title: Emergence of Carbapenem-Resistant Pseudomonas aeruginosa and Acinetobacter baumannii Clinical Isolates Collected from Some Libyan Hospitals.
abstract: The aim of the present study was to investigate the molecular mechanism of carbapenem resistance in Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates recovered from Libyan hospitals between April 2013 and April 2014. In total, 49 strains (24 P. aeruginosa and 25 A. baumannii) were isolated, including 21 P. aeruginosa and 22 A. baumannii isolates (87.75%) resistant to imipenem (minimum inhibitory concentrations ≥16 μg/ml). The blaVIM-2 gene was detected in 19 P. aeruginosa isolates. All imipenem-resistant P. aeruginosa isolates showed the presence of OprD mutations. Acquired OXA-carbapenemase-encoding genes were present in all A. baumannii isolates: blaOXA-23 (n=19) and blaOXA-24 (n=3). Finally, a total of 13 and 17 different sequence types were assigned to the 21 P. aeruginosa and the 22 A. baumannii carbapenem-resistant isolates, respectively. This study is the first report describing imipenem-resistant P. aeruginosa and A. baumannii isolated from patients in Libya. We report the first case of co-occurrence of blaVIM-2 with oprD porin loss in identical isolates of P. aeruginosa in Libya and demonstrate that these oprD mutations can be used as a tool to study the clonality in P. aeruginosa isolates. We also report the first identification of multidrug-resistant A. baumannii isolates harboring blaOXA-23-like, blaOXA-24-like, and blaOXA-48-like genes in Libya.
authors.affiliation: 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.|2Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Campus Universitaire, Université de Tunis El-Manar, El-Manar, Tunisie.
authors.forename: Najla
authors.initials: N
authors.lastname: Mathlouthi
authors.affiliation: 3Infection Control Office, Benghazi Medical Centre, Benghazi, Libya.|4Department of Microbiology, The Libyan Academy, Benghazi, Libya.
authors.forename: Zaynab
authors.initials: Z
authors.lastname: Areig
authors.affiliation: 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.
authors.forename: Charbel
authors.initials: C
authors.lastname: Al Bayssari
authors.affiliation: 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.
authors.forename: Sofiane
authors.initials: S
authors.lastname: Bakour
authors.affiliation: 3Infection Control Office, Benghazi Medical Centre, Benghazi, Libya.|5Department of Environmental Health, Faculty of Public Health, University of Benghazi, Benghazi, Libya.
authors.forename: Allaaeddin
authors.initials: A
authors.lastname: Ali El Salabi
authors.affiliation: 4Department of Microbiology, The Libyan Academy, Benghazi, Libya.|6Department of Botany, University of Benghazi, Benghazi, Libya.
authors.forename: Salha
authors.initials: S
authors.lastname: Ben Gwierif
authors.affiliation: 7Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Tripoli, Libya.
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Zorgani
authors.affiliation: 2Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Campus Universitaire, Université de Tunis El-Manar, El-Manar, Tunisie.
authors.forename: Karim
authors.initials: K
authors.lastname: Ben Slama
authors.affiliation: 2Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Campus Universitaire, Université de Tunis El-Manar, El-Manar, Tunisie.|8Université de Carthage, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Hammam-Lif, Tunisie.
authors.forename: Chedly
authors.initials: C
authors.lastname: Chouchani
authors.affiliation: 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.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015964:Gene Expression Regulation, Bacterial; D006761:Hospitals; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D008002:Libya / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D009154:Mutation; D010802:Phylogeny; D010957:Plasmids / Q000737:chemistry / Q000235:genetics / Q000378:metabolism; D018272:Porins / Q000235:genetics*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D018272:Porins; C077157:OprD protein, Pseudomonas aeruginosa; D015378:Imipenem; D001618:beta-Lactamases