1. Tn2008-driven carbapenem resistance in Acinetobacter baumannii isolates from a period of increased incidence of infections in a Southwest Virginia hospital (USA).
- Author
-
Rao J, Susanti D, Childress JC, Mitkos MC, Brima JK, Baffoe-Bonnie AW, Pearce SN, Grgurich D, Fernandez-Cotarelo MJ, Kerkering TM, and Mukhopadhyay B
- Subjects
- Acinetobacter Infections epidemiology, Acinetobacter baumannii classification, Acinetobacter baumannii genetics, Acinetobacter baumannii isolation & purification, Bacterial Proteins genetics, Bacterial Proteins metabolism, Cross Infection epidemiology, DNA Transposable Elements, Humans, Incidence, Microbial Sensitivity Tests, Multilocus Sequence Typing, Plasmids genetics, Plasmids metabolism, Tertiary Care Centers statistics & numerical data, Virginia epidemiology, beta-Lactamases genetics, beta-Lactamases metabolism, Acinetobacter Infections microbiology, Acinetobacter baumannii drug effects, Anti-Bacterial Agents pharmacology, Carbapenems pharmacology, Cross Infection microbiology, Drug Resistance, Multiple, Bacterial
- Abstract
Objectives: The objectives of this study were (i) to determine the genetic basis for carbapenem resistance in multidrug-resistant (MDR) Acinetobacter baumannii strains isolated from patients affected by a sudden increase in the incidence of infections by such organisms in a tertiary care hospital in Virginia, USA, in 2009-2010 and (ii) to examine whether such strains are commonly encountered in the hospital setting., Methods: The whole genomes of one outbreak strain as well as one carbapenem-resistant and one carbapenem-sensitive strain from sporadic infections in 2010-2012 were sequenced and analysed. Then, 5 outbreak isolates and 57 sporadic isolates (of which 39 were carbapenem-resistant) were screened by PCR for relevant DNA elements identified in the genomics investigation., Results: All three strains for which whole-genome sequences were obtained carried resistance genes linked to MDR phenotypes and a ca. 111-kbp plasmid (pCMCVTAb1) without drug resistance genes. Of these, the two carbapenem-resistant strains possessed a ca. 74-kbp plasmid (pCMCVTAb2) carrying a Tn2008 transposon that provides high-level carbapenem resistance. PCR analysis showed that all of the outbreak isolates carried both plasmids and Tn2008, and of the sporadic isolates 88% carried pCMCVTAb1, 25% contained pCMCVTAb2 and 50% of the latter group carried Tn2008., Conclusions: Carbapenem resistance in outbreak strains and 12% of sporadic isolates was due to the pCMCVTAb2-borne Tn2008. This is the first report of a Tn2008-driven outbreak of carbapenem-resistant A. baumannii infections in the Commonwealth of Virginia, which followed similar cases in Pennsylvania and Ohio., (Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF