تعیین شیوع و سکوانسینگ ژن های مقاومت به کارباپنم در گونه های اسینتوباکتر جدا شده از نمونه های کلینیکی
محورهای موضوعی : میکروب شناسیسارا عطاریه 1 , مجید علی پور 2
1 - گروه میکروب‌شناسی، واحد بابل، دانشگاه آزاد اسلامی، بابل، ایران
2 - گروه میکروب‌شناسی، واحد بابل، دانشگاه آزاد اسلامی، بابل، ایران
کلید واژه: شیوع, سکوانسینگ, ژن های مقاومت, کارباپنم, اسینتوباکتر.,
چکیده مقاله :
هدف: عفونت با اسینتوباکتر یکی از مهمترین مشکلات در بیمارستان ها بشمار می آید. بنابراین تشخیص این سویه ها و مکانیسم های مقاومت آنتی بیوتیکی مهم می باشد. هدف از این مطالعه بررسی مولکولی و مقاومت آنتی بیوتیکی اسینتوباکتر است.
مواد و روش ها: روش های فنوتاپی و واکنش زنجیره‌ای پلیمراز جهت شناسایی مقاومت آنتی بیوتیکی با ژن bla-NDM ، bla-IMP و bla-VIM استفاده شد و باندهای ایجاد شده محصول PCR سکانس گردید. برای تحلیل داده ها از 21 -SPSS، آزمون مجذور کای یا آزمون دقیق فیشر استفاده شد (05/0>P).
یافته ها: در این مطالعه 40 ایزوله گونه آسینتوباکتر جمع آوری شد. بیشترین ایزوله از بخش مراقبت های ویژه (50/77%) بودند و از نمونه های خلط (45%) جدا شدند. رابطه معنی داری بین جنس (004/0=p)، شیوع این باکتری در بخش های مختلف بیمارستان (001/0>p) و نوع نمونه (001/0>p) وجود داشت. بیشترین و کمترین مقاومت آنتی بیوتیکی به ترتیب مربوطه به آنتی بیوتیک سفتازیدیم (50/97%) و پیپراسیلین-تازوباکتام (20%) بودند. ژن های bla-NDM در 10 (25%)، bla-IMP در 9 (5/22%)، و bla-NDM در 1 (5/2%) نمونه شناسایی شدند. نتایج توالی یابی، اسینتوباکتر بومانی را نشان داد.
نتیجه گیری: وجود مقاومت آنتی بیوتیکی در اسینتوباکتر مشخص شد. انتخاب بهترین آنتی بیوتیک که باکتری مقاومت کمتری به آن دارد، همراه با روش های مولکولی به پیشگیری مقاومت آنتی بیوتیکی کمک خواهد کرد.
Objective: Acinetobacter infection is one of the most important problems in hospitals. Therefore, identifying the species, and mechanisms of antibiotic resistance are important. The purpose of this study is the molecular investigation and antibiotic resistance of Acinetobacter.
Materials and methods: Phenotypic and PCR were used to identify antibiotic resistance with bla-NDM, bla-IMP, and bla-VIMP genes and generated bands of PCR product were sequenced. SPSS -21, Chi-square test, or Fisher exact test were used for data analysis (P<0.05).
Findings: In this study, 40 isolates of Acinetobacter species were collected. Most isolates were from the intensive care unit (77.50%) and were isolated from sputum (45%). There was a significant relationship between genus (p=0.004), prevalence of this bacterium in different hospital departments (p<0.001), and sample type (p<0.001). The highest and lowest antibiotic resistance was to the antibiotics ceftazidime (97.50%) and piperacillin-tazobactam (20%), respectively. The bla-NDM genes were identified in 10 (25%), bla-IMP in 9 (22.5%), and bla-NDM in 1 (2.5%) samples. Sequencing results showed Acinetobacter baumannii.
Conclusion: In the present study, the presence of antibiotic resistance in Acinetobacter was determined and proven. Examining and selecting the best antibiotic that has less resistance to it along with molecular methods will help control antibiotic resistance.
1. Beijerinck M. Pigmenten als oxydatieproducten gevormd door bacterien. Versl Koninklijke Akad Wetensch Amsterdam. 1911;19:1092-103.
2. Peleg AY, Seifert H & Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clinical Microbiology Reviews. 2008;21(3):538-582.
3. Wong D, Nielsen TB, Bonomo RA, Pantapalangkoor P, Luna B & Spellberg B. Clinical and pathophysiological overview of Acinetobacter infections: a century of challenges. Clinical Microbiology Reviews. 2017;30(1):409-447.
4. Chusri S, Chongsuvivatwong V, Rivera JI, Silpapojakul K, Singkhamanan K, McNeil E & Doi Y. Clinical outcomes of hospital-acquired infection with Acinetobacter nosocomialis and Acinetobacter pittii. Antimicrobial Agents and Chemotherapy. 2014;58(7):4172-4179.
5. Chang W, Lu C, Huang C & Chuang Y. Community-acquired Acinetobacter meningitis in adults. Infection. 2000;28:395-397.
6. Levin AS, Levy CE, Manrique AEI, Medeiros EA & Costa SF. Severe nosocomial infections with imipenem-resistant Acinetobacter baumannii treated with ampicillin/sulbactam. International Journal of Antimicrobial Agents. 2003;21(1):58-62.
7. Carvalheira A, Silva J & Teixeira P. Acinetobacter spp. in food and drinking water - A review. Food Microbiology. 2021;95:103675.
8. Jung SY, Lee SH, Lee SY, Yang S, Noh H, Chung EK & Lee JI. Antimicrobials for the treatment of drug-resistant Acinetobacter baumannii pneumonia in critically ill patients: a systemic review and Bayesian network meta-analysis. Journal of Critical Care. 2017;21(1):319.
9. Wang Z & Li H. The tigecycline resistance mechanisms in Gram-negative bacilli. Frontiers in Cellular and Infection Microbiology. 2024;14:1471469.
10. Towner K. Acinetobacter: an old friend, but a new enemy. Journal of Hospital Infection. 2009;73(4):355-563.
11. Lolans K, Rice TW, Munoz-Price LS & Quinn JP. Multicity outbreak of carbapenem-resistant Acinetobacter baumannii isolates producing the carbapenemase OXA-40. Antimicrobial Agents and Chemotherapy. 2006;50(9):2941-2945.
12. Talbot GH, Bradley J, Edwards Jr JE, Gilbert D, Scheld M & Bartlett JG. Bad bugs need drugs: an update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America. Clinical Infectious Diseases. 2006;42(5):657-668.
13. Schreckenberger PC. Acinetobacter, Achromobacter, Chryseobacterium, Moraxella, and other Nonfermenitative Gram-negative Rods. Manual of Clinical Microbiology. 2004;1:749-751.
14. Alharbi LN, Rehman S, Azmi S, Alamri A, Alnimr A, Ansari MA. Novel circular antimicrobial peptides to combat a critical listed bacterial pathogen multi drug resistant Acinetobacter baumannii. Microbial Pathogenesis. 2025;203:107448.
15. Sarhaddi N, Dolatabadi S & Amel Jamehdar S. Drug resistance pattern of carbapenem-resistant Acinetobacter baumannii isolated from a referral burn center in northeast of Iran. Medical Journal of Mashhad university of Medical Sciences. 2016; 59(1): 1-8. [in persian]
16. Norouzi Bazgir Z, Ahanjan M, Hashemi Soteh MB & Reza Goli H. Prevalence of IMP and SPM Genes in Clinical Isolatesof Carbapenem Resistant Acinetobacter baumannii in Educational Hospitals of Sari, Iran. Journal of Mazandaran University of Medical Sciences. 2019;29(174):30-41. [in persian]
17. Piperaki ET, Tzouvelekis L, Miriagou V & Daikos G. Carbapenem-resistant Acinetobacter baumannii: in pursuit of an effective treatment. Clinical Microbiology and Infection. 2019;25(8):951-957.
18. Anchana SR, Girija SA, Gunasekaran S, Priyadharsini VJ. Detection of csgA gene in carbapenem-resistant Acinetobacter baumannii strains and targeting with Ocimum sanctum biocompounds. Iranian Journal of Basic Medical Sciences. 2021;24(5): 690-698.
19. Berlau J, Aucken H, Houang E & Pitt T. Isolation of Acinetobacter spp including A. baumannii from vegetables: implications for hospital-acquired infections. Journal of Hospital Infection. 1999;42(3):201-204.
20. Jalali M, Rasooli I, Ahmadi Zanoos K, Jahangiri A, Jalali Nadooshan M & Darvish Alipour Astaneh S. Immunogenicity of amino acid region 7601-8140 in biofilm associated protein of Acinetobacter baumannii. Pathobiology Research. 2014;16(4):15-26.
21. Calhoun JH, Murray CK & Manring M. Multidrug-resistant organisms in military wounds from Iraq and Afghanistan. Clinical Orthopaedics and Related Research. 2008;466:1356-62.
22. Constantiniu S, Romaniuc A, Iancu LS, Filimon R & Taraşi I. Cultural and biochemical characteristics of Acinetobacter spp. strains isolated from hospital units. Journal of Preventive Medicine. 2004;12(3-4):35-42.
23. Lin YC, Sheng WH, Chang SC, Wang JT, Chen YC, Wu RJ, Hsia KC & Li SY. Application of a microsphere-based array for rapid identification of Acinetobacter spp. with distinct antimicrobial susceptibilities. Journal of Clinical Microbiology. 2008;46(2):612-617.
24. Bernards A, Van der Toorn J, Van Boven C & Dijkshoorn L. Evaluation of the ability of a commercial system to identify Acinetobacter genomic species. European Journal of Clinical Microbiology and Infectious Diseases. 1996; 15: 303-308.
25. Mendes RE, Farrell DJ, Sader HS & Jones RN. Comprehensive assessment of tigecycline activity tested against a worldwide collection of Acinetobacter spp.(2005–2009). Diagnostic Microbiology and Infectious Disease. 2010;68(3):307-311.
26. Fillaux J, Dubouix A, Conil J-M, Laguerre J & Marty N. Retrospective analysis of multidrug-resistant Acinetobacter baumannii strains isolated during a 4-year period in a university hospital. Infection Control and Hospital Epidemiology. 2006;27(7):647-653.
27. Giamarellou H, Antoniadou A & Kanellakopoulou K. Acinetobacter baumannii: a universal threat to public health?. International Journal of Antimicrobial Agents. 2008;32(2):106-119.
28. Feng DY, Zhou YQ, Zou XL, Zhou M, Zhu JX, Wang YH & Zhang TT. Differences in microbial etiology between hospital-acquired pneumonia and ventilator-associated pneumonia: a single-center retrospective study in Guang Zhou. Infection and Drug Resistance. 2019;12:993-1000.
29. Spellberg B & Rex JH. The value of single-pathogen antibacterial agents. Nature Reviews Drug Discovery. 2013;12(12):963.
30. Sugawara E & Nikaido H. OmpA is the principal nonspecific slow porin of Acinetobacter baumannii. Journal of Bacteriology. 2012;194(15):4089-4096.
31. Zarrilli R, Giannouli M, Tomasone F, Triassi M & Tsakris A. Carbapenem resistance in Acinetobacter baumannii: the molecular epidemic features of an emerging problem in health care facilities. Journal of Infection in Developing Countries. 2009;3(05):335-341.
32. Sunenshine RH, Wright MO, Maragakis LL, Harris AD, Song X, Hebden J, Cosgrove SE, Anderson A, Carnell J, Jernigan DB, Kleinbaum DG, Perl TM, Standiford HC & Srinivasan A. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerging Infectious Diseases. 2007;13(1): 97-103.
33. Papenfort K & Bassler BL. Quorum sensing signal-response systems in Gram-negative bacteria. Nature Reviews Microbiology. 2016;14(9):576-588.
34. Mizuta K, Ohta M, Mori M, Hasegawa T, Nakashima I & Kato N. Virulence for mice of Klebsiella strains belonging to the O1 group: relationship to their capsular (K) types. Infection and Immunity. 1983;40(1):56-61.
35. Rosen DA, Pinkner JS, Jones JM, Walker JN, Clegg S & Hultgren SJ. Utilization of an intracellular bacterial community pathway in Klebsiella pneumoniae urinary tract infection and the effects of FimK on type 1 pilus expression. Infection and immunity. 2008;76(7):3337-3345.
36. Chen Y, Zhou Z, Jiang Y & Yu Y. Emergence of NDM-1-producing Acinetobacter baumannii in China. Journal of Antimicrobial Chemotherapy. 2011;66(6):1255-1259.
37. da Silva IR, Aires CAM, Conceição-Neto OC, de Oliveira Santos IC, Ferreira Pereira N, Moreno Senna JP, Carvalho-Assef APD, Asensi MD & Rocha-de-Souza CM. Distribution of clinical NDM-1-producing gram-negative bacteria in Brazil. Microb Drug Resist. Microbial Drug Resistance. 2019;25(3):394-399.
38. Chen YH, Lu PL, Huang CH, Liao CH, Lu CT, Chuang YC, Tsao SM, Chen YS, Liu YC, Chen WY, Jang TN, Lin HC, Chen CM, Shi ZY, Pan SC, Yang JL, Kung HC, Liu CE, Cheng YJ, Liu JW, Sun W, Wang LS, Ko WC, Yu KW, Chiang PC, Lee MH, Lee CM, Hsu GJ & Hsueh PR. Trends in the susceptibility of clinically important resistant bacteria to tigecycline: results from the Tigecycline In Vitro Surveillance in Taiwan study, 2006 to 2010. Antimicrobial Agents and Chemotherapy. 2012;56(3):1452-1457.
39. Khaledi A, Fatemeh D, Javad Hosseini S M, Meskini M & Esmaeili D. Antimicrobial resistance pattern of Acinetobacter baumannii strains isolated from intensive care unit patients. Medical Laboratory Journal. 2018; 12 (6):19-23.
40. Lasarte-Monterrubio C, Guijarro-Sánchez P, Bellés A, Vázquez-Ucha JC, Arca-Suárez J, Fernández-Lozano C, Bou G, Beceiro A & Spanish National Study Acinetobacter spp. 2020 Group. Carbapenem resistance in Acinetobacter nosocomialis and Acinetobacter junii conferred by acquisition of blaOXA-24/40 and genetic characterization of the transmission mechanism between Acinetobacter genomic species. Microbiology Spectrum. 2022;10(1):e0273421.
41. Mohammadi M, Bahrami N & Faghri J. The evaluation of antibiotic resistance pattern and frequency of blaVIM and blaNDM genes in isolated Acinetobacter baumannii from hospitalized patients in Isfahan and Shahrekord. Razi Journal of Medical Sciences. 2020;27(4):143-156.
42. Golestani F, Javadpour S, Kafilzadeh F & Ghalandarzadeh Daryaei Z. Determination of antibiotic resistance pattern and frequency of blaVIM & blaIMP genes in clinical isolates of Acinetobacter species in Bandar Abbass. Journal of Microbial World. 2018;10(4):299-309.
43. Liu S, Huang G, Gong Y, Jin X, Meng Y, Peng Y, Zhao J, Li X & Li Q. Rapid and accurate detection of carbapenem-resistance gene by isothermal amplification in Acinetobacter baumannii. Burns & Trauma. 2020;8:tkaa026.
