Korean J Lab Med.  2008 Feb;28(1):16-23. 10.3343/kjlm.2008.28.1.16.

Dissemination of IMP-1 and OXA Type beta-Lactamase in Carbapenem-resistant Acinetobacter baumannii

Affiliations
  • 1Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea. shkoo@cnu.ac.kr
  • 2Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
  • 3Department of Laboratory Medicine, Eulji University School of Medicine, Daejeon, Korea.
  • 4Department of Laboratory Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 5Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea.

Abstract

BACKGROUND: Acinetobacter baumannii is an aerobic, gram-negative, glucose-nonfermenting bacterium, which has emerged as a serious opportunistic pathogen. In recent years, the increasing instance of carbapenem-resistant A. baumannii producing metallo-beta-lactamases (MBLs) or OXAtype beta-lactamases is causing a serious clinical problem. In this study, we investigated the prevalence of Ambler class A, B, and D beta-lactamases and their extended-spectrum derivatives in carbapenem-resistant A. baumannii isolates.
METHODS
A total of 31 consecutive, non-duplicate, carbapenem-resistant A. baumannii were isolated from three university hospitals in the Chungcheong province of Korea. The modified Hodge and inhibitor-potentiated disk diffusion tests were conducted for the screening of carbapenemase and MBL production, respectively. PCR and DNA sequencing were performed for the detection of beta-lactamase genes. We also employed the enterobacterial repetitive intergenic consensus (ERIC)-PCR method for the epidemiologic study.
RESULTS
Twenty-three of 31 isolates harbored bla(OXA-2) (51.6%), bla(OXA-23) (22.6%), bla(IMP-1) (48.4%),and bla(VIM-2) (3.2%). All of the OXA-2-producing strains also evidenced MBLs. The strains that harbored bla(OXA-23) were isolated only in hospital C, and only in a limited fashion. The ERIC-PCR pattern of the five OXA-23 strains indicated that the isolates were closely related in terms of clonality. The six strains producing IMP-1 isolated from hospital A were confirmed to be identical strains.
CONCLUSIONS
A. baumannii strains harboring IMP-1 or OXA-type beta-lactamases are currently widely distributed throughout the Chungcheong province of Korea. The most notable finding in this study was that a bla(OXA-2)-producing A. baumannii harboring MBL, which has not been previously reported, can also lead to outbreaks.

Keyword

A. baumannii; MBL; OXA-2

MeSH Terms

Acinetobacter Infections/microbiology
Acinetobacter baumannii/drug effects/*enzymology/genetics
Anti-Bacterial Agents/*pharmacology
Carbapenems/*pharmacology
Disk Diffusion Antimicrobial Tests
Drug Resistance, Multiple, Bacterial
Humans
Polymerase Chain Reaction
beta-Lactamases/biosynthesis/genetics/*metabolism

Figure

  • Fig. 1. ERIC-PCR patterns of genomic DNA from seven clinical isolates of A. baumannii harboring blaoxa-23. Lane M1 and M2 are 1 kb and 100 bp DNA size markers, respectively.

  • Fig. 2. ERIC-PCR patterns of genomic DNA from ten clinical isolates of A. baumannii harboring blaIMP-1. Lane M1 is a 1 kb DNA size marker.


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