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Characterization of NDM-1- and OXA-23-producing Acinetobacter baumannii isolates from inanimate surfaces in a
K Zenati1, A Touati2, S Bakour1
1Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France; Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, 06000 Bejaia, Algeria.
Background:
Investigation of several outbreaks of multidrug-resistant Acinetobacter baumannii infection has demonstrated that contamination of the inanimate hospital environment could be implicated in the spread of these multidrug-resistant strains.
Aim:
To investigate the occurrence of carbapenem-resistant A. baumannii on inanimate surfaces and possible dissemination in the hospital environment in Algeria as a potential source of infection in humans.
Methods:
A. baumannii strains were isolated from the hospital environment and identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility was determined using disc diffusion and E-test methods. Carbapenemase activity was detected using microbiological tests, including modified Hodge test, modified Carba NP test, and EDTA test. Carbapenem resistance determinants were studied by polymerase chain reaction (PCR) and sequencing. Clonal relatedness was determined using multi-locus sequence typing (MLST).
Results:
A total of 67 A. baumannii isolates were obtained from 868 environmental samples and identified by MALDI-TOF MS. Among them, 61 isolates were resistant to imipenem with minimum inhibitory concentration >32 μg/mL and positive by the modified Hodge test and modified Carba NP test. In addition, the activity of carbapenemase was inhibited by EDTA in 32 strains. PCR and sequencing showed the presence of blaOXA-23 gene in 29 strains, and the blaNDM-1 gene in 32 isolates. MLST demonstrated the presence of five types of ST (ST19, ST2, ST85, ST98, and ST115).
Conclusion:
Our study demonstrated the dissemination of carbapenemase-producing A. baumannii strains recovered from inanimate surfaces in a hospital environment, surrounding patients, healthcare workers and visitors, in Algeria as a potential source for nosocomial infection.
Insights
Multidrug-resistant Acinetobacter baumannii strains, particularly carbapenem-resistant ones, were found on hospital surfaces in Algeria. This highlights the inanimate hospital environment as a significant source for potential patient infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Environmental Health
Background:
- Multidrug-resistant Acinetobacter baumannii infections pose a significant threat in healthcare settings.
- Contamination of hospital surfaces is a known factor in the spread of resistant bacteria.
Purpose of the Study:
- To investigate the presence and spread of carbapenem-resistant Acinetobacter baumannii on inanimate surfaces in Algerian hospitals.
- To identify potential sources of human infection within the hospital environment.
Main Methods:
- Isolation and identification of A. baumannii using MALDI-TOF MS.
- Antimicrobial susceptibility testing (disc diffusion, E-test).
- Detection of carbapenemase activity (modified Hodge test, Carba NP test, EDTA test).
- Genomic analysis for resistance genes (PCR, sequencing) and strain typing (MLST).
Main Results:
- 67 A. baumannii isolates were recovered from environmental samples.
- 61 isolates exhibited resistance to imipenem and tested positive for carbapenemase activity.
- blaOXA-23 and blaNDM-1 genes were identified in resistant strains.
- Five distinct sequence types (STs) were identified, indicating strain diversity.
Conclusions:
- Carbapenemase-producing A. baumannii strains are disseminated on inanimate hospital surfaces in Algeria.
- These environmental reservoirs pose a risk for nosocomial infections among patients, staff, and visitors.
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