Emergence and spread of resistant and biofilm-forming Acinetobacter baumannii in critically ill COVID-19 patients

• Published in: Microbial pathogenesis 2024-12, Vol.197, p.107078, Article 107078
• Main Authors: Silva, Rafael Thiago Pereira da, Rocha, Igor Vasconcelos, Dantas, Tainara Fernandes, Silva, Jaqueline dos Santos, Costa Júnior, Sérgio Dias da, Luz, Ana Carolina de Oliveira, Moreno, Marcelo, Leal-Balbino, Tereza Cristina, Araújo Lima, Ana Vitória, Silva, Evandro G.da, Coutinho, Henrique Douglas Melo, Oliveira, Maria Betânia Melo de
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii; Acinetobacter baumannii - drug effects; Acinetobacter baumannii - genetics; Acinetobacter Infections - drug therapy; Acinetobacter Infections - microbiology; aminoglycosides; Anti-Bacterial Agents - pharmacology; antibiotic resistance; Biofilm formation; Biofilms - drug effects; Biofilms - growth & development; carbapenems; Coinfection - microbiology; Coinfection - virology; COVID-19 - microbiology; COVID-19 infection; Critical Illness; cross infection; Cross Infection - microbiology; DNA; Drug resistance; Drug Resistance, Bacterial - genetics; Drug Resistance, Multiple, Bacterial - genetics; Epidemiological surveillance; Female; genetic analysis; Gram negative; hospitals; Humans; Male; matrix-assisted laser desorption-ionization mass spectrometry; Microbial Sensitivity Tests; microbiology; Middle Aged; opportunistic pathogens; pathogenesis; psychological stress; SARS-CoV-2 - drug effects; SARS-CoV-2 - genetics
• ISSN: 0882-4010; 1096-1208; 1096-1208
• DOI: 10.1016/j.micpath.2024.107078

The COVID-19 pandemic has raised concerns beyond the viral infection itself. Bacterial co-infections, particularly those involving Acinetobacter baumannii, have become a significant worry in critically ill COVID-19 patients. A. baumannii is an opportunistic pathogen that can cause nosocomial infections, especially in patients with compromised immune systems. This study investigated 36 A. baumannii isolates obtained from COVID-19 patients during a concurrent outbreak. The isolates were collected over two years through routine medical requests sent to the Clinical Microbiology laboratory. Identification of the strains was confirmed through biochemical tests, the Phoenix BD® Automated Microbiology System, and MALDI-TOF Mass Spectrometry. The study assessed the antimicrobial sensitivity of the isolates, with a specific focus on resistance to the beta-lactam group as well as aminoglycosides. The presence of specific antibiotic resistance genes (blaOXA-23, -24, -51 and -58, blaKPC, blaSHV, blaIMP, blaVIM, aac(6′)-Ib, ant(3″)-Ia, and aph(3′)-Ia) was investigated using PCR and Sanger DNA sequencing. Biofilm-forming capabilities of the isolates were also evaluated. The findings revealed diverse resistance profiles, with a high prevalence of resistant strains, including resistance to carbapenems. Genetic analysis suggested potential clonal spread of certain strains within the hospital setting. Moreover, a significant proportion of the isolates demonstrated strong biofilm-forming abilities, which can enhance persistence and antibiotic resistance. In conclusion, this study highlights the need for vigilant monitoring and targeted interventions to address bacterial co-infections in COVID-19 patients. The diversity in resistance patterns, potential clonal spread, and robust biofilm-forming abilities among A. baumannii isolates underscore the importance of addressing this issue to better manage and treat critically ill COVID-19 patients. •The isolates displayed Extensive Drug-Resistance.•Several isolates contained the coexistence of different resistance genes.•Genetic analysis suggests strain spread in the hospital, hinting at clonal transmission.•All isolates formed biofilms, with about 72 % considered strong producers.