Investigation of Metallo Beta Lactamases and Oxacilinases in Carbapenem Resistant Acinetobacter baumannii Strains Isolated from Inpatients

Year 2015, Volume: 32 Issue: 1, 79 - 83, 01.01.2015

M. Duygu Aksoy Şaban Çavuşlu H. Murat Tuğrul

Abstract

Background: Resistance to beta-lactam antibiotics is
widespread among Acinetobacter strains. Plasmid-mediated
metallo beta lactamases (MBL) are responsible
for carbapenem resistance, as are oxacillinases (OXA).
In recent years, MBL producing carbapenem-resistant
strains have been reported in the world and in Turkey
in increasing rates. In our country, besides the OXA 51-
like enzyme which is inherent in A. baumannii strains,
OXA 58-like and OXA 23-like carbapenemases producing
strains have also been widely detected. In addition,
Verona Imipenemase (VIM) and (IMP)-type MBL
have been reported in some centers.
Aims: The aim of our study was to investigate the presence
of carbapenemases in Acinetobacter strains isolated
from hospitalized patients in Edirne.
Study Design: Cross-sectional study.
Methods: A total of 52 imipenem-resistant A. baumannii
strains isolated between January and March 2013
were investigated. The presence of MBL was described
phenotypically by the combined disk diffusion test
(CDDT), double disk synergy test (DDST), MBL Etest
(only performed in 28 strains) and modified Hodge
test. blaIMP, blaVIM, blaGIM, blaSIM, blaSPM genes and
blaOXA-23, blaOXA-51, blaOXA-40, blaOXA-58 genes were investigated
by multiplex polymerase chain reaction (PCR).
The blaNDM-1 gene was determined by PCR.
Results: By modified Hodge test, 50 strains (96%)
were found to be MBL positive. Positivity of MBL was
21% by both CDDT (0.1 M EDTA) and DDST. Twenty-four
of 28 strains (85.7%) were positive by MBL
E-test. OXA 23-like and OXA 51-like carbapenemases
were detected in all strains, but OXA 58-like and OXA
40-like carbapenemases-producing A. baumannii were
not detected. Also, MBL genes were not detected by
genotypic methods.
Conclusion: Only OXA 23-like carbapenemase was
responsible for carbapenem resistance in carbapenemresistant
Acinetobacter strains in Edirne. The MBLproducing
Acinetobacter strain is not yet a problem in
our hospital. MBL resistance was found by phenotyping
tests, which must be confirmed by genotypic methods;
multiplex PCR tests can be easily used for screening
MBL

Keywords

Acinetobacter baumannii, metallo beta lactamases, oxacillinases

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