Prevalence and genetic characterization of carbapenem- and polymyxin-resistant acinetobacter baumanniiIsolated from a tertiary hospital in Terengganu, Malaysia

Lean, S.S. and Zarizal, S. and Salwani, I. and Nor Iza, A.R. and Fatimah Hazlina, A. and Zakaria, J. and Chew, C.Y. and Thong, Kwai Lin (2014) Prevalence and genetic characterization of carbapenem- and polymyxin-resistant acinetobacter baumanniiIsolated from a tertiary hospital in Terengganu, Malaysia. Prevalence and Genetic Characterization of Carbapenem- and Polymyxin-Resistant Acinetobacter baumanniiIsolated from a Tertiary Hospital in Terengganu, Malaysia, 2014.

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Abstract

Nosocomial infection caused by Acinetobacter baumannii is of great concern due to its increasing resistance to most antimicrobials. In this study, 54 nonrepeat isolates of A. baumannii from the main tertiary hospital in Terengganu, Malaysia, were analyzed for their antibiograms and genotypes. Out of the 54 isolates, 39 (72.2%) were multidrug resistant (MDR) and resistant to carbapenems whereas 14 (25.9%) were categorized as extensive drug resistant (XDR) with additional resistance to polymyxin B, the drug of “last resort.” Pulsed-field gel electrophoresis analyses showed that the polymyxin-resistant isolates were genetically diverse while the carbapenem-resistant isolates were clonally related. The 14 XDR isolates were further investigated for mutations in genes known to mediate polymyxin resistance, namely, pmrCAB, and the lipopolysaccharide biosynthesis genes, lpxA, lpxC, lpxD, and lpsB. All 14 isolates had a P102H mutation in pmrA with no mutation detected in pmrC and pmrB. No mutation was detected in lpxA but each polymyxin-resistant isolate had 2–4 amino acid substitutions in lpxD and 1-2 substitutions in lpxC. Eight resistant isolates also displayed a unique H181Y mutation in lpsB. The extent of polymyxin resistance is of concern and the novel mutations discovered here warrant further investigations.

Item Type:	Article
Funders:	UNSPECIFIED
Additional Information:	Institute of Biological Sciences, Faculty of Science Building, University of Malaya, 50603 Kuala Lumpur, MALAYSIA
Uncontrolled Keywords:	Biological Sciences
Subjects:	R Medicine > RB Pathology > Theories of disease. Etiology. Pathogenesis
Divisions:	Faculty of Science > Institute of Biological Sciences
Depositing User:	Prof. Dr Kwai Lin Thong
Date Deposited:	04 Dec 2014 06:43
Last Modified:	15 Oct 2018 05:33
URI:	http://eprints.um.edu.my/id/eprint/9950

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