Detection of acquired carbapenemase genes among Acinetobacter baumannii isolated from blood culture in patients with hematological malignancies

Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21(1):56-60

​ Khrulnova S.A., Korobova A.G., Fyodorova A.V., Frolova I.N., Savochkina Yu.A., Klyasova G.A.
10.36488/cmac.2019.1.56-60
Acinetobacter baumannii blood culture hematological malignancies carbapenems resistance OXA-carbapenemases
Section
Antimicrobial Resistance
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21(1):56-60

Objective.

To evaluate the prevalence of acquired carbapenemase genes among A. baumannii isolates collected from blood culture in patients with hematological malignancies.

Materials and Methods.

This prospective multicenter study included A. baumannii isolated from blood culture in hematological patients in 7 Russian hospitals (2003–2015). Minimum inhibitory concentrations (MICs) of meropenem and imipenem were determined by broth microdilution method (CLSI, 2017). All A. baumannii isolates were tested by multiplex real-time PCR for presence of acquired carbapenemase genes (blaOXA-23-like, blaOXA-24⁄40-like, blaOXA-58-like, blaNDM-like, blaVIM-like and blaIMP-like).

Results.

A total of 74 A. baumannii isolates were studied, of them 55 (74.3%) were non-susceptible to meropenem and/or imipenem. Genes of acquired OXA-carbapenemases were detected in 70.9% (39⁄55) of carbapenem non-susceptible isolates. Metallo-beta-lactamase genes (blaNDM-like, blaVIM-like and blaIMP-like) were not detected. The most prevalent carbapenemase genes were blaOXA-24⁄40-like (51.3%), followed by blaOXA-23-like (38.5%) and blaOXA-58-like (10.3%). The MIC50/90 values of meropenem and imipenem were higher in carbapenem non-susceptible A. baumannii harboring carbapenemase genes compared to isolates without acquired carbapenemase genes. A. baumannii isolates carrying blaOXA-24⁄40-like demonstrated the highest MIC50/90 values of carbapenems.

Conclusions.

The majority of carbapenem non-susceptible A. baumannii isolates (70.9%) carried acquired carbapenemase genes, of which blaOXA-24⁄40-like were predominant. The highest MIC50/90 values of carbapenems were detected in A. baumannii harboring blaOXA-24⁄40-like.

Svetlana A. Khrulnova

National Medical Research Center of Hematology, Moscow, Russia

Korobova A.G.

National Medical Research Center of Hematology, Moscow, Russia

Anastasiya V. Fyodorova

National Medical Research Center of Hematology, Moscow, Russia

Frolova I.N.

National Medical Research Center of Hematology, Moscow, Russia

Savochkina Yu.A.

Central Research Institute of Epidemiology, Moscow, Russia

Galina A. Klyasova

National Medical Research Center of Hematology, Moscow, Russia

  • 1. Peleg A.Y., Seifert H., Paterson D.L. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev. 2008;21(3):538-582. DOI: 10.1128/CMR.00058-07
  • 2. Klyasova G.А., Speranskaya L.L., Mironova А.V., et al. The pathogens causing sepsis in immunocompromized patients: structure and problems of antibiotic resistance. Results of a multi-center cooperative study. Gemаtologiya i trаnsfuziologiya. 2007;52(1):13-18.
  • 3. Klyasova G.A. Antimicrobial therapy. In: Savchenko V.G., ed. Program treatment of blood system diseases. Moscow: Praktika; 2012. p. 82753.
  • 4. Klyasova G.А. Okhmat V.А. Antimicrobial therapy. In: Savchenko V.G., ed. Algorithms of diagnosing and protocols of treatment of blood system diseases. Moscow: Praktika; 2018. P. 1069-1113.
  • 5. Wang X., Zhang L., Sun A., et al. Acinetobacter baumannii bacteraemia in patients with haematological malignancy: a multicenter retrospective study from the Infection Working Party of Jiangsu Society of Hematology. Eur J Clin Microbiol Infect Dis. 2017;36(7):10731081. DOI: 10.1007/s10096-016-2895-2
  • 6. Gedik H., Simşek F., Kantürk A., et al. Bloodstream infections in patients with hematological malignancies: which is more fatal – cancer or resistant pathogens? Ther Clin Risk Manag. 2014;10:743752. DOI: 10.2147/TCRM.S68450
  • 7. Stoma I., Karpov I., Milanovich N., Uss A., Iskrov I. Risk factors for mortality in patients with bloodstream infections during the preengraftment period after hematopoietic stem cell transplantation. Blood Res. 2016;51(2):102-106. DOI: 10.2147/TCRM.S68450
  • 8. Sukhorukova M.V., Edelstein M.V., Skleenova E.Yu., et al. Antimicrobal resistance of nosocomial Acinetobacter spp. isolates in Russia: results of multicenter epidemiological study «MARATHON» 20132014. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2017;19(1):42-47.
  • 9. Chung D.R., Song J.H., Kim S.H., et al. High prevalence of multidrugresistant nonfermenters in hospital-acquired pneumonia in Asia. Am J Respir Crit Care Med. 2011;184:1409-1417. DOI: 10.1164/rccm.201102-0349OC
  • 10. European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe 2015. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2017. Available at: https://ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-resistance-europe-2017.
  • 11. Mera R.M., Miller L.A., Amrine-Madsen H., Sahm D.F. Acinetobacter baumannii 2002-2008: increase of carbapenem-associated multiclass resistance in the United States. Microb Drug Resist. 2010;16:209215. DOI: 10.1089/mdr.2010.0052
  • 12. Martinovich A.A. Resistance Trends and Epidemiology of Acinetobacter Infections in Russia. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2010;12(2):96-105.
  • 13. Evans B.A., Amyes S.G. OXA β-lactamases. Clin Microbiol Rev. 2014;27:241-263. DOI: 10.1128/CMR.00117-13
  • 14. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Seventh Informational Supplement. CLSI document M100-S27. Wayne, PA: Clinical and Laboratory Standarts Institute; 2017.
  • 15. Dahdouh E., Gómez-Gil R., Pacho S., et.al. Clonality, virulence determinants, and profiles of resistance of clinical Acinetobacter baumannii isolates obtained from a Spanish hospital. PLoS One. 2017;12(4):e0176824. DOI: 10.1371/journal.pone.0176824
  • 16. Principe L., Piazza A., Giani T., et al. Epidemic diffusion of OXA-23-producing Acinetobacter baumannii isolates in Italy: results of the first cross-sectional countrywide survey. J Clin Microbiol. 2014;52(8):3004-3010. DOI: 10.1128/JCM.00291-14
  • 17. Mugnier P.D., Poirel L., Naas T., Nordmann P. Worldwide dissemination of the blaOXA-23 carbapenemase gene of Acinetobacter baumannii. Emerg Infect Dis. 2010;16(1):35-40. DOI: 10.3201/eid1601.090852
  • 18. Viana G.F., Zago M.C., Moreira R.R., et al. ISAba1/bla: a serious obstacle to controlling the spread and treatment of Acinetobacter baumannii strains. Am J Infect Control. 2016;44:593-595. DOI: 10.1016/j.ajic.2015.11.020
  • 19. Zarrilli R., Giannouli M., Tomasone F., Triassi M., Tsakris A. Carbapenem resistance in Acinetobacter baumannii: the molecular epidemic features of an emerging problem in health care facilities. J Infect Dev Ctries. 2009;3:481-489.
  • 20. Di Popolo A., Giannouli M., Triassi M., Brisse S., Zarrilli R. Molecular epidemiological investigation of multidrug-resistant Acinetobacter baumannii strains in four Mediterranean countries with a multilocus sequence typing scheme. Clin Microbiol Infect. 2011;17(2):197201. DOI: 10.1111/j.1469-0691.2010.03254.x
  • 21. Sukhorukova M.V., Edelstein M.V., Skleenova E.Yu., et al. Antimicrobal resistance of nosocomial Acinetobacter spp. isolates in Russia: results of multicenter epidemiological study «MARATHON» 2011-2012. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2014; 16 (4):266-272.
  • 22. Gordinskaya N.A., Sabirova E.V., Abramova N.V., Karaseva G.N., Nekaeva E.S. Antibiotics sensitivity and molecular mechanisms of resistance of Acinetobacter baumanii, infectious agents of burnwound infection. Medicinskij almanah. 2015;5(40):99-101.
  • 23. Migliavacca R., Espinal P., Principe L., et al. Characterization of resistance mechanisms and genetic relatedness of carbapenemresistant Acinetobacter baumannii isolated from blood, Italy. Diagn Microbiol Infect Dis. 2013;75(2):180-186. DOI: 10.1016/j.diagmicrobio.2012.11.002
  • 24. Mezzatesta M.L., Caio C., Gona F., et al. Carbapenem and multidrug resistance in Gram-negative bacteria in a single centre in Italy: considerations on in vitro assay of active drugs. Int J Antimicrob Agents. 2014;44:112-116. DOI: 10.1016/j.ijantimicag.2014.04.014
  • 25. Liakopoulos A., Miriagou V., Katsifas E.A., et al. Identification of OXA-23-producing Acinetobacter baumannii in Greece, 2010 to 2011. Euro Surveill. 2012;17(11). pii: 20117.
  • 26. Pournaras S., Dafopoulou K., Del Franco M., et al. Predominance of international clone 2 OXA-23-producing-Acinetobacter baumannii clinical isolates in Greece, 2015: results of a nationwide study. Int J Antimicrob Agents. 2017;49(6):749-753. DOI: 10.1016/j.ijantimicag.2017.01.028
  • 27. Grosso F., Quinteira S., Peixe L. Understanding the dynamics of imipenem-resistant Acinetobacter baumannii lineages within Portugal. Clin Microbiol Infect. 2011;17(8):1275-1279. DOI: 10.1111/j.1469-0691.2011.03469.x
Views
0 Abstract
0 PDF
0 Crossref citations
Shared