Emergence of OXA-carbapenemase- and 16S rRNA methylase-producing international clones of Acinetobacter baumannii in Norway

Author:

Karah Nabil12,Haldorsen Bjørg2,Hermansen Nils O.3,Tveten Yngvar4,Ragnhildstveit Eivind5,Skutlaberg Dag H.6,Tofteland Ståle7,Sundsfjord Arnfinn12,Samuelsen Ørjan2

Affiliation:

1. Research Group for Host–Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway

2. Reference Centre for Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway

3. Department of Microbiology, Oslo University Hospital Ullevål, Oslo, Norway

4. Department of Microbiology, Vestfold Hospital, Tønsberg, Norway

5. Department of Microbiology, Østfold Hospital, Fredrikstad, Norway

6. Department of Microbiology, Haukeland University Hospital, Bergen, Norway

7. Department of Microbiology, Sørlandet Hospital, Kristiansand, Norway

Abstract

This study was designed to investigate the molecular epidemiology and antibiotic-resistance characteristics of 11 carbapenem-resistant clinical isolates of Acinetobacter baumannii obtained in Norway between 2004 and 2009. Interestingly, all the isolates were linked with recent hospitalization outside Norway. The epidemiological status was investigated by multilocus sequence typing (MLST), multiplex PCR assays for major international clones, typing of bla OXA-51-like variants and PFGE. The genotypic-resistance characteristics, including the occurrence of OXA-carbapenemase-encoding and 16S rRNA methylase-encoding genes and class 1 integrons, were investigated by PCR assays and sequencing. Seven isolates were found to harbour bla OXA-66 and belong to MLST clonal complexes (CCs) CC2P (Pasteur Institute scheme) and CC92B (Bartual scheme), and international clone II. One isolate harboured bla OXA-69, and belonged to CC1P, CC109B and international clone I. Two isolates belonged to sequence group 9, probably a subgroup of international clone I, and one isolate belonged to sequence group 4, a proposed novel international clone. All isolates contained an acquired OXA-carbapenemase-encoding gene: bla OXA-23-like (n=9), bla OXA-24-like (n=1) and bla OXA-58-like (n=1). Four isolates with high-level aminoglycoside-resistance contained the 16S rRNA methylase-encoding armA gene. Class 1 integrons with six different variable regions were detected. Sequence analysis of gene cassettes identified four aminoglycoside (aacA4, aac(6′)-Im, aadA1 and aacC1), two chloramphenicol (catB8 and cm1A5), one β-lactamase (bla OXA-20) and one rifampicin (arr-2) resistance gene in various combinations. In conclusion, the occurrence of A. baumannii isolates producing OXA carbapenemase and 16S rRNA methylase in Norway was related to the worldwide distribution of international clones I and II, and the emergence of novel international clones.

Publisher

Microbiology Society

Subject

Microbiology (medical),General Medicine,Microbiology

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