TY - JOUR
T1 - Changing carbapenemase gene pattern in an epidemic multidrug-resistant Acinetobacter baumannii lineage causing multiple outbreaks in central Italy
AU - D'Arezzo, Silvia
AU - Principe, Luigi
AU - Capone, Alessandro
AU - Petrosillo, Nicola
AU - Petrucca, Andrea
AU - Visca, Paolo
PY - 2011/1
Y1 - 2011/1
N2 - Objectives: Infections caused by multidrug-resistant (MDR) Acinetobacter baumannii are a challenging problem worldwide. Here, the molecular epidemiology and the genetic basis of antibiotic resistance in 111 MDR A. baumannii strains isolated from June 2005 to March 2009 from infected patients in 10 intensive care units (ICUs) in central Italy were investigated. Methods: Epidemiological typing was performed by random amplification of polymorphic DNA, PCR-based sequence grouping and macrorestriction analysis. MICs of antibiotics were determined by the broth microdilution method. Genes for OXA carbapenemases, metallo-β-lactamases and the CarO porin were searched for by PCR. Results: Molecular genotyping identified one predominant A. baumannii lineage, related to the international clonal lineage II, accounting for 95.6% of isolates. Isolates referable to this lineage were recovered from all ICUs surveyed and were resistant to nearly all classes of antimicrobials, with the exception of tigecycline and colistin. A high percentage (60.5%) of A. baumannii isolates showed elevated resistance to imipenem (MICs ≥128 mg/L), concomitant with resistance to meropenem. Carbapenem resistance was associated with the presence of either bla
OXA-58-like (22.8%) or bla
OXA-23-like (71.1%) carbapenemase genes. Molecular typing showed that the epidemic lineage encoding OXA-23 emerged in 2007 and displaced a genetically related clone encoding OXA-58 that had been responsible for previous ICU outbreaks in the same region. Conclusions: Emergence of the OXA-23 epidemic lineage could result from selective advantage conferred by the bla
OXA-23-like determinant, which provides increased resistance to carbapenems.
AB - Objectives: Infections caused by multidrug-resistant (MDR) Acinetobacter baumannii are a challenging problem worldwide. Here, the molecular epidemiology and the genetic basis of antibiotic resistance in 111 MDR A. baumannii strains isolated from June 2005 to March 2009 from infected patients in 10 intensive care units (ICUs) in central Italy were investigated. Methods: Epidemiological typing was performed by random amplification of polymorphic DNA, PCR-based sequence grouping and macrorestriction analysis. MICs of antibiotics were determined by the broth microdilution method. Genes for OXA carbapenemases, metallo-β-lactamases and the CarO porin were searched for by PCR. Results: Molecular genotyping identified one predominant A. baumannii lineage, related to the international clonal lineage II, accounting for 95.6% of isolates. Isolates referable to this lineage were recovered from all ICUs surveyed and were resistant to nearly all classes of antimicrobials, with the exception of tigecycline and colistin. A high percentage (60.5%) of A. baumannii isolates showed elevated resistance to imipenem (MICs ≥128 mg/L), concomitant with resistance to meropenem. Carbapenem resistance was associated with the presence of either bla
OXA-58-like (22.8%) or bla
OXA-23-like (71.1%) carbapenemase genes. Molecular typing showed that the epidemic lineage encoding OXA-23 emerged in 2007 and displaced a genetically related clone encoding OXA-58 that had been responsible for previous ICU outbreaks in the same region. Conclusions: Emergence of the OXA-23 epidemic lineage could result from selective advantage conferred by the bla
OXA-23-like determinant, which provides increased resistance to carbapenems.
KW - Genotyping
KW - Intensive care units
KW - OXA-23
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U2 - 10.1093/jac/dkq407
DO - 10.1093/jac/dkq407
M3 - Article
C2 - 21088019
AN - SCOPUS:78650359537
VL - 66
SP - 54
EP - 61
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
IS - 1
M1 - dkq407
ER -