AUTHOR=Farshadzadeh Zahra , Hashemi Farhad B. , Rahimi Sara , Pourakbari Babak , Esmaeili Davoud , Haghighi Mohammad A. , Majidpour Ali , Shojaa Saeed , Rahmani Maryam , Gharesi Samira , Aziemzadeh Masoud , Bahador Abbas 

TITLE=Wide distribution of carbapenem resistant Acinetobacter baumannii in burns patients in Iran

JOURNAL=Frontiers in Microbiology

VOLUME=6

YEAR=2015

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2015.01146

DOI=10.3389/fmicb.2015.01146

ISSN=1664-302X

ABSTRACT=<p>Antimicrobial resistance in carbapenem non-susceptible <italic>Acinetobacter baumannii</italic> (CNSAb) is a major public health concern globally. This study determined the antibiotic resistance and molecular epidemiology of CNSAb isolates from a referral burn center in Tehran, Iran. Sixty-nine CNSAb isolates were tested for susceptibility to antimicrobial agents using the E test methodology. Multiple locus variable number tandem repeat analysis (MLVA), Multilocus sequence typing (MLST) and multiplex PCR were performed. PCR assays tested for ambler classes A, B, and D β-lactamases. Detection of IS<italic>Aba</italic>1, characterization of integrons, and biofilm formation were investigated. Fifty-three (77%) isolates revealed XDR phenotypes. High prevalence of <italic>bla</italic><sub>OXA-23</sub>-like (88%) and <italic>bla</italic><sub>PER-1</sub> (54%) were detected. IS<italic>Aba</italic>1 was detected upstream of <italic>bla</italic><sub>ADC</sub>, <italic>bla</italic><sub>OXA-23</sub>-like and <italic>bla</italic><sub>OXA51</sub>-like genes in, 97, 42, and 26% of isolates, respectively. Thirty-one (45%) isolates were assigned to international clone (IC) variants. MLVA identified 56 distinct types with six clusters and 53 singleton genotypes. Forty previously known MLST sequence types forming 5 clonal complexes were identified. The Class 1 integron (class 1 integrons) gene was identified in 84% of the isolates. The most prevalent (33%) cassette combination was <italic>aac</italic>A4-<italic>cat</italic>B8-<italic>aad</italic>A1. The IC variants were predominant in the <italic>A. baumannii</italic> lineage with the ability to form strong biofilms. The XDR-CNSAb from burned patients in Iran is resistant to various antimicrobials, including tigecycline. This study shows wide genetic diversity in CNSAb. Integrating the new Iranian <italic>A. baumannii</italic> IC variants into the epidemiologic clonal and susceptibility profile databases can help effective global control measures against the XDR-CNSAb pandemic.</p>