Shirehan M Ibrahim, Elamin M Ibrahim, Omer A Ibrahim, Enas Awad, Omnia M Hamid, Hassan A Alaziz
Background: The emergence of carbapenemase producing Acinetobacter baumannii (CPAB) is increasingly reported nowadays and constitutes a major problem to the intensive care unit (ICU) patients with remarkable ability to acquire antibiotic resistance. The aim of this study was to determine the antibiotic resistance patterns, presence of carbapanemase genes of A. baumannii isolated from various clinical specimens, Khartoum State-Sudan.
Methods: one hundredof Gram-negative coccobacilli isolates were collected from ICU patients admitted to RoyalCare International Hospital and the National Ribbat Hospital. All the samples were processed using conventional microbiological and molecular methods for A. baumanii identification. Antimicrobial susceptibility testing was performed by dis diffusion technique. The carbapenemase-encoding genes (blaKP, blaIMP, blaVIM, blaOXA, blaNDM, blaGES, blaOXA-51 and blaOXA-23) were tested by polymerase chain reaction (PCR) method.
Results: The prevalence of A. baumanii was 39.0% (39/100) among ICU patients and carbapenem resistance A. baumanii (CRAB) was high, 97.4% (38/39) and 57.9 (22/38) of CRAB was carbapenemase gene producer. The most common carbapenemase associated with resistance was blaOXA gene followed by blaNDM and blaGES A. baumanii isolates. All isolates were resistance to all tested antimicrobial agents and 63.6% resistance to colistin.
Conclusion: This study shown that blaOXA followed by NDMis the predominant carbapenemase gene presenting among ICU patients of both hospitals. Here, we detected an emergent blaOXA-143 identified in two A. baumannii strains which reported as High-Risk Clones.Colistin no longer remains drug of choice for treatment of CRAB.This highlights the importance of national mentoring of CPAB in the hospital to avoid clone dissemination.