MOLECULAR INVESTIGATION OF EXTREMELY DRUG RESISTANT ACINETOBACTER BAUMANNII OUTBREAK IN THE ICU OF A TERTIARY HEALTHCARE CENTER IN LEBANON

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طب

الملخص

Antimicrobial resistance (AMR) represents one of the major global health issues today. Infections with extensively drug-resistant (XDR) and pan drug-resistant(PDR) bacteria are associated with prolonged treatment periods and high lethality, owing to the limited and sometimes absent therapeutic options. Due to the misuse of antibiotics by means of over-prescription and their abuse in agriculture, AMR is continuously spreading and causing dangerous outbreaks that prompt establishing persistent and accurate surveillance. Hospitals and other healthcare establishments are fertile ground fordrug-resistant bacteria to flourish, especially biofilm-forming bacteria such as the WHO top priority pathogen Acinetobacter baumannii. In this study, we utilize next-generationsequencing (NGS) as a fast and effective diagnostic tool to gain insight into the genomic diversity and clonality of an A. baumannii outbreak at a tertiary care center in Beirut, Lebanon. Methods: A total of 54 A. baumannii isolates from ICU patients and from the hospital environment collected from AUBMC Clinical Microbiology Laboratory were screened for their susceptibility using the Broth Micro-dilution assay (BMD) against 12 different antimicrobials from different antimicrobial classes. For the purpose of determining AMR genes, sequence type (ST) and international clones (IC), whole-genome sequencing(WGS) using Illumina sequencing was performed on all these isolates. Results: According to CLSI guidelines, two A. baumannii isolates were found to be resistant to colistin. All isolates showed resistance to Bactrim. Resistance rates were 98%for imipenem, meropenem, tazocin, ciprofloxacin, levofloxacin, ceftazidime, and cefepime, while resistance to gentamicin and amikacin accounted for 93% and 94%,respectively. Furthermore, 96% of tested A. baumannii isolates can be categorized asXDR, 2% as PDR while 2% were susceptible to antibiotics. Additionally, many antimicrobial resistance genes were detected, including the carbapenem resistance geneOXA-23. All our isolates were of ST 2, with 93% of them belonging to IC 2.Conclusion: The study focused on A. baumannii isolates and found that those belonging to ST-2 and IC-2 were the most prevalent. These isolates were clustered together and had similar antimicrobial resistance genes. WGS was crucial in identifying these differences and highlighting the importance of advanced techniques in tracking and identifying outbreaks accurately. The finding that most isolates detected belongs to IC-2 and ST-2carrying blaOXA-23 suggests that the current outbreak strain might have originated from older isolates dating back to 2014-2020. This study emphasizes the importance of 3utilizing NGS in monitoring the antibiotic-resistant pathogens as a way to prevent and control outbreaks.

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02c5073e-8c9d-4b46-b308-3decde8cf069

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0

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Crawler

نوع المحتوى

الرسائل العلمية

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رسائل ماجيستير

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pdf text

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2325987_1.pdf

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[{"name_ar":"أنطوان أبو فايد","title_ar":"اشراف","title_en":"Supervision"},{"name_ar":"غسان مطر","title_ar":"اشراف","title_en":"Supervision"},{"name_ar":"فاتيما عماد درويش","title_ar":"اعداد","title_en":"Preparation"}]

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English

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اسم المصدر

MOLECULAR INVESTIGATION OF EXTREMELY DRUG RESISTANT ACINETOBACTER BAUMANNII OUTBREAK IN THE ICU OF A TERTIARY HEALTHCARE CENTER IN LEBANON

المحتوى والصفحات

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0

كلمات الباحثين

Show simple item record dc.contributor.advisor Matar, Ghassan dc.contributor.advisor Abou Fayad, Antoine dc.contributor.author Darwiche, Fatima dc.date.accessioned 2023-05-10T07:46:56Z dc.date.available 2023-05-10T07:46:56Z dc.date.issued 5/10/2023 dc.date.submitted 5/9/2023 dc.identifier.uri http://hdl.handle.net/10938/24055 dc.description.abstract Antimicrobial resistance (AMR) represents one of the major global healthissues today. Infections with extensively drug-resistant (XDR) and pan drug-resistant(PDR) bacteria are associated with prolonged treatment periods and high lethality, owingto the limited and sometimes absent therapeutic options. Due to the misuse of antibioticsby means of over-prescription and their abuse in agriculture, AMR is continuouslyspreading and causing dangerous outbreaks that prompt establishing persistent andaccurate surveillance. Hospitals and other healthcare establishments are fertile ground fordrug-resistant bacteria to flourish, especially biofilm-forming bacteria such as the WHOtop priority pathogen Acinetobacter baumannii. In this study, we utilize next-generationsequencing (NGS) as a fast and effective diagnostic tool to gain insight into the genomicdiversity and clonality of an A. baumannii outbreak at a tertiary care center in Beirut,Lebanon.Methods: A total of 54 A. baumannii isolates from ICU patients and from the hospitalenvironment collected from AUBMC Clinical Microbiology Laboratory were screenedfor their susceptibility using the Broth Micro-dilution assay (BMD) against 12 differentantimicrobials from different antimicrobial classes. For the purpose of determining AMRgenes, sequence type (ST) and international clones (IC), whole-genome sequencing(WGS) using Illumina sequencing was performed on all these isolates.Results: According to CLSI guidelines, two A. baumannii isolates were found to beresistant to colistin. All isolates showed resistance to Bactrim. Resistance rates were 98%for imipenem, meropenem, tazocin, ciprofloxacin, levofloxacin, ceftazidime, andcefepime, while resistance to gentamicin and amikacin accounted for 93% and 94%,respectively. Furthermore, 96% of tested A. baumannii isolates can be categorized asXDR, 2% as PDR while 2% were susceptible to antibiotics. Additionally, manyantimicrobial resistance genes were detected, including the carbapenem resistance geneOXA-23. All our isolates were of ST 2, with 93% of them belonging to IC 2.Conclusion: The study focused on A. baumannii isolates and found that those belongingto ST-2 and IC-2 were the most prevalent. These isolates were clustered together and hadsimilar antimicrobial resistance genes. WGS was crucial in identifying these differencesand highlighting the importance of advanced techniques in tracking and identifyingoutbreaks accurately. The finding that most isolates detected belongs to IC-2 and ST-2carrying blaOXA-23 suggests that the current outbreak strain might have originated fromolder isolates dating back to 2014-2020. This study emphasizes the importance of 3utilizing NGS in monitoring the antibiotic-resistant pathogens as a way to prevent andcontrol outbreaks. dc.language.iso en dc.subject Acinetobacter Baumannii, MDR, Outbreak

إشراف وإعداد

الإشراف

أنطوان أبو فايد, غسان مطر

الإعداد

فاتيما عماد درويش

الاقتباسات الببليوغرافية