Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center

  • K.M. H
  • A.M. H
  • E.A. H
 et al. 
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Abstract

Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multidrug-resistant (MDR) Acinetobacter baumannii isolates. In order to anticipate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter sp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC). Susceptibility testing, PCR amplification of the genetic determinants of resistance, and clonality were determined. Seventy-five unique patient isolates were included in this study: 53% were from bloodstream infections, 89% were resistant to at least three classes of antibiotics, and 15% were resistant to all nine antibiotics tested. Thirty-seven percent of the isolates were recovered from patients nosocomially infected or colonized at the WRAMC. Sixteen unique resistance genes or gene families and four mobile genetic elements were detected. In addition, this is the first report of blaOXA-58-like and blaPER-like genes in the U.S. MDRA baumannii isolates with at least eight identified resistance determinants were recovered from 49 of the 75 patients. Molecular typing revealed multiple clones, with eight major clonal types being nosocomially acquired and with more than 60% of the isolates being related to three pan-European types. This report gives a "snapshot" of the complex genetic background responsible for antimicrobial resistance in Acinetobacter spp. from the WRAMC. Identifying genes associated with the MDR phenotype and defining patterns of transmission serve as a starting point for devising strategies to limit the clinical impact of these serious infections. Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Author-supplied keywords

  • *Acinetobacter
  • *antibiotic resistance
  • *bacterial gene
  • *multidrug resistance
  • Acinetobacter baumannii
  • Afghanistan
  • Europe
  • Iraq
  • United States
  • adolescent
  • adult
  • aged
  • amikacin
  • aminoglycoside antibiotic agent
  • ampicillin
  • army
  • article
  • bacteremia/dr [Drug Resistance]
  • bacteremia/et [Etiology]
  • bacterial colonization
  • bacterium isolate
  • beta lactam antibiotic
  • beta lactamase inhibitor
  • bla PER gene
  • bla oxa 58 gene
  • carbapenem derivative
  • cefepime
  • ceftazidime
  • cephalosporin derivative
  • child
  • ciprofloxacin
  • clonal variation
  • controlled study
  • drug classification
  • female
  • gene identification
  • gentamicin
  • hospital infection/dr [Drug Resistance]
  • hospital infection/et [Etiology]
  • human
  • imipenem
  • kanamycin
  • major clinical study
  • male
  • meropenem
  • molecular typing
  • multigene family
  • neomycin
  • nonhuman
  • phenotype
  • polymerase chain reaction
  • priority journal
  • public hospital
  • quinolone derivative
  • spectinomycin
  • streptomycin
  • sultamicillin
  • tobramycin

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Authors

  • Hujer K.M.

  • Hujer A.M.

  • Hulten E.A.

  • Bajaksouzian S.

  • Adams J.M.

  • Donskey C.J.

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