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Jang, Park, Uh, Lee, Kim, and Choi: Molecular Characteristics of blaOXA-23-Producing Acinetobacter baumannii Isolated from a University Hospital
Original Article

Ann Clin Microbiol 2013;16(3):126-133.

Published online: 5 December 2013

DOI: https://doi.org/10.5145/ACM.2013.16.3.126

Molecular Characteristics of blaOXA-23-Producing Acinetobacter baumannii Isolated from a University Hospital

In-Ho Jang1, Soon Deok Park1, Young Uh1, Gyu-sang Lee2, Jong-Bae Kim2, Il Choi3

1Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

2Department of Biomedical Laboratory Science, College of Health Science, Yonsei University, Wonju, Korea

3Department of Animal Science and Technology, College of Life Science and Natural Resources, Sangi University, Wonju, Korea

Correspondence: Young Uh, Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, 162, Ilsan-dong, Wonju 220-701, Korea. (Tel) 82-33-741-1592, (Fax) 82-33-731-0506, (E-mail) u931018@yonsei.ac.kr

Received 18 March 201310 May 2013       Accepted 27 May 2013

Copyright © 2013 The Korean Society of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Background

Multidrug resistant (MDR) Acinetobacter baumannii has emerged as a significant infectious agent in hospitals worldwide. The purpose of this study was to determine the molecular characterization of MDR A. baumannii clinical isolates.

Methods

Two hundred eighty-five strains of non-du-plicated A. baumannii collected from March to Novem-ber 2011 from a university hospital laboratory located in the Wonju area of the Gangwon province of Korea were analyzed for MDR genes.

Results

All of the 285 imipenem-resistant A. baumannii isolates were encoded by a blaOXA-23-like gene, and all isolates with the blaOXA-23-like gene had the upstream element IS Aba1. The 16S rRNA methylase gene arm A was detected in 153 (50.2%) clinical isolates, but rmt A, rmt B, rmt C, rmt D and npm A were not detected in any isolates in the present study. The gene encoding aac(6')-Ib was the most prevalent aminoglycoside-modifying enzyme. The sequencing data for the quinolone resistance-determining region of gyrA and parC revealed the presence of Ser (TCA) 83 to Leu (TTA) and Ser (TCG) 80 to Leu (TTG) substitutions. All but one of the 285 A. baumannii isolates showed similar band patterns on re-petitive extragenic palindromic-PCR profiles.

Conclusion

The molecular characteristics of the resistance genes of MDR A. baumannii isolates ob-tained from the Wonju area of Gangwon province were similar to those of other areas in Korea.

Keywords: Acinetobacter baumannii, Beta-lactama-ses, Genes, Multidrug resistance, Imipe-nem

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Fig. 1.
Dendrogram of the similarity index by unweighted pair group method with mathematical averaging (UPGMA) among two hundred sixty-five A. baumannii isolates provided by REP-PCR analysis.
acm-16-126f1.tif
Table 1.
Antimicrobial resistance for 285 imipenem-resistant A. baumannii isolates
Antimicrobial classes Antimicrobial agents % susceptibility
S I R
Penicillins Piperacillin 0 0 100
β-lactam/β -lactamase inhibitor Cefoperazone/sulbactam 1.4 20 78.6
Piperacillin/tazobactam 0 0 100
Cephems Ceftazidime 0 0 100
Cefepime 0.4 1.4 98.2
Carbapenem Meropenem 0 0 100
Monobactam Aztreonam 0.4 4.2 95.4
Aminoglycosides Amikacin 9.5 20.4 70.2
Gentamicin 2.5 1.4 96.1
Tobramycin 3.2 0.4 96.5
Quinolone Levofloxacin 0 0 100
Folate pathway inhibitor Trimethoprim/sulfamethoxazole 0.4 1.4 98.2
Lipopeptide Colistin 100 0 0

Abbreviations: S, susceptible; I, intermediate; R, resistant.

Table 2.
Distribution of quinolone resistant genotypes in A. baumannii
Target genes Genotypes Mutations Number of isolates (%)
gyr A Amino acid substitution Ser 83 to Leu TCA→ T T A 285 (100.0%)
Polymorphism Ser 71 GGT→ GG G 285 (100.0%)
  Arg 162 CGA→ CG T 285 (100.0%)
par C Amino acid substitution Ser 80 to Leu TCG→ T T G 285 (100.0%)
Polymorphism Pro 109 CCT→ CC A 149 (52.3%)
  Pro 109 CCT→ CC G 136 (47.7%)
  Lys 124 AAA→ AA G 136 (47.7%)
  Lys 126 TCG→ TC A 136 (47.7%)
Table 3.
Distribution of aminoglycoside resistance genes in A. baumannii
Genotypes Number of isolates (%)
aac(3)-Ia 81 (28.4)
aac(3)-IIa 0 (0.0)
aac(6')-Ih 0 (0.0)
aac(6')-Ib 101 (35.4)
aph(3')-Ia 28 (9.8)
aph(3')-VI 0 (0.0)
ant(2'')-Ia 0 (0.0)
rrn 0 (0.0)
aac(3)-Ia＋ aac(6')-Ib 52 (18.3)
aac(3)-Ia＋ aph(3')-Ia＋ aac(6')-Ib 28 (9.8)
arm A 143 (50.2)
rmt A 0 (0.0)
rmt B 0 (0.0)
rmt C 0 (0.0)
rmt D 0 (0.0)
npm A 0 (0.0)
arm A＋ aac(3)-Ia 1 (0.3)
arm A＋ aac(6')-Ib 17 (6.0)
arm A＋ aac(3)-Ia＋ aph(3')-Ia 46 (16.1)
arm A＋ aac(3)-Ia＋ aph(3')-Ia＋ aac(6')-Ib 26 (9.1)
Table 4.
Molecular characterization group of MDR A. baumannii by REP-PCR similarity index
Group Number of isolates (n=285) Number of isolates showing resistance patterns (%)
β -lactam Aminoglycoside Quinolone
Aminoglycoside modifying enzyme 16S rRNA methylase gyr A par C
bla OXA-23-like/ bla OXA-51-like IS Aba1/ bla OXA-23-like aac(3)-Ia aac(6')-Ib aph(3)-Ia arm A Substitution Polymorphism Substitution Polymorphism
83 71 162 80 109 (A) 109 (G) 124 126
1 36 36 (100.0) 36 (100.0) 12 (33.3) 16 (44.4) 4 (11.1) 22 (61.1) 36 (100.0) 36 (100.0) 36 (100.0) 36 (100.0) 10 (27.8) 26 (72.2) 26 (72.2) 26 (72.2)
1-sub 28 28 (100.0) 28 (100.0) 8 (28.6) 20 (71.4) 0 24 (85.7) 28 (100.0) 28 (100.0) 28 (100.0) 28 (100.0) 0 28 (100.0) 28 (100.0) 28 (100.0)
2 57 57 (100.0) 57 (100.0) 8 (13.8) 20 (35.1) 8 (13.8) 3 (5.3) 57 (100.0) 57 (100.0) 57 (100.0) 57 (100.0) 55 (94.8) 3 (5.2) 3 (5.2) 3 (5.2)
3 55 55 (100.0) 55 (100.0) 3 (5.4) 3 (5.4) 0 0 55 (100.0) 55 (100.0) 55 (100.0) 55 (100.0) 55 (100.0) 0 0 0
4 107 107 (100.0) 107 (100.0) 57 (53.3) 61 (57.0) 23 (21.5) 92 (86.0) 107 (100.0) 107 (100.0)1 107 (100.0) 107 (100.0) 28 (26.2) 79 (73.8) 79 (73.8) 79 (73.8)
Other 1 1 (100.0) 1 (100.0) 0 0 0 0 1 (100.0) 1 (100.0) 1 (100.0) 1 (100.0) 1 (100.0) 0 0 0
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