Characterization of Antimicrobial Resistance and Prevalence of OXA Genes in the Emerging Threat Acinetobacter baumannii Causing Blood Stream Infection in ICU Patients | ||||
| Egyptian Journal of Medical Microbiology | ||||
| Volume 27, Issue 4, October 2018, Page 141-148 PDF (355.53 K) | ||||
| Document Type: New and original researches in the field of Microbiology. | ||||
| DOI: 10.21608/ejmm.2018.285803 | ||||
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| Authors | ||||
Sanaa S. Hamam1; Samah M. Awad  2
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| 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Menoufia University, Egypt. | ||||
| 2Department of Clinical Microbiology and Immunology and Molecular Microbiology in Liver and GIT, National Liver Institute, Menoufia University, Egypt | ||||
| Abstract | ||||
| Background: Acinetobacter baumannii became one of the emerging life-threatening hospital acquired infection pathogens with marked antibiotic resistance due to multiple resistance mechanisms. One of these mechanisms is production of carbapenemase enzymes like Ambler Class B and Class D enzymes that hydrolyze carbapenems the last resort antimicrobial drug for treating multidrug resistant organisms. Objectives: To study the antimicrobial resistance of A. baumannii with detection of blaOXA carbapenemase genes responsible for resistance to carbapenems. Also to evaluate effectiveness of newly issued commercial Rapidec Carba NP kit test for detection of carbapenemases production and to assess the effect of implementing infection prevention and control (IPC) practices in decreasing rate of ICU blood stream infections. Methodology: This study was conducted from May 2017 to September 2018 by collecting blood cultures from ICU patients. A. baumannii species were identified and antibiotic susceptibility was run by VITEK 2Compact automated ID/AST instrument. Carbapenemase production was tested phenotypically by using Rapidec Carba NP kit test. A. baumannii species were tested for carbapenemase genes blaOXA-51, blaOXA-23, blaOXA-24 and blaOXA-58by multiplex PCR. Results: there was a significant decrease in number of ICU blood stream infections after implementing IPC practices. Isolated A. baumannii species were 100 % resistant to Ampicillin/Sulbactam, Cefipime, Ceftriaxone, Imipenem and Trimethoprim/Sulphamethoxazole, while highest sensitivity was to Amikacin (27.4 %). All isolates A. baumannii species gave positive results with Rapidec Carba NP kit test. Only blaOXA-23 (82.4 %) andblaOXA-51 (88.2 %) were detected in isolated A. baumannii species but blaOXA-24 andblaOXA-58 were not detected. Conclusion: A. baumannii is a great life-threatening hospital acquired pathogen with marked drug resistant and easy spread. Rapidec Carba NP kit test is an easy, non-labor phenotypic test for carbapenemases production detection which can replace old cumbersome, difficult and labor Carba NP test. | ||||
| Keywords | ||||
| Acinetobacter baumannii; antimicrobial resistance; OXA genes; blood stream infections; ICU patients | ||||
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