Characterisation of carbapenem-resistant Acinetobacter baumannii outbreak strains producing OXA-58 in Turkey

Kulah, Canan; Mooij, Marlies J.; Comert, Fusun; Aktas, Elif; Celebi, Guven; Ozlu, Nagihan; Rijnsburger, Martine C.; Savelkoul, Paul H.M.

doi:10.1016/j.ijantimicag.2010.03.017

« Previous Next »International Journal of Antimicrobial Agents
Volume 36, Issue 2 , Pages 114-118, August 2010

Characterisation of carbapenem-resistant Acinetobacter baumannii outbreak strains producing OXA-58 in Turkey

Canan Kulah
- Department of Microbiology and Clinical Microbiology, Medical Faculty, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
- These two authors contributed equally to this study.
- Corresponding author. Tel.: +90 532 445 3250; fax: +90 372 261 0155.
Marlies J. Mooij
- Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam, The Netherlands
- These two authors contributed equally to this study.
- Present address: BIOMERIT Research Centre, Microbiology Department, University College Cork, National University of Ireland, Cork, Ireland.
Fusun Comert
- Department of Microbiology and Clinical Microbiology, Medical Faculty, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
Elif Aktas
- Department of Microbiology and Clinical Microbiology, Medical Faculty, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
Guven Celebi
- Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Zonguldak Karaelmas University, Turkey
Nagihan Ozlu
- Department of Microbiology and Clinical Microbiology, Medical Faculty, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
Martine C. Rijnsburger
- Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam, The Netherlands
Paul H.M. Savelkoul
- Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam, The Netherlands

Received 16 September 2009; accepted 8 March 2010. published online 31 May 2010.

Abstract

The aim of this study was to characterise the molecular epidemiology and mechanisms of carbapenem resistance of nosocomial Acinetobacter baumannii isolates in a new university hospital in Turkey. A total of 145 carbapenem-resistant A. baumannii (CRAB) isolates were collected during the period 2003–2006. All isolates were typed by amplified fragment length polymorphism (AFLP) analysis. AFLP analysis showed three predominant clusters consisting of 72, 20 and 12 clinical strains as well as some smaller clusters and 23 unique strains. The three main clonal AFLP types corresponded to three major antibiotic susceptibility patterns. One environmental isolate was found related to the major outbreak clone. The reference type strains of European clones I, II and III were also typed by AFLP and analysed for clonal similarity. Polymerase chain reaction (PCR) analysis of different carbapenem resistance genes showed that strains from each of the three main clusters as well as 79% of the remaining strains harboured the bla_OXA-58 gene. No genes encoding the metallo-β-lactamases GIM-1, SIM-1, SPM-1, IMP-like and VIM-like or the oxacillinases OXA-24-like and OXA-23-like were detected. In conclusion, multiple clones of CRAB strains producing OXA-58-type oxacillinase were responsible for a sustained CRAB outbreak occurring in a hospital in Turkey. These isolates were not associated with A. baumannii strains of the major European clones I, II or III.

Keywords: Acinetobacter baumannii, Outbreak, OXA-58, bla_OXA-58, Oxacillinase, Carbapenems