Emergence of Colistin- and Carbapenem-Resistant Acinetobacter baumannii ST2 Clinical Isolate in Algeria: First Case Report

Microb Drug Resist. 2015 Jun;21(3):279-85. doi: 10.1089/mdr.2014.0214. Epub 2015 Jan 14.

Abstract

Aim: The aim of this study was to investigate the prevalence and the mechanisms of carbapenem and colistin resistance in Acinetobacter baumannii clinical isolates in an Algerian hospital.

Results: Twelve isolates were collected between October 2013 and March 2014. All isolates were resistant to almost all antibiotics tested with a high-level resistance to imipenem (minimum inhibitory concentrations [MICs] >32 mg/L) with one strain showing resistance to colistin (MIC=16 mg/L). The results of the modified Hodge test and the modified Carba NP test were positive for all isolates. Besides, the activity of β-lactamases was inhibited by EDTA in only two isolates. All the 12 isolates contained the naturally occurring blaOXA-51-like gene. Ten of them harbored the OXA β-lactamases: blaOXA-23 (six isolates) and blaOXA-24 (four isolates) genes, while two isolates were positive for blaNDM-1 gene. The colistin-resistant isolate producing OXA-24 enzyme harbored a single mutation in the pmrB gene. Multilocus sequence typing demonstrated that the 12 isolates belonged to 2 clones: 10 to ST2 and 2 to ST85.

Conclusions: Here, we describe the mechanisms of carbapenem resistance and we report the first colistin and carbapenemase-producing A. baumannii clinical isolate from a patient in Algeria.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / epidemiology
  • Acinetobacter Infections / microbiology
  • Acinetobacter baumannii / classification
  • Acinetobacter baumannii / genetics*
  • Acinetobacter baumannii / isolation & purification
  • Algeria / epidemiology
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / metabolism
  • Base Sequence
  • Clone Cells
  • Colistin / pharmacology*
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Edetic Acid / pharmacology
  • Female
  • Gene Expression Regulation, Bacterial*
  • Humans
  • Imipenem / pharmacology*
  • Male
  • Microbial Sensitivity Tests
  • Molecular Sequence Data
  • Multilocus Sequence Typing
  • Mutation
  • Phylogeny
  • Plasmids / chemistry
  • Plasmids / metabolism
  • Sequence Alignment
  • Sequence Analysis, DNA
  • Transcription Factors / genetics*
  • Transcription Factors / metabolism
  • beta-Lactamases / genetics*
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • PmrB protein, bacteria
  • Transcription Factors
  • Imipenem
  • Edetic Acid
  • beta-Lactamases
  • Colistin