Antibiogram, Prevalence of OXA Carbapenemase Encoding Genes, and RAPD-Genotyping of Multidrug-Resistant Acinetobacter baumannii Incriminated in Hidden Community-Acquired Infections

Waleed El-Kazzaz; Lobna Metwally; Reham Yahia; Najwa Al-Harbi; Ayat El-Taher; Helal F Hetta

doi:10.3390/antibiotics9090603

Antibiogram, Prevalence of OXA Carbapenemase Encoding Genes, and RAPD-Genotyping of Multidrug-Resistant Acinetobacter baumannii Incriminated in Hidden Community-Acquired Infections

Antibiotics (Basel). 2020 Sep 15;9(9):603. doi: 10.3390/antibiotics9090603.

Authors

Waleed El-Kazzaz¹, Lobna Metwally^{2

3}, Reham Yahia⁴, Najwa Al-Harbi⁵, Ayat El-Taher⁶, Helal F Hetta^{7

8}

Affiliations

¹ Molecular Microbiology Lab., Botany Department, Faculty of Science, Suez Canal University, Ismailia 41522, Egypt.
² Microbiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt.
³ Department of Microbiology, College of Medicine, Taif University, Al-Taif 11099, Saudi Arabia.
⁴ Basic Sciences Department, College of Science and Health Professions, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh 11481, Saudi Arabia.
⁵ Molecular Microbiology Lab., King Abdul Aziz University, Riyadh 11481, Saudi Arabia.
⁶ Botany Department, Faculty of Science, Suez Canal University, Ismailia 41522, Egypt.
⁷ Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
⁸ Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 452221, USA.

Abstract

Acinetobacter spp. has gained fame from their ability to resist difficult conditions and their constant development of antimicrobial resistance. This study aimed to investigate the prevalence, susceptibility testing, OXA carbapenemase-encoding genes, and RAPD-genotyping of multidrug resistant Acinetobacter baumannii incriminated in hidden community-acquired infections in Egypt. The antimicrobial susceptibility testing was assessed phenotypically using Kirby-Bauer disk diffusion method. Also, Modified-Hodge test (MHT) was carried out to detect the carbapenemases production. Multiplex-PCR was used to detect the carbapenemase-encoding genes. Furthermore, the genetic relationship among the isolated strains was investigated using RAPD fingerprinting. The bacteriological examination revealed that, out of 200 Gram-negative non-fermentative isolates, 44 (22%) were identified phenotypically and biochemically as Acinetobacter spp. and 23 (11.5%) were molecularly confirmed as A.baumannii. The retrieved A.baumannii strains were isolated from urine (69%), sputum (22%), and cerebrospinal fluid (csf) (9%). The isolated A. baumannii strains exhibited multidrug resistance and the production rates of carbapenemases were 56.5, 60.9, and 78.3% with meropenem, imipenem, and ertapenem disks, respectively. The bla_OXA-24-like genes were the most predominant among the tested strains (65.2%), followed by bla_OXA-23 (30.4%) and bla_OXA-58 (17.4%), in addition, the examined strains are harbored IMP, VIM, and NDM genes with prevalence of 60.9, 43.5, and 13%, respectively, while KPC and GES genes were not detected. RAPD-PCR revealed that the examined strains are clustered into 11 different genotypes at ≥90% similarity. Briefly, to the best of our knowledge, this study is the first report concerning community-associated A. baumannii infections in Egypt. The high prevalence of hidden multidrug-resistant (MDR) and extensively drug-resistant (XDR) A.baumannii strains associated with non-hospitalized patients raises an alarm for healthcare authorities to set strict standards to control the spread of such pathogens with high rates of morbidity and mortality.

Keywords: Acinetobacter baumannii; MDR; RAPD-genotyping; antibiogram; carbapenemase encoding genes.