Isolation and genetic characterization of metallo-p-lactamase and carbapenamase producing strains of Acinetobacter baumannii from patients at Tehran hospitals

ABSTRACT

Carbapenems are therapeutic choice against infections caused by gram-negative bacilli including strains of Acinetobacter baumannii. Resistance to these antibiotics is mediated by efflux pumps, porins, PBPs and B-lactamases. The aim of this study was to determine the possibility of existence of MBLs, OXAs and GES-1 betalactamase genes among clinical isolates of Acinetobacter collected from Tehran hospitals. Two hundred and three Acinetobacter isolates were collected from patient at Tehran hospitals. The isolates were identified using biochemical tests. The susceptibility to different antibiotics was evaluated by disk diffusion method and MICs of imipenem were determined using Micro broth dilution method [CLSI]. PCR was performed for detection of bla[VIM-2], bla[SPM-1], bla[IMP-2], bla[GES-2], bla[OXA-51, bla[OXA-23] betalactamase genes. Clonal relatedness was estimated by PFGE with the restriction enzyme Smal. Of 100 isolates of imipenem resistant Acinetobacter spp. collected from Tehran hospitals in 2009 and 2010,6 isolates produced metallo-beta-lactamases and 94 isolates produced OXA- type carbapenemase. The bla[spm-1], bla[GES-1], bla[OXA-51, bla[OXA-23] genes were detected by PCR among 6, 2, 94 and 84 isolates of A. baumannii, respectively. The MICs of isolates to imipenem were 8-128 microg/mL. PFGE analysis of 29 bla[OXA-51] and BLA[OXA-23]-positive A baumannii isolates gave 6 different patterns. This is the first report of SPM-1 and GES-1 beta-lactamase producing A. baumannii. Production of the OXA-23, OXA-51, GES-1 and SPM-1 enzyme presents an emerging threat of carbapenem resistance among A. baumannii in Iran