Co-Existence of Carbapenemase-Encoding Genes in Acinetobacter baumannii from Cancer Patients
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ORIGINAL RESEARCH
Co-Existence of Carbapenemase-Encoding Genes in Acinetobacter baumannii from Cancer Patients Reham Wasfi . Fatma Rasslan . Safaa S. Hassan . Hossam M. Ashour
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Ola A. Abd El-Rahman
Received: September 20, 2020 / Accepted: October 24, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Acinetobacter baumannii is an opportunistic pathogen, which can acquire new resistance genes. Infections by carbapenem-resistant A. baumannii (CRAB) in cancer patients cause high mortality. Methods: CRAB isolates from cancer patients were screened for carbapenemase-encoding genes that belong to Ambler classes (A), (B), and (D), followed by genotypic characterization by enterobacterial-repetitive-Intergenic-
R. Wasfi Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt F. Rasslan O. A. Abd El-Rahman Department of Microbiology and Immunology, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt S. S. Hassan Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt H. M. Ashour (&) Department of Integrative Biology, College of Arts and Sciences, University of South Florida, St. Petersburg, FL, USA e-mail: [email protected] H. M. Ashour Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
consensus–polymerase chain reaction (ERIC–PCR) and multilocus-sequence-typing (MLST). Results: A total of 94.1% of CRAB isolates coharbored more than one carbapenemase-encoding gene. The genes blaNDM, blaOXA-23-like, and blaKPC showed the highest prevalence, with rates of 23 (67.7%), 19 (55.9%), and 17 (50%), respectively. ERIC-PCR revealed 19 patterns (grouped into 9 clusters). MLST analysis identified different sequence types (STs) (ST-268, ST195, ST-1114, and ST-1632) that belong to the highly resistant easily spreadable International clone II (IC II). Genotype diversity indicated the dissemination of carbapenem-hydrolyzing, b-lactamase-encoding genes among genetically unrelated isolates. We observed a high prevalence of metallo-b-lactamase (MBL)-encoding genes (including the highly-resistant blaNDM gene that is capable of horizontal gene transfer) and of isolates harboring multiple carbapenemase-encoding genes from different classes. Conclusion: The findings are alarming and call for measures to prevent and control the spread of MBL-encoding genes among bacteria causing infections in cancer patients and other immunocompromised patient populations. Keywords: Cancer; Carbapenem-resistant Acinetobacter baumannii (CRAB); Metallo-blactamase (MBL); Multilocus sequence typing (MLST)
Infect Dis Ther
Key Summary Points The majority (94.1%) of carbapenemresistant A. baumannii (CRAB) isolates from cancer patients harbored more than one carbapenemase-encoding genes. We observed a high prevalence of metallob-lactamase-encoding genes including blaNDM, blaOXA-23-like, and blaKPC. MLST analysis identified different STs that belong to the highly resistant easily spreadable
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