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Molecular Detection of blaoxa-23 Gene from Carbapenem Resistant Acinetobacter Baumannii Isolated from a Tertiary Care Hospital of Nepal
Laxmi Neupane
Tribhuvan University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0331-5636
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Background: Infections associated with Acinetobacter baumannii are increasing in many parts of the world especially the healthcare associated infections (HAIs). Antibiotics resistance is a great concern of public health which is either an inherent or adaptation property of microorganisms to resist the action of antibiotics. Carbapenem resistance, mainly among gram-negative bacteria is an ongoing problem that causes serious infections and dramatically limits the treatment alternatives. The prospective cross-sectional study was designed to detect the blaOXA-23 gene from carbapenem-resistant A. baumannii isolates in a tertiary care hospital of Nepal.
Methods: A total of 380 clinical specimens (tracheal aspirate, urine, sputum, blood and wound samples, Foleys tips, and catheter tips) were collected from the study population and were examined by microbiological procedures including Gram’s staining, culture, and various biochemical tests. Antibiotic susceptibility testing (AST) was done as per the protocol of Kirby-Bauer disk diffusion technique and the CLSI guidelines while screening of carbapenemase production was checked through Modified Hodge Test (MHT) using Meropenem (10µg) disc. All the phenotypically positive results for carbapenemase production were further analysed by PCR and agarose gel electrophoresis for molecular detection of the blaOXA-23 gene.
Results: Among 380 specimens analysed, 55.3% (210/310) of samples were positive for bacterial growth where 15.7% (33/210) of bacterial isolates were A. baumannii and 69.7% (23/33) were carbapenem-resistant. High prevalence (21.2%) of A. baumannii was among the patients of age group 51-60 followed by 41-50 years (18.2%) years but the result was statistically insignificant (P>0.05) and more isolates were from ICU (60.6%) followed by post-operative patients (18.2%) The blaOXA-23 carbapenemase gene was found in 82.6% (19/23) of meropenem resistant isolates while 97% isolates of A. baumannii were susceptible to colistin.
Conclusion: The high rate of antibiotic resistance is funnelling the therapeutic options for the treatment of infections associated with A. baumannii which clearly shows a need for rational use of antibiotics. Systematic network surveillance should be established for monitoring and controlling the spread of the antibiotic-resistant gene of pathogenic bacteria especially in a resource-limited clinical setting like Nepal.
Keywords
Acinetobacter baumannii, carbapenemase, blaOXA-23, antibiotic-resistant, Nepal
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Research
Molecular Detection of blaoxa-23 Gene from Carbapenem Resistant Acinetobacter Baumannii Isolated from a Tertiary Care Hospital of Nepal
Laxmi Neupane
Tribhuvan University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0331-5636
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 28 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Infections associated with Acinetobacter baumannii are increasing in many parts of the world especially the healthcare associated infections (HAIs). Antibiotics resistance is a great concern of public health which is either an inherent or adaptation property of microorganisms to resist the action of antibiotics. Carbapenem resistance, mainly among gram-negative bacteria is an ongoing problem that causes serious infections and dramatically limits the treatment alternatives. The prospective cross-sectional study was designed to detect the blaOXA-23 gene from carbapenem-resistant A. baumannii isolates in a tertiary care hospital of Nepal.
Methods: A total of 380 clinical specimens (tracheal aspirate, urine, sputum, blood and wound samples, Foleys tips, and catheter tips) were collected from the study population and were examined by microbiological procedures including Gram’s staining, culture, and various biochemical tests. Antibiotic susceptibility testing (AST) was done as per the protocol of Kirby-Bauer disk diffusion technique and the CLSI guidelines while screening of carbapenemase production was checked through Modified Hodge Test (MHT) using Meropenem (10µg) disc. All the phenotypically positive results for carbapenemase production were further analysed by PCR and agarose gel electrophoresis for molecular detection of the blaOXA-23 gene.
Results: Among 380 specimens analysed, 55.3% (210/310) of samples were positive for bacterial growth where 15.7% (33/210) of bacterial isolates were A. baumannii and 69.7% (23/33) were carbapenem-resistant. High prevalence (21.2%) of A. baumannii was among the patients of age group 51-60 followed by 41-50 years (18.2%) years but the result was statistically insignificant (P>0.05) and more isolates were from ICU (60.6%) followed by post-operative patients (18.2%) The blaOXA-23 carbapenemase gene was found in 82.6% (19/23) of meropenem resistant isolates while 97% isolates of A. baumannii were susceptible to colistin.
Conclusion: The high rate of antibiotic resistance is funnelling the therapeutic options for the treatment of infections associated with A. baumannii which clearly shows a need for rational use of antibiotics. Systematic network surveillance should be established for monitoring and controlling the spread of the antibiotic-resistant gene of pathogenic bacteria especially in a resource-limited clinical setting like Nepal.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6