1887

Abstract

This study was designed to investigate the molecular epidemiology and antibiotic-resistance characteristics of 11 carbapenem-resistant clinical isolates of obtained in Norway between 2004 and 2009. Interestingly, all the isolates were linked with recent hospitalization outside Norway. The epidemiological status was investigated by multilocus sequence typing (MLST), multiplex PCR assays for major international clones, typing of -like variants and PFGE. The genotypic-resistance characteristics, including the occurrence of OXA-carbapenemase-encoding and 16S rRNA methylase-encoding genes and class 1 integrons, were investigated by PCR assays and sequencing. Seven isolates were found to harbour and belong to MLST clonal complexes (CCs) CC2 (Pasteur Institute scheme) and CC92 (Bartual scheme), and international clone II. One isolate harboured , and belonged to CC1, CC109 and international clone I. Two isolates belonged to sequence group 9, probably a subgroup of international clone I, and one isolate belonged to sequence group 4, a proposed novel international clone. All isolates contained an acquired OXA-carbapenemase-encoding gene: -like (=9), -like (=1) and -like (=1). Four isolates with high-level aminoglycoside-resistance contained the 16S rRNA methylase-encoding gene. Class 1 integrons with six different variable regions were detected. Sequence analysis of gene cassettes identified four aminoglycoside (, , and ), two chloramphenicol ( and ), one -lactamase ( ) and one rifampicin () resistance gene in various combinations. In conclusion, the occurrence of isolates producing OXA carbapenemase and 16S rRNA methylase in Norway was related to the worldwide distribution of international clones I and II, and the emergence of novel international clones.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.028340-0
2011-04-01
2024-04-16
Loading full text...

Full text loading...

/deliver/fulltext/jmm/60/4/515.html?itemId=/content/journal/jmm/10.1099/jmm.0.028340-0&mimeType=html&fmt=ahah

References

  1. Adams M. D., Goglin K., Molyneaux N., Hujer K. M., Lavender H., Jamison J. J., MacDonald I. J., Martin K. M., Russo T. other authors 2008; Comparative genome sequence analysis of multidrug-resistant Acinetobacter baumannii . J Bacteriol 190:8053–8064 [CrossRef]
    [Google Scholar]
  2. Adams-Haduch J. M., Paterson D. L., Sidjabat H. E., Pasculle A. W., Potoski B. A., Muto C. A., Harrison L. H., Doi Y. 2008; Genetic basis of multidrug resistance in Acinetobacter baumannii clinical isolates at a tertiary medical center in Pennsylvania. Antimicrob Agents Chemother 52:3837–3843 [CrossRef]
    [Google Scholar]
  3. Bartual S. G., Seifert H., Hippler C., Luzon M. A. D., Wisplinghoff H., Rodríguez-Valera F. 2005; Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii . J Clin Microbiol 43:4382–4390 [CrossRef]
    [Google Scholar]
  4. Cho Y. J., Moon D. C., Jin J. S., Choi C. H., Lee Y. C., Lee J. C. 2009; Genetic basis of resistance to aminoglycosides in Acinetobacter spp. and spread of armA in Acinetobacter baumannii sequence group 1 in Korean hospitals. Diagn Microbiol Infect Dis 64:185–190 [CrossRef]
    [Google Scholar]
  5. Corvec S., Poirel L., Naas T., Drugeon H., Nordmann P. 2007; Genetics and expression of the carbapenem-hydrolyzing oxacillinase gene bla OXA-23 in Acinetobacter baumannii . Antimicrob Agents Chemother 51:1530–1533 [CrossRef]
    [Google Scholar]
  6. Diancourt L., Passet V., Nemec A., Dijkshoorn L., Brisse S. 2010; The population structure of Acinetobacter baumannii : expanding multiresistant clones from an ancestral susceptible genetic pool. PLoS ONE 5:e10034 [CrossRef]
    [Google Scholar]
  7. Dijkshoorn L., Nemec A., Seifert H. 2007; An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii . Nat Rev Microbiol 5:939–951 [CrossRef]
    [Google Scholar]
  8. Doi Y., Arakawa Y. 2007; 16S ribosomal RNA methylation: emerging resistance mechanism against aminoglycosides. Clin Infect Dis 45:88–94 [CrossRef]
    [Google Scholar]
  9. Evans B. A., Hamouda A., Towner K. J., Amyes S. G. 2008; OXA-51-like β -lactamases and their association with particular epidemic lineages of Acinetobacter baumannii . Clin Microbiol Infect 14:268–275 [CrossRef]
    [Google Scholar]
  10. Fritsche T. R., Castanheira M., Miller G. H., Jones R. N., Armstrong E. S. 2008; Detection of methyltransferases conferring high-level resistance to aminoglycosides in enterobacteriaceae from Europe. North America, and Latin America. Antimicrob Agents Chemother 52:1843–1845 [CrossRef]
    [Google Scholar]
  11. Giannouli M., Cuccurullo S., Crivaro V., Di Popolo A., Bernardo M., Tomasone F., Amato G., Brisse S., Triassi M. other authors 2010; Molecular epidemiology of multidrug-resistant Acinetobacter baumannii in a tertiary care hospital in Naples, Italy, shows the emergence of a novel epidemic clone. J Clin Microbiol 48:1223–1230 [CrossRef]
    [Google Scholar]
  12. Hamouda A., Evans B. A., Towner K. J., Amyes S. G. 2010; Characterization of epidemiologically unrelated Acinetobacter baumannii isolates from four continents by use of multilocus sequence typing, pulsed-field gel electrophoresis, and sequence-based typing of bla OXA-51-like genes. J Clin Microbiol 48:2476–2483 [CrossRef]
    [Google Scholar]
  13. Han H. L., Jang S. J., Park G., Kook J. K., Shin J. H., Shin S. H., Kim D. M., Cheon J. S., Moon D. S., Park Y. J. 2008; Identification of an atypical integron carrying an IS 26 -disrupted aadA1 gene cassette in Acinetobacter baumannii . Int J Antimicrob Agents 32:165–169 [CrossRef]
    [Google Scholar]
  14. Héritier C., Poirel L., Fournier P. E., Claverie J. M., Raoult D., Nordmann P. 2005; Characterization of the naturally occurring oxacillinase of Acinetobacter baumannii . Antimicrob Agents Chemother 49:4174–4179 [CrossRef]
    [Google Scholar]
  15. Higgins P. G., Lehmann M., Seifert H. 2010a; Inclusion of OXA-143 primers in a multiplex polymerase chain reaction (PCR) for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int J Antimicrob Agents 35:305–314
    [Google Scholar]
  16. Higgins P. G., Dammhayn C., Hackel M., Seifert H. 2010b; Global spread of carbapenem-resistant Acinetobacter baumannii . J Antimicrob Chemother 65:233–238 [CrossRef]
    [Google Scholar]
  17. Ibrahim A., Gerner-Smidt P., Liesack W. 1997; Phylogenetic relationship of the twenty-one DNA groups of the genus Acinetobacter as revealed by 16S ribosomal DNA sequence analysis. Int J Syst Bacteriol 47:837–841 [CrossRef]
    [Google Scholar]
  18. Jolley K. A., Chan M.-S., Maiden M. C. J. 2004; mlstdbNet – distributed multi-locus sequence typing (MLST) databases. BMC Bioinformatics 5:86 [CrossRef]
    [Google Scholar]
  19. Karthikeyan K., Thirunarayan M. A., Krishnan P. 2010; Coexistence of bla OXA-23 with bla NDM-1 and armA in clinical isolates of Acinetobacter baumannii from India. J Antimicrob Chemother 65:2253–2254 [CrossRef]
    [Google Scholar]
  20. Ko K. S., Kim H. W., Choi J. Y., Song J. H. ANSORP 2010; Dissemination of limited imipenem-resistant Acinetobacter baumannii clones in Asian countries. In Abstracts of the Twentieth European Congress of Clinical Microbiology and Infectious Diseases. Vienna, Austria, 10–13 April 2010 poster 1722 Basel: European Society of Clinical Microbiology and Infectious Diseases;
    [Google Scholar]
  21. Koeleman J. G., Stoof J., Van Der Bijl M. W., Vandenbroucke-Grauls C. M., Savelkoul P. H. 2001; Identification of epidemic strains of Acinetobacter baumannii by integrase gene PCR. J Clin Microbiol 39:8–13 [CrossRef]
    [Google Scholar]
  22. Mendes R. E., Kiyota K. A., Monteiro J., Castanheira M., Andrade S. S., Gales A. C., Pignatari A. C. C., Tufik S. 2007; Rapid detection and identification of metallo- β -lactamase-encoding genes by multiplex real-time PCR assay and melt curve analysis. J Clin Microbiol 45:544–547 [CrossRef]
    [Google Scholar]
  23. Mugnier P. D., Poirel L., Naas T., Nordmann P. 2010; Worldwide dissemination of the bla OXA-23 carbapenemase gene of Acinetobacter baumannii . Emerg Infect Dis 16:35–40
    [Google Scholar]
  24. Nemec A., Dolzani L., Brisse S., van den Broek P., Dijkshoorn L. 2004; Diversity of aminoglycoside-resistance genes and their association with class 1 integrons among strains of pan-European Acinetobacter baumannii clones. J Med Microbiol 53:1233–1240 [CrossRef]
    [Google Scholar]
  25. Nemec A., Krízová L., Maixnerová M., Diancourt L., van der Reijden T. J., Brisse S, van den Broek P., Dijkshoorn L. 2008; Emergence of carbapenem resistance in Acinetobacter baumannii in the Czech Republic is associated with the spread of multidrug-resistant strains of European clone II. J Antimicrob Chemother 62:484–489 [CrossRef]
    [Google Scholar]
  26. Nemec A., Musílek M., Maixnerová M., De Baere T., van der Reijden T. J., Vaneechoutte M., Dijkshoorn L. 2009; Acinetobacter beijerinckii sp. nov. and Acinetobacter gyllenbergii sp. nov., haemolytic organisms isolated from humans. Int J Syst Evol Microbiol 59:118–124 [CrossRef]
    [Google Scholar]
  27. Onarheim H., Høivik T., Harthug S., Digranes A., Mylvaganam H., Vindenes H. A. 2000; Outbreak of multiresistant Acinetobacter baumannii infection. Tidsskr Nor Laegeforen 120:1028–1033
    [Google Scholar]
  28. Park Y. K., Choi J. Y., Jung S. I., Park K. H., Lee H., Jung D. S., Heo S. T., Kim S. W., Chang H. H., Cheong H. S. 2009; Two distinct clones of carbapenem-resistant Acinetobacter baumannii isolates from Korean hospitals. Diagn Microbiol Infect Dis 64:389–395 [CrossRef]
    [Google Scholar]
  29. Poirel L., Nordmann P. 2006a; Carbapenem resistance in Acinetobacter baumannii : mechanisms and epidemiology. Clin Microbiol Infect 12:826–836 [CrossRef]
    [Google Scholar]
  30. Poirel L., Nordmann P. 2006b; Genetic structures at the origin of acquisition and expression of the carbapenem-hydrolyzing oxacillinase gene bla OXA-58 in Acinetobacter baumannii . Antimicrob Agents Chemother 50:1442–1448 [CrossRef]
    [Google Scholar]
  31. Post V., White P. A., Hall R. M. 2010; Evolution of AbaR-type genomic resistance islands in multiply antibiotic-resistant Acinetobacter baumannii . J Antimicrob Chemother 65:1162–1170 [CrossRef]
    [Google Scholar]
  32. Samuelsen O., Naseer U., Tofteland S., Skutlaberg D. H., Onken A., Hjetland R., Sundsfjord A., Giske C. G. 2009; Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. J Antimicrob Chemother 63:654–658 [CrossRef]
    [Google Scholar]
  33. Samuelsen O., Toleman M. A., Sundsfjord A., Rydberg J., Leegaard T. M., Walder M., Lia A., Ranheim T. E., Rajendra Y. other authors 2010; Molecular epidemiology of metallo- β -lactamase-producing Pseudomonas aeruginosa isolates from Norway and Sweden shows import of international clones and local clonal expansion. Antimicrob Agents Chemother 54:346–352 [CrossRef]
    [Google Scholar]
  34. Toleman M. A., Vinodh H., Sekar U., Kamat V., Walsh T. R. 2007; bla VIM-2-harboring integrons isolated in India, Russia, and the United States arise from an ancestral class 1 integron predating the formation of the 3′ conserved sequence. Antimicrob Agents Chemother 51:2636–2638 [CrossRef]
    [Google Scholar]
  35. Towner K. J., Levi K., Vlassiadi M. on behalf of the ARPAC Steering Group 2008; Genetic diversity of carbapenem-resistant isolates of Acinetobacter baumannii in Europe. Clin Microbiol Infect 14:161–167 [CrossRef]
    [Google Scholar]
  36. Turton J. F., Gabriel S. N., Valderrey C., Kaufmann M. E., Pitt T. L. 2007; Use of sequence-based typing and multiplex PCR to identify clonal lineages of outbreak strains of Acinetobacter baumannii . Clin Microbiol Infect 13:807–815 [CrossRef]
    [Google Scholar]
  37. Vila J., Ruiz J., Goñi P., Marcos A., Jimenez de Anta T. 1995; Mutation in the gyrA gene of quinolone-resistant clinical isolates of Acinetobacter baumannii . Antimicrob Agents Chemother 39:1201–1203 [CrossRef]
    [Google Scholar]
  38. Vila J., Ruiz J., Goñi P., Jimenez de Anta T. 1997; Quinolone-resistance mutations in the topoisomerase IV parC gene of Acinetobacter baumannii . J Antimicrob Chemother 39:757–762 [CrossRef]
    [Google Scholar]
  39. Woodford N., Ellington M. J., Coelho J. M., Turton J. F., Ward M. E., Brown S., Amyes S. G. B., Livermore D. M. 2006; Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int J Antimicrob Agents 27:351–353 [CrossRef]
    [Google Scholar]
  40. Xu X., Kong F., Cheng X., Yan B., Du X., Gai J., Ai H., Shi L., Iredell J. 2008; Integron gene cassettes in Acinetobacter spp. strains from South China. Int J Antimicrob Agents 32:441–445 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.028340-0
Loading
/content/journal/jmm/10.1099/jmm.0.028340-0
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error