Antibiogram, Prevalence of OXA Carbapenemase Encoding Genes, and RAPD-Genotyping of Multidrug-Resistant <i>Acinetobacter baumannii</i> Incriminated in Hidden Community-Acquired Infections

• Main Authors: Waleed El-Kazzaz, Lobna Metwally, Reham Yahia, Najwa Al-Harbi, Ayat El-Taher, Helal F. Hetta
• Format: Article
• Language: English
• Published: MDPI AG 2020-09-01
• Series: Antibiotics
• Subjects: <i>Acinetobacter baumannii</i>; antibiogram; MDR; carbapenemase encoding genes; RAPD-genotyping
• Online Access: https://www.mdpi.com/2079-6382/9/9/603

<i>Acinetobacter</i> spp. has gained fame from their ability to resist difficult conditions and their constant development of antimicrobial resistance. This study aimed to investigate the prevalence, susceptibility testing, OXA carbapenemase-encoding genes, and RAPD-genotyping of multidrug resistant <i>Acinetobacter baumannii</i> incriminated in hidden community-acquired infections in Egypt. The antimicrobial susceptibility testing was assessed phenotypically using Kirby–Bauer disk diffusion method. Also, Modified-Hodge test (MHT) was carried out to detect the carbapenemases production. Multiplex-PCR was used to detect the carbapenemase-encoding genes. Furthermore, the genetic relationship among the isolated strains was investigated using RAPD fingerprinting. The bacteriological examination revealed that, out of 200 Gram-negative non-fermentative isolates, 44 (22%) were identified phenotypically and biochemically as <i>Acinetobacter</i> spp. and 23 (11.5%) were molecularly confirmed as <i>A.</i><i>baumannii</i>. The retrieved <i>A.</i><i>baumannii</i> strains were isolated from urine (69%), sputum (22%), and cerebrospinal fluid (csf) (9%). The isolated <i>A. baumannii</i> strains exhibited multidrug resistance and the production rates of carbapenemases were 56.5, 60.9, and 78.3% with meropenem, imipenem, and ertapenem disks, respectively. The <i>bla</i>_OXA-24-like genes were the most predominant among the tested strains (65.2%), followed by <i>bla</i>_OXA-23 (30.4%) and <i>bla</i>_OXA-58 (17.4%), in addition, the examined strains are harbored IMP, VIM, and NDM genes with prevalence of 60.9, 43.5, and 13%, respectively, while KPC and GES genes were not detected. RAPD-PCR revealed that the examined strains are clustered into 11 different genotypes at ≥90% similarity. Briefly, to the best of our knowledge, this study is the first report concerning community-associated <i>A. baumannii</i> infections in Egypt. The high prevalence of hidden multidrug-resistant (MDR) and extensively drug-resistant (XDR) <i>A.</i><i>baumannii</i> strains associated with non-hospitalized patients raises an alarm for healthcare authorities to set strict standards to control the spread of such pathogens with high rates of morbidity and mortality.