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Antimicrobial Resistance & Infection Control

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Open Access 01-12-2017 | Research

Clonal diversity and detection of carbapenem resistance encoding genes among multidrug-resistant Acinetobacter baumannii isolates recovered from patients and environment in two intensive care units in a Moroccan hospital

Authors: Jean Uwingabiye, Abdelhay Lemnouer, Ignasi Roca, Tarek Alouane, Mohammed Frikh, Bouchra Belefquih, Fatna Bssaibis, Adil Maleb, Yassine Benlahlou, Jalal Kassouati, Nawfal Doghmi, Abdelouahed Bait, Charki Haimeur, Lhoussain Louzi, Azeddine Ibrahimi, Jordi Vila, Mostafa Elouennass

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2017

Abstract

Background

Carbapenem-resistant Acinetobacter baumannii has recently been defined by the World Health Organization as a critical pathogen. The aim of this study was to compare clonal diversity and carbapenemase-encoding genes of A. baumannii isolates collected from colonized or infected patients and hospital environment in two intensive care units (ICUs) in Morocco.

Methods

The patient and environmental sampling was carried out in the medical and surgical ICUs of Mohammed V Military teaching hospital from March to August 2015. All A. baumannii isolates recovered from clinical and environmental samples, were identified using routine microbiological techniques and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry. Antimicrobial susceptibility testing was performed using disc diffusion method. The carbapenemase-encoding genes were screened for by PCR. Clonal relatedness was analyzed by digestion of the DNA with low frequency restriction enzymes and pulsed field gel electrophoresis (PFGE) and the multi locus sequence typing (MLST) was performed on two selected isolates from two major pulsotypes.

Results

A total of 83 multidrug-resistant A. baumannii isolates were collected: 47 clinical isolates and 36 environmental isolates. All isolates were positive for the bla _OXA51-like and bla _OXA23-like genes. The coexistence of bla _NDM-1 /bla _OXA-23-like and bla _{OXA 24-like} /bla _OXA-23-like were detected in 27 (32.5%) and 2 (2.4%) of A. baumannii isolates, respectively. The environmental samples and the fecally-colonized patients were significantly identified (p < 0.05) as the most common sites of isolation of NDM-1-harboring isolates. PFGE grouped all isolates into 9 distinct clusters with two major groups (0007 and 0008) containing up to 59% of the isolates. The pulsotype 0008 corresponds to sequence type (ST) 195 while pulsotype 0007 corresponds to ST 1089.The genetic similarity between the clinical and environmental isolates was observed in 80/83 = 96.4% of all isolates, belonging to 7 pulsotypes.

Conclusion

This study shows that the clonal spread of environmental A. baumannii isolates is related to that of clinical isolates recovered from colonized or infected patients, being both associated with a high prevalence of the bla _OXA23-like and bla _NDM-1genes. These findings emphasize the need for prioritizing the bio-cleaning of the hospital environment to control and prevent the dissemination of A. baumannii clonal lineages.

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Title: Clonal diversity and detection of carbapenem resistance encoding genes among multidrug-resistant Acinetobacter baumannii isolates recovered from patients and environment in two intensive care units in a Moroccan hospital
Authors: Jean Uwingabiye
Abdelhay Lemnouer
Ignasi Roca
Tarek Alouane
Mohammed Frikh
Bouchra Belefquih
Fatna Bssaibis
Adil Maleb
Yassine Benlahlou
Jalal Kassouati
Nawfal Doghmi
Abdelouahed Bait
Charki Haimeur
Lhoussain Louzi
Azeddine Ibrahimi
Jordi Vila
Mostafa Elouennass
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Antimicrobial Resistance & Infection Control / Issue 1/2017
Electronic ISSN: 2047-2994
DOI: https://doi.org/10.1186/s13756-017-0262-4

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Abstract

Background

Methods

Results

Conclusion

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