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Polymyxin B Heteroresistance and Adaptive Resistance in Multidrug- and Extremely Drug-Resistant Acinetobacter baumannii
Current Microbiology ( IF 2.6 ) Pub Date : 2020-06-03 , DOI: 10.1007/s00284-020-02064-6
Gabrielle Limeira Genteluci 1, 2 , Paula Araujo de Souza 1 , Daniela Betzler Cardoso Gomes 1, 2 , Verônica Santos Sousa 1 , Maria José de Souza 3 , José Roberto Lannes Abib 4 , Eduardo Almeida Ribeiro de Castro 5 , Karyne Rangel 6 , Maria Helena Simões Villas Bôas 1
Affiliation  

Acinetobacter baumannii is an emerging pathogen associated with nosocomial infections and multidrug resistance. Polymyxin B has been used to treat infections caused by multidrug-resistant (MDR) A. baumannii but an increase in polymyxin B resistance has been observed. We aimed to determine the diversity, antimicrobial susceptibility, presence of polymyxin B heteroresistance and adaptive resistance in 72 A. baumannii clinical isolates from two public hospitals in Rio de Janeiro. The isolates were identified by sequencing of rpoB gene. Determination of the genetic diversity of isolates was performed by pulsed-field gel electrophoresis and oxacillinases genes were detected by polymerase chain reaction. The polymyxin B heteroresistance was analyzed by population analysis profile and adaptive resistance was evaluated after serial daily passages of isolates in broth containing increasing polymyxin B concentrations. The results showed that 49% of the isolates were collected from respiratory system and 62% were MDR, while 35% were extensively drug resistant. Additionally, all the isolates carried blaOXA-23-like, blaOXA-51-like genes and ISAba1, while 1% had blaOXA-24-like gene. The association of ISAba1-blaOXA-23 was found in 96% of the isolates. Polymyxin B heteroresistance was found in 36% of the isolates and polymyxin B adaptive resistance was not found in the isolates. Our study demonstrated the high resistance to antimicrobials used in clinical practice and the spread of oxacillinases genes and insertion sequence (IS). We also reported the presence of heteroresistance to polymyxin B used as a last-resort therapy for MDR A. baumannii.

中文翻译:

耐多药和超耐药鲍曼不动杆菌的多粘菌素B异源耐药性和适应性耐药性

鲍曼不动杆菌是一种与医院感染和多药耐药相关的新兴病原体。多粘菌素 B 已被用于治疗由多重耐药 (MDR) 鲍曼不动杆菌引起的感染,但已观察到多粘菌素 B 耐药性增加。我们旨在确定来自里约热内卢两家公立医院的 72 株鲍曼不动杆菌临床分离株的多样性、抗菌药敏感性、多粘菌素 B 异抗性和适应性耐药性的存在。通过rpoB基因测序鉴定分离株。通过脉冲场凝胶电泳确定分离物的遗传多样性,通过聚合酶链反应检测苯唑西林酶基因。多粘菌素 B 异种抗性通过种群分析概况进行分析,并在含有增加的多粘菌素 B 浓度的肉汤中连续每日传代分离株后评估适应性抗性。结果表明,49%的分离株来自呼吸系统,62%为耐多药,35%为广泛耐药。此外,所有分离株均携带 blaOXA-23-like、blaOXA-51-like 基因和 ISAba1,而 1% 的菌株携带 blaOXA-24-like 基因。在 96% 的分离株中发现了 ISAba1-blaOXA-23 的关联。在 36% 的分离株中发现了多粘菌素 B 异源抗性,在分离株中未发现多粘菌素 B 适应性耐药。我们的研究证明了对临床实践中使用的抗菌剂的高度耐药性以及苯唑西林酶基因和插入序列 (IS) 的传播。
更新日期:2020-06-03
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