Nadia Jaidane1, Thierry Naas2, Saoussen Oueslati3, Sandrine Bernabeu3, Noureddine Boujaafar4, Olfa Bouallegue5, Rémy A Bonnin6. 1. UR 12 SP 37, Emerging Bacterial Resistance and Safety of Care, Department of Clinical Microbiology, University Hospital of Sahloul, Sousse, Tunisia; Clinical Microbiology Laboratory, University Hospital of Sahloul, Sousse, Tunisia; EA7361, Université Paris-Sud, Université Paris-Saclay, LabEx Lermit, Bacteriology-Hygiene Unit, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Faculty of Pharmacy, University of Monastir, Monastir, Tunisia. 2. EA7361, Université Paris-Sud, Université Paris-Saclay, LabEx Lermit, Bacteriology-Hygiene Unit, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; EERA 'Evolution and Ecology of Resistance to Antibiotics' Unit, Institut Pasteur-APHP-Université Paris Sud, Paris, France; Associated French National Reference Centre for Antibiotic Resistance 'Carbapenemase-producing Enterobacteriaceae', Le Kremlin-Bicêtre, France. 3. EA7361, Université Paris-Sud, Université Paris-Saclay, LabEx Lermit, Bacteriology-Hygiene Unit, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Associated French National Reference Centre for Antibiotic Resistance 'Carbapenemase-producing Enterobacteriaceae', Le Kremlin-Bicêtre, France. 4. UR 12 SP 37, Emerging Bacterial Resistance and Safety of Care, Department of Clinical Microbiology, University Hospital of Sahloul, Sousse, Tunisia; Clinical Microbiology Laboratory, University Hospital of Sahloul, Sousse, Tunisia; Faculty of Pharmacy, University of Monastir, Monastir, Tunisia. 5. UR 12 SP 37, Emerging Bacterial Resistance and Safety of Care, Department of Clinical Microbiology, University Hospital of Sahloul, Sousse, Tunisia; Clinical Microbiology Laboratory, University Hospital of Sahloul, Sousse, Tunisia; Faculty of Medicine Ibn El Jazzar, University of Sousse, Sousse, Tunisia. 6. EA7361, Université Paris-Sud, Université Paris-Saclay, LabEx Lermit, Bacteriology-Hygiene Unit, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; EERA 'Evolution and Ecology of Resistance to Antibiotics' Unit, Institut Pasteur-APHP-Université Paris Sud, Paris, France; Associated French National Reference Centre for Antibiotic Resistance 'Carbapenemase-producing Enterobacteriaceae', Le Kremlin-Bicêtre, France. Electronic address: remy.bonnin@u-psud.fr.
Abstract
BACKGROUND: New Delhi metallo-β-lactamase (NDM)-producing Acinetobacter baumannii have been described in several countries worldwide, and studies have suggested that Acinetobacter spp. could play the role of intermediate progenitor of the blaNDM-1 gene between environmental progenitor and Enterobacteriaceae. MATERIALS AND METHODS: In total, 246 carbapenem-resistant A. baumannii isolates from a teaching hospital in Sousse, Tunisia were investigated between 1st June 2013 and 31st December 2015 to detect metallo-ß-lactamase (MBL) production. Polymerase chain reaction (PCR), antibiotic susceptibility testing, and genetic and whole-genome sequencing tools were used to study the underlying carbapenem resistance mechanisms. RESULTS: PCR screening of the 246 carbapenem-resistant A. baumannii isolates revealed that 242 of 246 isolates harboured carbapenemase genes (seven of 246 positive for blaNDM-1, four of 246 positive for blaNDM-1 and blaOXA-23, 231 positive for blaOXA-23). Conjugation and electroporation experiments suggested that the blaNDM-1 gene is likely to be chromosomally located. All the NDM-1-producing A. baumannii isolates were clonally related, and belonged to ST85 according to the Pasteur Institute's multi-locus sequence typing scheme. Analysis of the immediate genetic environment of the blaNDM-1 gene revealed that the gene was located within a truncated isoform of Tn125 transposon (ΔTn125). The blaOXA-23 gene was located within transposon Tn2008. CONCLUSION: This study showed the dissemination of a single clone of NDM-1-producing A. baumannii in a Tunisian hospital. Countries in north Africa may constitute a significant reservoir for NDM-1-producing A. baumannii. The spread of the blaNDM-1 gene in A. baumannii was linked to clonal spread in this study.
BACKGROUND: New Delhi metallo-β-lactamase (NDM)-producing Acinetobacter baumannii have been described in several countries worldwide, and studies have suggested that Acinetobacter spp. could play the role of intermediate progenitor of the blaNDM-1 gene between environmental progenitor and Enterobacteriaceae. MATERIALS AND METHODS: In total, 246 carbapenem-resistant A. baumannii isolates from a teaching hospital in Sousse, Tunisia were investigated between 1st June 2013 and 31st December 2015 to detect metallo-ß-lactamase (MBL) production. Polymerase chain reaction (PCR), antibiotic susceptibility testing, and genetic and whole-genome sequencing tools were used to study the underlying carbapenem resistance mechanisms. RESULTS: PCR screening of the 246 carbapenem-resistant A. baumannii isolates revealed that 242 of 246 isolates harboured carbapenemase genes (seven of 246 positive for blaNDM-1, four of 246 positive for blaNDM-1 and blaOXA-23, 231 positive for blaOXA-23). Conjugation and electroporation experiments suggested that the blaNDM-1 gene is likely to be chromosomally located. All the NDM-1-producing A. baumannii isolates were clonally related, and belonged to ST85 according to the Pasteur Institute's multi-locus sequence typing scheme. Analysis of the immediate genetic environment of the blaNDM-1 gene revealed that the gene was located within a truncated isoform of Tn125 transposon (ΔTn125). The blaOXA-23 gene was located within transposon Tn2008. CONCLUSION: This study showed the dissemination of a single clone of NDM-1-producing A. baumannii in a Tunisian hospital. Countries in north Africa may constitute a significant reservoir for NDM-1-producing A. baumannii. The spread of the blaNDM-1 gene in A. baumannii was linked to clonal spread in this study.
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