title: Prevalence of digestive tract colonization of carbapenem-resistant Acinetobacter baumannii in hospitals in Saudi Arabia.
abstract: Carbapenem-resistant Acinetobacter baumannii is a major health problem worldwide, especially in intensive care units (ICUs). This study aimed to detect the prevalence of A. baumannii colonization of the gastrointestinal tract of patients admitted to the ICU in two hospitals in Saudi Arabia. In addition, it aimed to characterize the molecular mechanisms of carbapenem resistance in these isolates. From January to June 2014, 565 rectal swab specimens were screened for Acinetobacer strains and carbapenem resistance using CHROMagar Acinetobacter and CHROMagar KPC agar plates, respectively. Organism identification and susceptibility were detected using the Vitek 2 system. A total of 47 Acinetobacter spp. were detected, and 35 were resistant to carbapenem, making the prevalence of Acinetobacter spp. 8.3% (47/565) and carbapenem resistance (6.2%, 35/565). The 47 strains showed remarkable clonal diversity as revealed by PFGE. Using PCR, OXA-51, a chromosomal marker for A. baumannii, was detected in 46 strains. OXA-23 β-lactamase was detected in all 35 carbapenem-resistant A. baumannii. No IMP, VIM, SPM, SIM, GIM, KPC or NDM β-lactamases were detected in these isolates. Thus, OXA-23 was the main mechanism of carbapenem resistance in these isolates. To the best of our knowledge, this is the first study to detect the prevalence of Acinetobacter colonization in the digestive tract of ICU patients in Saudi Arabia. This study revealed the importance of having well-established protocols for early identification of these multidrug-resistant organisms, optimizing infection-control strategies and having active surveillance studies to reduce morbidity, mortality and cost.
authors: Department of Microbiology, College of Medicine, University of Dammam, PO Box 2208, AlKhobar, Kingdom of Saudi Arabia.
authors: Reem
authors: R
authors: Aljindan
authors: Department of Medicine, College of Medicine, University of Dammam, PO Box 2208, AlKhobar, Kingdom of Saudi Arabia.
authors: Huda
authors: H
authors: Bukharie
authors: Department of Clinical Laboratory Science, College of Applied Medical Science, University of Dammam, PO Box 2208, AlKhobar, Kingdom of Saudi Arabia.
authors: Amer
authors: A
authors: Alomar
authors: Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, PO Box 15215, Dammam, Kingdom of Saudi Arabia.
authors: Baha
authors: B
authors: Abdalhamid
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001431:Bacteriological Techniques; D015780:Carbapenems / Q000494:pharmacology*; D016521:Electrophoresis, Gel, Pulsed-Field; D041981:Gastrointestinal Tract / Q000382:microbiology*; D014644:Genetic Variation; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D058889:Molecular Typing; D015995:Prevalence; D012007:Rectum / Q000382:microbiology; D012529:Saudi Arabia; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000032:analysis
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases