title: Wide dissemination of GES-type carbapenemases in Acinetobacter baumannii isolates in Kuwait.
abstract: Acinetobacter baumannii is an opportunistic pathogen that is an important source of nosocomial infections. Production of extended-spectrum β-lactamases (ESBLs) of the GES type in A. baumannii has been increasingly reported, and some of these GES-type enzymes possess some carbapenemase activity. Our aim was to analyze the resistance determinants and the clonal relationships of carbapenem-nonsusceptible A. baumannii clinical isolates recovered from hospitals in Kuwait. A total of 63 isolates were analyzed, and all were found to be positive for bla(GES)-type genes. One isolate harbored the bla(GES-14) gene encoding an ESBL with significant carbapenemase activity, whereas the other isolates harbored the bla(GES-11) ESBL gene. Thirty-three isolates coharbored the bla(OXA-23) and bla(GES-11) genes. Analyses of the genetic locations indicated that the bla(GES-11/-14) genes were plasmid located. It is noteworthy that the bla(OXA-23) and bla(GES-11) genes were colocated onto a single plasmid. Nine different pulsotypes were observed among the 63 isolates. This study showed the emergence of GES-type ESBLs in A. baumannii in Kuwait, further suggesting that the Middle East region might be a reservoir for carbapenemase-producing A. baumannii.
authors.affiliation: Service de Bactériologie-Virologie, INSERM U914, Emerging Resistance to Antibiotics, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, Le Kremlin-Bicêtre, France.
authors.forename: Rémy A
authors.initials: RA
authors.lastname: Bonnin
authors.forename: Vincent O
authors.initials: VO
authors.lastname: Rotimi
authors.forename: Mona
authors.initials: M
authors.lastname: Al Hubail
authors.forename: Elise
authors.initials: E
authors.lastname: Gasiorowski
authors.forename: Noura
authors.initials: N
authors.lastname: Al Sweih
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000145:classification / Q000235:genetics*; D015373:Bacterial Typing Techniques; D015780:Carbapenems / Q000494:pharmacology*; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D010957:Plasmids; D018440:beta-Lactam Resistance / Q000187:drug effects / Q000235:genetics; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase