Increased blaOXA-23-like prevalence in Acinetobacter baumannii at a tertiary care center in Lebanon (2007-2013)

  • Souha S Kanj American University of Beirut Medical Center, Beirut, Lebanon
  • Ralph Tayyar American University of Beirut Medical Center, Beirut, Lebanon
  • Marwa Shehab American University of Beirut Medical Center, Beirut, Lebanon
  • Bassam El-Hafi American University of Beirut Medical Center, Beirut, Lebanon
  • Sari S Rasheed American University of Beirut Medical Center, Beirut, Lebanon
  • Kohar Annie Berge Kissoyan American University of Beirut Medical Center, Beirut, Lebanon
  • Zeina A Kanafani American University of Beirut Medical Center, Beirut, Lebanon
  • Rima Hanna Wakim American University of Beirut Medical Center, Beirut, Lebanon
  • Nada Kara Zahreddine American University of Beirut Medical Center, Beirut, Lebanon
  • George F Araj American University of Beirut Medical Center, Beirut, Lebanon
  • Ghassan Dbaibo American University of Beirut Medical Center, Beirut, Lebanon
  • Ghassan M Matar American University of Beirut Medical Center, Beirut, Lebanon
Keywords: Acinetobacter baumannii, carbapenem resistance, blaOXA-23-like, horizontal gene transfer, outbreak

Abstract

Introduction: Acinetobacter baumannii has become one of the most feared organisms in hospital-acquired infections during the past decades. Their multi-drug resistant profiles have rendered many broad-spectrum antibiotics ineffective. The purpose of this retrospective study is to describe and compare molecular characteristics of A. baumannii isolated from patients at a tertiary care center in Lebanon from two outbreaks, the first in 2007-2008 as part of a case-controlled study involving Acinetobacter baumannii cases admitted to the ICU and the second in 2013. Methodology: A total of 148 A. baumannii clinical isolates were collected from various clinical specimens during 2007-2008 and 2013. All A. baumannii isolates were subjected to PCR amplification of blaOXA-23-like and blaOXA-51-like genes of carbapenem resistance. Random amplification of polymorphic DNA (RAPD) was also performed to assess their genomic relatedness. Results: There was an increase in the prevalence of blaOXA-23-like and blaOXA-51-like between the two time periods; however, only with 22% genomic relatedness between 2007-2008 and 2013 isolates. Taking 80% as margin of compatibility, 31 distinct clusters containing 2 to 11 strains were observed in both time periods. Conclusion: The presence of numerous clusters accompanied by a predominant increase in the prevalence of blaOXA-23-like gene between 2007 and 2013 suggests a horizontal transmission of the gene within various strains of the species, constituting a primary factor in the continued increase of carbapenem resistance over the years. As such, infection control measures ought to be taken with the highest priority and compliance among all involved healthcare workers is of utmost importance.

Author Biographies

Souha S Kanj, American University of Beirut Medical Center, Beirut, Lebanon

Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Ralph Tayyar, American University of Beirut Medical Center, Beirut, Lebanon

Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Marwa Shehab, American University of Beirut Medical Center, Beirut, Lebanon

Department of Experimental Pathology, Immunology & Microbiology, American University of Beirut, Beirut, Lebanon

Bassam El-Hafi, American University of Beirut Medical Center, Beirut, Lebanon

Department of Experimental Pathology, Immunology & Microbiology, American University of Beirut, Beirut, Lebanon

Sari S Rasheed, American University of Beirut Medical Center, Beirut, Lebanon

Department of Experimental Pathology, Immunology & Microbiology, American University of Beirut, Beirut, Lebanon

Kohar Annie Berge Kissoyan, American University of Beirut Medical Center, Beirut, Lebanon

Department of Experimental Pathology, Immunology & Microbiology, American University of Beirut, Beirut, Lebanon

Zeina A Kanafani, American University of Beirut Medical Center, Beirut, Lebanon

Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Rima Hanna Wakim, American University of Beirut Medical Center, Beirut, Lebanon

Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Nada Kara Zahreddine, American University of Beirut Medical Center, Beirut, Lebanon

Infection Control and Prevention Program, American University of Beirut Medical Center, Beirut, Lebanon

George F Araj, American University of Beirut Medical Center, Beirut, Lebanon

Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Ghassan Dbaibo, American University of Beirut Medical Center, Beirut, Lebanon

Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Ghassan M Matar, American University of Beirut Medical Center, Beirut, Lebanon

Professor

Department of Experimental Pathology, Immunology & Microbiology, American University of Beirut, Beirut, Lebanon

Published
2018-04-30
How to Cite
1.
Kanj S, Tayyar R, Shehab M, El-Hafi B, Rasheed S, Kissoyan KA, Kanafani Z, Wakim R, Kara Zahreddine N, Araj G, Dbaibo G, Matar G (2018) Increased blaOXA-23-like prevalence in Acinetobacter baumannii at a tertiary care center in Lebanon (2007-2013). J Infect Dev Ctries 12:228-234. doi: https://doi.org/10.3855/jidc.9642
Section
Original Articles