title: Limited genetic diversity and extensive antimicrobial resistance in clinical isolates of Acinetobacter baumannii in north-east Iran.
abstract: This study determined the mechanisms and patterns of antimicrobial resistance among the isolates obtained from different wards of a teaching hospital in the city of Mashhad in north-east Iran. Between January 2012 and the end of June 2012, 36 isolates of Acinetobacter baumannii were collected from different wards of Ghaem Hospital. Antimicrobial susceptibility testing and epsilometer testing (E-test) were performed. The genetic resistance determinants of A, B and D classes of β-lactamases, aminoglycoside modifying enzymes (AMEs), efflux pumps and ISAba1 elements were assessed by PCR. Repetitive extragenic palindromic element (REP)-PCR was performed to find the genetic relatedness of the isolates. Colistin was the most effective antibiotic of those tested, where all isolates were susceptible. E-test results revealed high rates of resistance to imipenem, ceftazidime and ciprofloxacin. The majority of isolates (97  %) were multidrug-resistant. OXA-51, OXA-23 and tetB genes were detected in all isolates, but OXA-58, IMP and tetA were not detected. The prevalence of OXA-24, bla(TEM), bla(ADC), bla(VIM) and adeB were 64, 95, 61, 64 and 86  %, respectively. ISAba1 was found to be inserted into the 5' end of OXA-23 in 35 isolates (97  %). Of the AMEs, aadA1 (89  %) was the most prevalent, followed by aphA1 (75  %). The band patterns reproduced by REP-PCR showed that 34 out of 36 isolates belonged to one clone and two singletons were identified. The results confirmed that refractory A. baumannii isolates were widely distributed and warned the hospital infection control team to exert strict measures to control the infection. An urgent surveillance system should be implemented.
authors.affiliation: Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.|Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Farsiani
authors.affiliation: Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.|Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Arman
authors.initials: A
authors.lastname: Mosavat
authors.affiliation: Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.|Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Saman
authors.initials: S
authors.lastname: Soleimanpour
authors.affiliation: Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahbobeh Naderi
authors.initials: MN
authors.lastname: Nasab
authors.affiliation: Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.|Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Himen
authors.initials: H
authors.lastname: Salimizand
authors.affiliation: Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Saeid Amel
authors.initials: SA
authors.lastname: Jamehdar
authors.affiliation: Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Kiarash
authors.initials: K
authors.lastname: Ghazvini
authors.affiliation: Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Aryan
authors.affiliation: Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.|Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali-Asghar
authors.initials: AA
authors.lastname: Baghani
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; D003091:Colistin / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D004251:DNA Transposable Elements / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D014644:Genetic Variation / Q000235:genetics; D006784:Hospitals, Teaching; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D013753:Tetracycline Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D004251:DNA Transposable Elements; D001618:beta-Lactamases; D003091:Colistin