AUTHOR=Vali Leila , Dashti Khadija , Opazo-Capurro Andrés F. , Dashti Ali A. , Al Obaid Khaled , Evans Benjamin A. 

TITLE=Diversity of multi-drug resistant Acinetobacter baumannii population in a major hospital in Kuwait

JOURNAL=Frontiers in Microbiology

VOLUME=6

YEAR=2015

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2015.00743

DOI=10.3389/fmicb.2015.00743

ISSN=1664-302X

ABSTRACT=<p><italic>Acinetobacter baumannii</italic> is one of the most important opportunistic pathogens that causes serious health care associated complications in critically ill patients. In the current study we report on the diversity of the clinical multi-drug resistant (MDR) <italic>A. baumannii</italic> in Kuwait by molecular characterization. One hundred <italic>A. baumannii</italic> were isolated from one of the largest governmental hospitals in Kuwait. Following the identification of the isolates by molecular methods, the amplified <italic>bla</italic><sub>OXA-51</sub>-like gene product of one isolate (KO-12) recovered from blood showed the insertion of the ISAba19 at position 379 in <italic>bla</italic><sub>OXA-78</sub>. Of the 33 MDR isolates, 28 (85%) contained <italic>bla</italic><sub>OXA-23</sub>, 2 (6%) <italic>bla</italic><sub>OXA-24</sub> and 6 (18%) <italic>bla</italic><sub>PER-1</sub> gene. We did not detect <italic>bla</italic><sub>OXA-58</sub>, <italic>bla</italic><sub>VIM</sub>, <italic>bla</italic><sub>IMP</sub>, <italic>bla</italic><sub>GES,</sub><italic>bla</italic><sub>VEB</sub>, and <italic>bla</italic><sub>NDM</sub> genes in any of the tested isolates. In three <italic>bla</italic><sub>PER-1</sub> positive isolates the genetic environment of <italic>bla</italic><sub>PER-1</sub> consisted of two copies of ISPa12 (tnpiA1) surrounding the <italic>bla</italic><sub>PER-1</sub> gene on a highly stable plasmid of ca. 140-kb. Multilocus-sequence typing (MLST) analysis of the 33 <italic>A. baumannii</italic> isolates identified 20 different STs, of which six (ST-607, ST-608, ST-609, ST-610, ST-611, and ST-612) were novel. Emerging STs such as ST15 (identified for the first time in the Middle East), ST78 and ST25 were also detected. The predominant clonal complex was CC2. Pulsed-field gel electrophoresis and MLST defined the MDR isolates as multi-clonal with diverse lineages. Our results lead us to believe that <italic>A. baumannii</italic> is diverse in clonal origins and/or is undergoing clonal expansion continuously while multiple lineages of MDR <italic>A. baumannii</italic> circulate in hospital ward simultaneously.</p>