Multiple sequence types responsible for healthcare-associated Acinetobacter baumannii dissemination in a single centre in Egypt

• Published in: BMC infectious diseases 2019-10, Vol.19 (1), p.829-829, Article 829
• Main Authors: Al-Hassan, Leena, Zafer, Mai M, El-Mahallawy, Hadir
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii; Acinetobacter baumannii - genetics; Acinetobacter baumannii - isolation & purification; Acinetobacter infections; Acinetobacter Infections - diagnosis; Acinetobacter Infections - drug therapy; Acinetobacter Infections - epidemiology; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacterial Typing Techniques; Beef cattle; Behavior; beta-Lactamases; Birds; Cancer; Cancer Care Facilities; Cancer patients; Cancer research; Carbapenem resistance; Carbapenems - adverse effects; Carbapenems - therapeutic use; Cloning; Cross infection; Demographic aspects; Drug resistance; Drug Resistance, Multiple, Bacterial; Egypt - epidemiology; Epidemiology; Female; Forecasts and trends; Genes; Genes, Bacterial; Genetic aspects; Genotype; Health care; Health Personnel; Health risks; Humans; Immunocompromised host; Immunocompromised hosts; Infection; Infections; Infectious diseases; Medical personnel; Microbial drug resistance; Microbial Sensitivity Tests; Migratory birds; MLST; Multidrug resistance; Multilocus Sequence Typing; Novels; Oxalic acid; Patients; Risk factors; Studies; Workers
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-4433-1

Acinetobacter baumannii is an increasingly worrying organism in the healthcare setting, due to its multidrug resistance and persistence. Prolonged hospitalisation, immunocompromised patients and excessive antibiotic exposure all contribute to increasing the risk of A. baumannii infections, which makes cancer patients a significant risk group. This study aims to investigate the dissemination of A. baumannii at the National Cancer Institute (NCI) in Cairo - Egypt. All bacterial isolates were typed using Multi-locus Sequence Typing (MLST) to characterise the epidemiology of isolates. The intrinsic OXA-51-like, and the acquired carbapanemases OXA-23, - 24/40, - 58, NDM, IMP, and VIM were also amplified and sequenced to genetically identify mechanisms of carbapenem resistance. MLST results show a high degree of multi-clonal dissemination, with 18 different Sequence Types (STs) identified, including 5 novel. The majority of isolates belonged to International Clone (IC) 2, and carbapenem resistance was detected in 93% of isolates and mediated by bla , bla , bla and bla . We also report the presence of a resistant ST732 (OXA-378) which has been previously identified in migratory birds CONCLUSIONS: Multiple highly resistant clones were identified in a Cancer hospital in Cairo. It is vital that clinicians and healthcare workers are aware of the population of A. baumannii present in order to have appropriate treatment and infection control practices.