First report of blaNDM-1-producing Acinetobacter baumannii isolated in Lebanon from civilians wounded during the Syrian war

Int J Infect Dis. 2014 Apr:21:21-3. doi: 10.1016/j.ijid.2014.01.004. Epub 2014 Feb 19.

Abstract

Objectives: The emergence of carbapenem-resistant Acinetobacter baumannii has been observed worldwide. We describe the first detection of A. baumannii carrying the blaNDM-1 gene in Lebanon, isolated from Syrian patients wounded during the civil war.

Methods: Four carbapenem-resistant A. baumannii strains isolated in 2012 in the Tripoli Government Hospital, Lebanon, from civilians wounded during the Syrian war, were analysed. Susceptibility was determined by disk diffusion testing, and resistance to carbapenems was confirmed by Etest. The presence of blaOXA-23-like, blaOXA-24-like, blaOXA-58-like, blaOXA-143-like, and blaNDM was investigated by PCR. Clonal relationships were studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and blaOXA-51 sequence-based typing.

Results: All isolates harboured the blaNDM-1 gene and were negative for other tested carbapenemases. They all belonged to the sequence type 85 and formed a single cluster by PFGE. Finally, blaOXA-51-like gene sequencing revealed the presence of the blaOXA-94 variant in all four isolates.

Conclusion: These findings show that Syria constitutes a reservoir for NDM-1-producing bacteria. These results also highlight the need for effective measures to stop the threatening spread of such strains.

Keywords: Acinetobacter baumannii; Lebanon; Multidrug-resistant bacteria; NDM-1; Syrian civil war.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / microbiology*
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / enzymology
  • Acinetobacter baumannii / genetics*
  • Acinetobacter baumannii / isolation & purification
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Carbapenems / therapeutic use
  • Ethnic Violence
  • Female
  • Gene Expression
  • Humans
  • Infant
  • Lebanon
  • Male
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Plasmids
  • Wounds, Penetrating / drug therapy
  • Wounds, Penetrating / microbiology*
  • Young Adult
  • beta-Lactam Resistance / genetics*
  • beta-Lactamases / genetics*
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • beta-Lactamases
  • beta-lactamase NDM-1