Emergence of carbapenem-resistant Acinetobacter baumannii harboring the OXA-23 carbapenemase in intensive care units of Egyptian hospitals

作者：Fouad Mahmoud; Attia Ahmed S^*; Tawakkol Wael M; Hashem Abdelgawad M

来源：International Journal of Infectious Diseases, 2013, 17(12): E1252-E1254.

DOI：10.1016/j.ijid.2013.07.012

• Acinetobacter baumannii
• Carbapenem resistance
• OXA-23 carbapenemase
• Egypt

Background: Healthcare-associated infections are a worldwide threat to hospitalized patients, especially those in intensive care units. The prevalence of these infections in Egypt, and their antimicrobial resistance patterns and mechanisms, were investigated in this study. %26lt;br%26gt;Methods: A total of 547 cases of healthcare-associated infections were investigated. Causative agents were identified and antimicrobial susceptibility determined. Carbapenem-resistant Acinetobacter baumannii isolates were further investigated for their resistance mechanism via the modified Hodge test, inhibitor-potentiated disk diffusion test, synergy with carbonyl cyanide chlorophenylhydrazone, and PCR. Moreover, clonal linkage was examined via enterobacterial repetitive intergenic consensus (ERIC)-PCR. %26lt;br%26gt;Results: Klebsiella spp was the most prevalent species in the isolates examined (217; 40%). Although A. baumannii represented only 10% of the total isolates, it showed the highest percentage of carbapenem resistance (74%). PCR showed that 100% of the resistant isolates carried both bla(OXA-51) and bla(OXA-23) genes, 85% carried the class 1 integrase genes, and only 2.5% carried metallo-beta-lactamase (bla(VIM)). ERIC-PCR indicated that isolates from different hospitals were genetically linked. %26lt;br%26gt;Conclusions: These findings represent the first report of the alarming spread of OXA-23 carbapenemase in A. baumannii in Egyptian intensive care units. The spread of such strains has serious health consequences and requires the application of strict infection control measures.

• 出版日期2013-12