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High frequency of carbapenemase in extensively drug-resistant Acinetobacter baumannii isolates in central Iran

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Abstract

Objectives

We assessed the frequency of occurrence for infections caused by wild-type A. baumannii, multidrug-resistant (MDR) or XDR A. baumannii, and CRAB. We detected different antibiotic resistance genes in the genomes of infectious A. baumannii strains from central Iran.

Methods

This study investigated 546 clinical patient samples for the presence of A. baumannii by using conventional culture methods and PCR. Antibiotic resistance profiles, and the phenotypic and genotypic characteristics of various antibiotic genes were analyzed.

Results

Out of 546 samples, 87 (15.9%) A. baumannii isolates were obtained using culture and all culture positive samples were also positive by PCR. The most effective antibiotics were polymyxin B (n = 84 strains) (96.6% susceptibility), colistin (n = 81) (93.1%), and ampicillin/sulbactam (n = 18) (20.7%). All clinical A. baumannii isolates were ESBL-positive. The number of CRAB was 84 (96.5%). All CRAB isolates were both MDR and XDR. Of all CRAB isolates, 78 out of 84 (92.4%) produced metallo-β-lactamase (MBL) by phenotypic diagnosis. The most abundant genes were blaPER (32/87; 36.7%), blaTEM (29/87; 33.3%), blaVEB (26/87; 29.8%) for ESBL and Ambler class D β -lactamases included blaOXA−23 (69/84; 82.1%), blaOXA−24 (46/84; 54.7%), MBLs included blaVIM (51/84; 60.7%), and blaIMP (28/84; 33.3%) for carbapenemase.

Conclusion

High frequencies of XDR A. baumannii and CRAB (96.5%) were detected in central Iran. Quick and accurate diagnosis, appropriate isolation of patients colonized or infected by CRAB isolates, application of accurate and effective infection control policies and programs, and appropriate preventive measures are deemed helpful in preventing the further spread of these resistant and clinically highly relevant strains.

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Data Availability

The raw data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher.

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Acknowledgements

The authors gratefully acknowledge the educational assistance of Khomein University of Medical Sciences and its financial contributions to and support of this study.

Funding

This work was financially supported by the Khomein University of Medical Sciences (Number: ARAKMU.REC.1396.3.7). The funder had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. This funding is only for purchasing materials in this study. No additional external funding was received for this study.

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EA were involved in the data generation, collection, performed data analysis and writing of the first version of the paper. EGR conceptualized and designed the study. AvB performed data analysis and helped in writing of the paper. All authors have read and approved this final version of the manuscript.

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Correspondence to Ehsanollah Ghaznavi-Rad.

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Abbasi, E., van Belkum, A. & Ghaznavi-Rad, E. High frequency of carbapenemase in extensively drug-resistant Acinetobacter baumannii isolates in central Iran. World J Microbiol Biotechnol 39, 321 (2023). https://doi.org/10.1007/s11274-023-03778-y

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