Rayane Rafei1, Fouad Dabboussi2, Monzer Hamze2, Matthieu Eveillard3, Carole Lemarié4, Hassan Mallat2, Jean-Marc Rolain5, Marie-Laure Joly-Guillou3, Marie Kempf6. 1. Institut de Biologie en Santé - IRIS, Groupe d'Etude des Interactions Hôte-Pathogène, Université d'Angers, L'UNAM, Angers, France; Laboratoire de Microbiologie, Ecole Doctorale des Sciences et de Technologie, Université Libanaise, Tripoli, Lebanon. 2. Laboratoire de Microbiologie, Ecole Doctorale des Sciences et de Technologie, Université Libanaise, Tripoli, Lebanon. 3. Institut de Biologie en Santé - IRIS, Groupe d'Etude des Interactions Hôte-Pathogène, Université d'Angers, L'UNAM, Angers, France; Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, 4 rue Larrey, 49933 Angers cedex, France. 4. Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, 4 rue Larrey, 49933 Angers cedex, France. 5. Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergents (URMITE), IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France. 6. Institut de Biologie en Santé - IRIS, Groupe d'Etude des Interactions Hôte-Pathogène, Université d'Angers, L'UNAM, Angers, France; Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, 4 rue Larrey, 49933 Angers cedex, France. Electronic address: makempf@chu-angers.fr.
Abstract
OBJECTIVES: The emergence of carbapenem-resistant Acinetobacter baumannii has been observed worldwide. We describe the first detection of A. baumannii carrying the blaNDM-1 gene in Lebanon, isolated from Syrian patients wounded during the civil war. METHODS: Four carbapenem-resistant A. baumannii strains isolated in 2012 in the Tripoli Government Hospital, Lebanon, from civilians wounded during the Syrian war, were analysed. Susceptibility was determined by disk diffusion testing, and resistance to carbapenems was confirmed by Etest. The presence of blaOXA-23-like, blaOXA-24-like, blaOXA-58-like, blaOXA-143-like, and blaNDM was investigated by PCR. Clonal relationships were studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and blaOXA-51 sequence-based typing. RESULTS: All isolates harboured the blaNDM-1 gene and were negative for other tested carbapenemases. They all belonged to the sequence type 85 and formed a single cluster by PFGE. Finally, blaOXA-51-like gene sequencing revealed the presence of the blaOXA-94 variant in all four isolates. CONCLUSION: These findings show that Syria constitutes a reservoir for NDM-1-producing bacteria. These results also highlight the need for effective measures to stop the threatening spread of such strains.
OBJECTIVES: The emergence of carbapenem-resistant Acinetobacter baumannii has been observed worldwide. We describe the first detection of A. baumannii carrying the blaNDM-1 gene in Lebanon, isolated from Syrian patients wounded during the civil war. METHODS: Four carbapenem-resistant A. baumannii strains isolated in 2012 in the Tripoli Government Hospital, Lebanon, from civilians wounded during the Syrian war, were analysed. Susceptibility was determined by disk diffusion testing, and resistance to carbapenems was confirmed by Etest. The presence of blaOXA-23-like, blaOXA-24-like, blaOXA-58-like, blaOXA-143-like, and blaNDM was investigated by PCR. Clonal relationships were studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and blaOXA-51 sequence-based typing. RESULTS: All isolates harboured the blaNDM-1 gene and were negative for other tested carbapenemases. They all belonged to the sequence type 85 and formed a single cluster by PFGE. Finally, blaOXA-51-like gene sequencing revealed the presence of the blaOXA-94 variant in all four isolates. CONCLUSION: These findings show that Syria constitutes a reservoir for NDM-1-producing bacteria. These results also highlight the need for effective measures to stop the threatening spread of such strains.
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