Wide Dissemination of GES-Type Carbapenemases in Acinetobacter baumannii Isolates in Kuwait

Abstract

ABSTRACTAcinetobacter baumanniiis an opportunistic pathogen that is an important source of nosocomial infections. Production of extended-spectrum β-lactamases (ESBLs) of the GES type inA. baumanniihas been increasingly reported, and some of these GES-type enzymes possess some carbapenemase activity. Our aim was to analyze the resistance determinants and the clonal relationships of carbapenem-nonsusceptibleA. baumanniiclinical isolates recovered from hospitals in Kuwait. A total of 63 isolates were analyzed, and all were found to be positive forblaGES-type genes. One isolate harbored theblaGES-14gene encoding an ESBL with significant carbapenemase activity, whereas the other isolates harbored theblaGES-11ESBL gene. Thirty-three isolates coharbored theblaOXA-23andblaGES-11genes. Analyses of the genetic locations indicated that theblaGES-11/-14genes were plasmid located. It is noteworthy that theblaOXA-23andblaGES-11genes were colocated onto a single plasmid. Nine different pulsotypes were observed among the 63 isolates. This study showed the emergence of GES-type ESBLs inA. baumanniiin Kuwait, further suggesting that the Middle East region might be a reservoir for carbapenemase-producingA. baumannii.