Dissemination of multidrug-resistant Acinetobacter baumannii carrying Bla(OxA-23) from hospitals in central Taiwan

作者：Lee Mei Hui; Chen Te Li; Lee Yi Tzu; Huang Lei; Kuo Shu Chen^*; Yu Kwok Woon; Hsueh Po Ren; Dou Horng Yunn; Su Ih Jen; Fung Chang Phone

来源：Journal of Microbiology, Immunology, and Infection, 2013, 46(6): 419-424.

DOI：10.1016/j.jmii.2012.08.006

• Acinetobacter baumannii
• bla(OxA-23)
• Carbapenem resistance
• Molecular epidemiology

Background: Imipenem-resistant Acinetobacter baumannii (IRAB) poses a great threat to healthcare systems. Production of carbapenem-hydrolyzing class D beta-lactamases (CHDLs) is the major mechanism for imipenem resistance. In this study, we found a high prevalence of IRAB carrying a gene encoding CHDL, bla(OxA-23), in central Taiwan and elucidated the molecular characteristics and possible mechanisms of the spread of these isolates. %26lt;br%26gt;Methods: During 2007, we collected 291 nonrepetitive A baumannii isolates from 10 teaching hospitals in Taiwan. The antimicrobial susceptibility of the isolates was determined by agar dilution or Etest. The genes encoding carbapenemase and related structure were detected by polymerase chain reaction mapping and sequencing, and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis. Plasmid localization of bla(OxA-23) was determined by extraction of plasmid with commercial kit and Southern blot analysis. %26lt;br%26gt;Results: Among 142 IRAB isolates, 30 harbored the bla(OxA-23). The prevalence of IRAB with bla(OxA-23) was highest in central Taiwan compared to other areas [24.8% (27/109) vs. 1.6% (3/182); p %26lt; 0.001]. These IRAB with bla(OxA-23) were also resistant to other antimicrobial agents, except colistin. The PCR methods showed the presence of bla(OxA-51) in all isolates. We could exclude clonal spreading due to the diversity of the pulsotype. The bla(OxA-23) gene was detected in the plasmids of 6 isolates. Tn2006 was present in 22 (73.3%) isolates, and Tn2008, in 6 other isolates (26.7%). Two strains had bla(Oxa-23)-Delta ATPase but lacked upstream ISAba1. %26lt;br%26gt;Conclusion: The high prevalence of bla(OxA-23)-harboring IRAB in central Taiwan might be attributed to the transposition event of Tn2006.

• 出版日期2013-12