Virulence genes and plasmid replicon profiles of selected β-lactamase-producing Acinetobacter baumannii from orthopaedic patients and the environment in a tertiary referral hospital in Tanzania, East Africa

B R Kidenya; G Mboowa; I Sserwadda; S Kanyerezi; E Nakafu; I L Akaro; B Mkinze; M L Joloba; J Seni

doi:10.1016/j.jhin.2023.09.005

Virulence genes and plasmid replicon profiles of selected β-lactamase-producing Acinetobacter baumannii from orthopaedic patients and the environment in a tertiary referral hospital in Tanzania, East Africa

J Hosp Infect. 2023 Nov:141:223-226. doi: 10.1016/j.jhin.2023.09.005. Epub 2023 Sep 18.

Authors

B R Kidenya¹, G Mboowa², I Sserwadda³, S Kanyerezi⁴, E Nakafu⁵, I L Akaro⁶, B Mkinze⁶, M L Joloba⁷, J Seni⁸

Affiliations

¹ Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania. Electronic address: benkidenya@gmail.com.
² Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda; African Center of Excellence in Bioinformatics and Data-Intensive Sciences, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Africa Centres for Disease Control and Prevention, African Union Commission, Roosevelt Street, Addis Ababa, Ethiopia.
³ Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda; Department of Biochemistry and Bioinformatics, School of Pure and Applied Sciences, Pwani University, Kilifi, Kenya; African Center of Excellence in Bioinformatics and Data-Intensive Sciences, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
⁴ Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda; African Center of Excellence in Bioinformatics and Data-Intensive Sciences, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
⁵ College of Veterinary Medicine, Animal Resources and Bio-security (COVAB), Makerere University, Kampala, Uganda.
⁶ Department of Surgery, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
⁷ Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
⁸ Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.

PMID: 37729952
DOI: 10.1016/j.jhin.2023.09.005

Abstract

Acinetobacter baumannii has emerged as an important nosocomial pathogen due to its high resistance to multi-drugs and disinfectants plus its ability to survive in hospital environments. Rectal swabs were collected for screening β-lactamases-producing Acinetobacter baumannii among hospitalized orthopedic patients at a tertiary referral hospital in Tanzania. Swabs were also taken from patients' caretakers, healthcare workers, and the neighboring inanimate environment. A total of 26 confirmed β-lactamases producing Acinetobacter baumannii were isolated, of which 4 representative isolates (two from patients and two from hospital environment) underwent whole-genome sequencing (WGS) to detect sequence types (ST), β-lactamases genes, plasmid replicon types, and virulence genes. All four isolates harbored multiple β-lactamases genes including blaADC-25(3), blaOXA(4), blaCTX-M-15(2) and blaNDM-1(2). Furthermore, isolates harbored virulence genes encoding outer membrane protein (ompA), curli protein (csg), siderophore biosynthesis systems (enterobactin [entABCDEFS, fepABCDG, fes]; yersiniabactin [ybtAEPQSTUX, irp1, irp2, fyuA] and aerobactin [iucABCD, iutA]), transport secretion system type II (T2SS) and type III (T3SS), E. coli common pilus (ecpRABCDE operon), type 1 fimbriae (fim), arylsulfatase (aslA) and adhesions (fedC). Only isolates from patients harbored 4 plasmid replicons each, with the most common plasmid replicons being IncFIA_1; IncY_1 and IncFIB(AP001918)_1. Admitted orthopedic patients and the hospital environment act as a reservoir of multiple β-lactamases producing Acinetobacter baumannii (including those against carbapenems like blaOXA and blaNDM-1) endowed with virulence genes, highlighting the necessity to routinely screening of orthopedic patients with open fractures on admission as well as reinforcing infection prevention and control measures to reduce the dissemination of nosocomial infection within the hospital environment.

Keywords: Acinetobacter baumannii; Plasmid replicon; Tanzania; Virulence.

MeSH terms

Acinetobacter baumannii*
Anti-Bacterial Agents / therapeutic use
Bacterial Proteins / genetics
Escherichia coli / genetics
Humans
Microbial Sensitivity Tests
Orthopedics*
Plasmids
Tanzania / epidemiology
Tertiary Care Centers
Virulence / genetics
beta-Lactamases / genetics
beta-Lactamases / metabolism

Substances

beta-Lactamases
Anti-Bacterial Agents
Bacterial Proteins