Carbapenem resistance and acquired class D beta-lactamases in Acinetobacter baumannii from Croatia 2009–2010
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The molecular epidemiology and the genetic basis of carbapenem resistance was investigated in 185 Acinetobacter baumannii isolates obtained from 13 centers of northern Croatia and Istria during 2009–2010. All isolates were multidrug-resistant, and 35 % (n = 64) were resistant to both imipenem and meropenem. ISAba1-driven overexpression of the intrinsic bla OXA-51-like gene was observed in all carbapenem resistant isolates, and 69 % of these (n = 44) also produced acquired OXA-type carbapenemases. The presence of bla OXA-58-like, bla OXA-24/40-like, and bla OXA-23-like genes was demonstrated in 33 % (n = 21), 27 % (n = 17) and 9 % (n = 6) of carbapenem-resistant isolates, respectively. None of the isolates harbored the bla IMP, bla VIM, bla SIM, bla NDM or bla PER β-lactamase genes, while bla TEM-1 was detected in five carbapenem- and ampicillin/sulbactam-resistant isolates. Sequence group determination showed a high prevalence (81 %) of isolates belonging to the International clonal lineage (ICL)-I, although the majority (80 %) of isolates carrying acquired carbapenemase genes belonged to the ICL-II. Random amplified polymorphic DNA analysis and multilocus-sequence typing of a subset of carbapenem-resistant isolates revealed a low degree of genetic variability within both ICL-I and ICL-II populations, irrespective of the genetic basis of carbapenem resistance. Overall, an increasing trend toward carbapenem resistance was observed for A. baumannii in Croatia, and the emergence of ICL-II strains producing a variety of acquired carbapenemases.
KeywordsImipenem Meropenem Acinetobacter Baumannii Carbapenem Resistance Baumannii Isolate
This study was supported by a grant from the Croatian Ministry of Science, Education and Sport (Grant No108-1080-0015) and a visiting fellowship from Roma Tre University to BB. We thank to all Croatian collaborative centers for collecting A. baumannii isolates: Arjana Tambić Andrašević (UHI), Ana Budimir (UHC), Vlatka Janeš-Poje (GHK), Marina Payer-Pal (GHC), Snježana Nađ (GHVI), Branka Nemet (GHVA), Zdenka Peršić (NIPH), Ljiljana Čičak Smirnjak (GHVA), Sanja Krešić (GHB), Khalil Nemer (GHS), and Nada Barišić (GHP). We thank platform Genotyping of Pathogens and Public Health (Institut Pasteur) for coding MLST alleles and profiles, and to P. Higgins and G. Rossolini for providing control strains. Part of this manuscript was presented as a poster at the 23rd European Congress of Clinical Microbiology and Infectious Diseases (Berlin, 27–30 April 2013) and the 9th International Symposium on the Biology of Acinetobacter (Cologne, 19–21 June 2013).
Conflict of interest
The authors declare that they have no conflict of interest.
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