Acinetobacter baumannii infections in Amazon Region driven by extensively drug resistant international clones, 2016-2018

Mem Inst Oswaldo Cruz. 2019 Nov 25:114:e190232. doi: 10.1590/0074-02760190232. eCollection 2019.

Abstract

Background: Acinetobacter baumannii is a leading cause of nosocomial infections. This species is characterised by the presence of pandemic lineages (International Clones) that present a broad antimicrobial resistance profile.

Objective: To perform the molecular epidemiology of carbapenem-resistant A. baumannii from a clinical setting in the Amazon Basin, and to characterise their antimicrobial resistance determinants.

Methods: The genetic relationship of carbapenem-resistant A. baumannii were assessed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Class A, B and D β-lactamase genes were screened by polymerase chain reaction (PCR) and sequencing. The antimicrobial susceptibility profile was obtained by Disc-diffusion method and minimum inhibitory concentration (MIC) determination.

Findings: All carbapenem-resistant A. baumannii strains belonged to three international clones, IC-1, IC-5 and IC-6, the latter recently reported by the first time in Brazil. The major determinant of carbapenem resistance in IC-1 and IC-5 strains was bla OXA-23, associated with ISAba1 and ISAba3, respectively, while IC-6 harboured the bla OXA-72.

Conclusions: The A. baumannii epidemiology in Brazilian Amazon Region was unknown. It was demonstrated that A. baumannii XDR international clones were responsible for nosocomial infections in Boa Vista during 2016-2018, revealing that the epidemiological scenario of A. baumannii infections in Amazon Region resembles those from the cosmopolitan regions worldwide.

MeSH terms

  • Acinetobacter Infections / virology*
  • Acinetobacter baumannii / classification
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / genetics*
  • Anti-Bacterial Agents / pharmacology*
  • Brazil
  • Disk Diffusion Antimicrobial Tests
  • Drug Resistance, Bacterial / genetics*
  • Electrophoresis, Gel, Pulsed-Field
  • Genotype
  • Humans
  • Multilocus Sequence Typing
  • Phenotype
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases