First identification of multidrug-resistant Acinetobacter bereziniae isolates harboring bla NDM-1 from hospitals in South China

Xiao-Mei Mo; Qing Pan; Harald Seifert; Xi-Wen Xing; Jing Yuan; Zi-Yuan Zhou; Xing-Yu Luo; Hou-Ming Liu; Yong-Li Xie; Liu-Qing Yang; Xiao-Bing Hong; Paul G Higgins; Nai-Kei Wong

doi:10.1016/j.heliyon.2022.e12365

First identification of multidrug-resistant Acinetobacter bereziniae isolates harboring bla _NDM-1 from hospitals in South China

Heliyon. 2022 Dec 24;9(1):e12365. doi: 10.1016/j.heliyon.2022.e12365. eCollection 2023 Jan.

Authors

Xiao-Mei Mo^{1

2}, Qing Pan³, Harald Seifert^{4

5}, Xi-Wen Xing⁶, Jing Yuan², Zi-Yuan Zhou^{1

2

7}, Xing-Yu Luo⁸, Hou-Ming Liu², Yong-Li Xie^{2

9}, Liu-Qing Yang², Xiao-Bing Hong^{1

10

11}, Paul G Higgins^{4

5}, Nai-Kei Wong^{1

2

11}

Affiliations

¹ Clinical Pharmacology Section, Department of Pharmacology, Shantou University Medical College, Shantou, China.
² National Clinical Research Center for Infectious Diseases, Shenzhen Third People's Hospital, The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China.
³ AlphaMol Science Ltd., Shenzhen, China.
⁴ Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany.
⁵ German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
⁶ Department of Biotechnology, College of Life Science and Technology, Jinan University Guangzhou, China.
⁷ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
⁸ Graduate School, Zhejiang Chinese Medical University, Hangzhou, China.
⁹ Shenzhen Key Laboratory of Microbial Genetic Engineering, College of Life Sciences and Oceanology, Shenzhen University, Shenzhen, China.
¹⁰ Department of Pharmacy, The Second Affiliated Hospital of Shantou University of Medical College, Shantou, China.
¹¹ Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, China.

Abstract

This study is a first report on the identification of multidrug-resistant (MDR) Acinetobacter bereziniae among non-baumannii acinetobacters that had previously escaped automated laboratory detection, and characterize their clinical courses of infection at two tertiary-care hospitals in Shenzhen city, China (2015-2017). Herein, definitive identification by PCR was performed with universal and species-specific primers targeting 16S rDNA and rpoB genes, respectively, followed by Sanger sequencing and blast analysis. Antimicrobial susceptibility of A. bereziniae isolates was assessed accordingly. Three of the five identified A. bereziniae isolates exhibited carbapenem-resistance and were subjected to a multiplex PCR assay to detect drug-resistance genes. Sequences of the rpoB amplicon were aligned with curated sequences from global databases for phylogenetic analysis on evolutionary relations. Five clinical isolates of A. bereziniae were thereby re-identified, whose infections were primarily nosocomial. Automated identification and susceptibility testing systems (Phoenix-100 and VITEK 2) proved insufficient for discriminating A. bereziniae from other acinetobacters such as Acinetobacter baumannii and Acinetobacter guillouiae. Among these isolates, three exhibited carbapenem-resistant phenotypes indistinguishable from that of carbapenem-resistant A. baumannii. The carbapenem-resistant A. bereziniae isolates were subsequently confirmed to carry a bla _NDM-1 (New Delhi metallo-β-lactamase-1) gene downstream of ISAba125. Phylogenetic analysis revealed that A. bereziniae isolates evolved slowly but independently in local habitats. A. bereziniae isolates are difficult to distinguish by traditional automated detection systems. PCR-based identification via amplification and sequencing of selected house-keeping genes provides sufficient resolution for discriminating the isolates.

Keywords: Acinetobacter bereziniae; Antimicrobial resistance; Emerging pathogen; Healthcare-associated infection; NDM-1 (New Delhi metallo-β-lactamase-1).