High prevalence of metallo-β-lactamase carbapenemase-producing Acinetobacter baumannii in Tripoli, Libya: dominance of OXA-23 and NDM-1

7th Euroscicon Conference on Clinical Pathology and Epidemiology
February 27-28, 2019 | Prague, Czech Republic

Abdulaziz Zorgani, Nasim Abukhatwa, Nada Elgrew, Balsem Bezan, Najib Sufya, Abdallah Bashien and Omar Elahmer

University of Tripoli, Libya

Posters & Accepted Abstracts: J Infec Dis Treat

DOI: 10.21767/2472-1093-C1-009

Abstract

Background: Acinetobacter baumannii is an opportunistic pathogen causing various nosocomial infections. The aim of this study was to characterize the molecular support of carbapenem-resistant A baumannii clinical isolates recovered from two Libyan hospitals.

Methods: Bacterial isolates were identified and antibiotic susceptibility test was performed using automated system. Carbapenem resistance determinants were studied phenotypically using three different techniques: metallo-β-lactamase (MBL) E-test; chromogenic culture media and modified Hodge test (MHT). Polymerase chain reaction (PCR) amplification was used to determine the presence of metallo-β-lactamase blaNDM-1, blaOXA23, blaOXA48 and blaOXA51 genes among isolates.

Results: A total of 108 A. baumannii isolates were characterized, overall the resistance prevalence was extremely high for aminoglycosides, fluoroquinolones, cepahosporens and carbapenemes (93.2-100%), all isolates were susceptible to colistin. In addition, 97.5% of isolates were identified as multidrug resistance (MDR). Varying degree of phenotypic detection of carbapenemes was determined; highest levels of carbapenemes were detected using chromogenic media (75.5%) compared with MBL E-test (45.5%) and MHT (71.4%). The carbapeneme resistance-encoding genes detected were blaNDM1 (70.6%), blaOXA23 (84%), blaOXA48 (46.2%) and blaOXA51 (73.1%); the highest carbapeneme genes were demonstrated in Burn and Plastic Surgery Hospital (73.7%). The co-occurrence of blaNDM1, blaOXA23 and blaOXA48 genes were demonstrated in (30/119; 25.2%) showing dissemination of carbapenemes resistance MDR A. baumannii in hospitals. MLST analysis for A. baumannii isolates revealed also the presence of multiple clones in our study. The clones belonging to ST1 and ST2 were the most frequent

Conclusion: This study shows that the high prevalence of NDM-1 and OXA-23 contribute to antibiotic resistance in Libyan hospitals and represents the high incidence of carbapenemases in an autochthonous MDR A. baumannii isolated from patients in Libya, indicating that there is a longstanding infection control problem in these hospitals.

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