Extensively drug resistant Acinetobacter baumannii (XDR-Ab), has emerged as an important pathogen in several outbreaks. The aim of our study was to investigate the eventual genetic relatedness of XDR-Ab strains recovered from burn patients and environment sites in the largest Tunisian Burn Intensive Care Unit (BICU) and to characterize β-lactamase encoding genes in these strains. Between March 04th, 2019 and April 22nd, 2019 an outbreak of XDR-Ab was suspected. Environmental screening was done. All isolates were screened by simplex PCR for β-lactamase genes. Genetic relatedness was determined by pulsed field gel electrophoresis (PFGE) of ApaI-digested total DNA. During the study period, 21 strains of A. baumannii were isolated in burn patients, mainly in blood culture (n = 7) and central vascular catheter (n = 6). All strains were susceptible to colistin but resistant to imipenem (n = 23), ciprofloxacin (n = 23), amikacin (n = 22), tigecyclin (n = 5) and rifampicin (n = 4). The blaOXA-51-like, blaOXA23, and blaADC genes were present in all strains. These resistance determinants were associated with blaPER-1 in 10 strains. The ISAba1 was inserted upstream of blaOXA-23 in all isolates. PFGE revealed two major clusters A (n = 11) and B (n = 5). This is the first description in Tunisia of clonally related PER-1 producing XDR-Ab in burn patients with probable environmental origin.

中文翻译：

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PER-1 和 OXA-23 在突尼斯烧伤重症监护病房爆发期间产生广泛耐药鲍曼不动杆菌的克隆传播。

广泛耐药鲍曼不动杆菌 (XDR-Ab) 已成为数次爆发的重要病原体。我们研究的目的是调查从最大的突尼斯烧伤重症监护病房 (BICU) 的烧伤患者和环境地点恢复的 XDR-Ab 菌株的最终遗传相关性，并表征这些菌株中的 β-内酰胺酶编码基因。2019 年 3 月 4 日至 2019 年 4 月 22 日期间，怀疑爆发了 XDR-Ab。进行了环境筛选。所有分离株均通过单链 PCR 筛选 β-内酰胺酶基因。通过 ApaI 消化的总 DNA 的脉冲场凝胶电泳 (PFGE) 确定遗传相关性。在研究期间，在烧伤患者中分离出 21 株鲍曼不动杆菌，主要是在血培养（n = 7）和中心血管导管（n = 6）中。所有菌株对粘菌素敏感，但对亚胺培南 (n = 23)、环丙沙星 (n = 23)、阿米卡星 (n = 22)、替加环素 (n = 5) 和利福平 (n = 4) 耐药。blaOXA-51 样、blaOXA23 和 blaADC 基因存在于所有菌株中。这些抗性决定因素与 10 个菌株中的 blaPER-1 相关。ISAba1 被插入到所有分离株中 blaOXA-23 的上游。PFGE 揭示了两个主要集群 A (n = 11) 和 B (n = 5)。这是突尼斯首次描述可能是环境起源的烧伤患者中产生克隆相关 PER-1 的 XDR-Ab。ISAba1 被插入到所有分离株中 blaOXA-23 的上游。PFGE 揭示了两个主要集群 A (n = 11) 和 B (n = 5)。这是突尼斯首次描述可能是环境起源的烧伤患者中产生克隆相关 PER-1 的 XDR-Ab。ISAba1 被插入到所有分离株中 blaOXA-23 的上游。PFGE 揭示了两个主要集群 A (n = 11) 和 B (n = 5)。这是突尼斯首次描述可能是环境起源的烧伤患者中产生克隆相关 PER-1 的 XDR-Ab。