period

Runnegar, N., Sidjabat, H., Goh, H. M. S., Nimmo, G. R., Schembri, M. A. and Paterson, D. L. (2010) Molecular epidemiology of multidrug-resistant Acinetobacter baumannii in a single institution over a 10-year period. Journal of Clinical Microbiology, 48 11: 4051-4056. doi:10.1128/JCM.01208-10

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Author Runnegar, N.
Sidjabat, H.
Goh, H. M. S.
Nimmo, G. R.
Schembri, M. A.
Paterson, D. L.
Title Molecular epidemiology of multidrug-resistant Acinetobacter baumannii in a single institution over a 10-year period
Formatted title
Molecular epidemiology of multidrug-resistant Acinetobacter baumannii in a single institution over a 10-year period
Journal name Journal of Clinical Microbiology   Check publisher's open access policy
ISSN 0095-1137
Publication date 2010-11-01
Year available 2010
Sub-type Article (original research)
DOI 10.1128/JCM.01208-10
Open Access Status File (Publisher version)
Volume 48
Issue 11
Start page 4051
End page 4056
Total pages 6
Place of publication Washington, DC, United States
Publisher American Society for Microbiology
Language eng
Abstract 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.
Formatted abstract
Multidrug-resistant Acinetobacter baumannii is a worldwide nosocomial menace. We sought to better understand its behavior through studying the molecular epidemiology of this organism at the Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia, over a 10-year period. Multilocus sequence typing (MLST), semiautomated repetitive sequence-based PCR (rep-PCR), and pulsed-field gel electrophoresis (PFGE) were performed on a selection of 31 A. baumannii isolates collected over the 10-year period to determine their relationships to one another. MLST also allowed us to put this information in a global context. The presence or absence of blaOXA-23 was also established. The presence of blaOXA-23 closely correlated with carbapenem resistance in our collection. Sequence type 92 (ST92) was the dominant sequence type and was present in the hospital for 9 years. There was also evidence of the spread of ST69, ST73, and ST125 (novel) within the hospital, but this was not sustained over long periods. There were only single examples of the novel sequence types ST126 and ST127. The different typing methods clustered the isolates similarly; however, PFGE and rep-PCR were more discriminatory than MLST. Worldwide, ST92 and the associated clonal complex 92 represent the most sampled and widespread sequence type(s) and are also known as European clone 2 and worldwide clonal lineage 2. Antibiotic susceptibility within ST92 is variable, suggesting a role for mechanisms other than antibiotic resistance in its success.
Copyright © 2010, American Society for Microbiology. All Rights Reserved.
Keyword Field gel electrophoresis
Medical center
Typing scheme
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID G1100135
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2011 Collection
School of Chemistry and Molecular Biosciences
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Citation counts: TR Web of Science Citation Count  Cited 52 times in Thomson Reuters Web of Science Article | Citations
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Created: Sun, 21 Nov 2010, 10:03:47 EST