title: Wide distribution of carbapenem resistant Acinetobacter baumannii in burns patients in Iran.
abstract: Antimicrobial resistance in carbapenem non-susceptible Acinetobacter baumannii (CNSAb) is a major public health concern globally. This study determined the antibiotic resistance and molecular epidemiology of CNSAb isolates from a referral burn center in Tehran, Iran. Sixty-nine CNSAb isolates were tested for susceptibility to antimicrobial agents using the E test methodology. Multiple locus variable number tandem repeat analysis (MLVA), Multilocus sequence typing (MLST) and multiplex PCR were performed. PCR assays tested for ambler classes A, B, and D β-lactamases. Detection of ISAba1, characterization of integrons, and biofilm formation were investigated. Fifty-three (77%) isolates revealed XDR phenotypes. High prevalence of bla OXA-23-like (88%) and bla PER-1 (54%) were detected. ISAba1 was detected upstream of bla ADC, bla OXA-23-like and bla OXA51-like genes in, 97, 42, and 26% of isolates, respectively. Thirty-one (45%) isolates were assigned to international clone (IC) variants. MLVA identified 56 distinct types with six clusters and 53 singleton genotypes. Forty previously known MLST sequence types forming 5 clonal complexes were identified. The Class 1 integron (class 1 integrons) gene was identified in 84% of the isolates. The most prevalent (33%) cassette combination was aacA4-catB8-aadA1. The IC variants were predominant in the A. baumannii lineage with the ability to form strong biofilms. The XDR-CNSAb from burned patients in Iran is resistant to various antimicrobials, including tigecycline. This study shows wide genetic diversity in CNSAb. Integrating the new Iranian A. baumannii IC variants into the epidemiologic clonal and susceptibility profile databases can help effective global control measures against the XDR-CNSAb pandemic.
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Farshadzadeh
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Farhad B
authors.initials: FB
authors.lastname: Hashemi
authors.affiliation: Department of Microbiology, School of Medicine, Bushehr University of Medical Sciences Bushehr, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Rahimi
authors.affiliation: Pediatrics Infectious Diseases Research Center, School of Medicine, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Pourakbari
authors.affiliation: Molecular Biology Research Center, Baqiyatallah University of Medical Sciences Tehran, Iran.
authors.forename: Davoud
authors.initials: D
authors.lastname: Esmaeili
authors.affiliation: Department of Microbiology, School of Medicine, Bushehr University of Medical Sciences Bushehr, Iran.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Haghighi
authors.affiliation: Anti-microbial Resistance Research Center, Iran University of Medical Sciences Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Majidpour
authors.affiliation: Department of Microbiology, Faculty of Medicine, Hormozgan University of Medical Sciences Bandar Abbas, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shojaa
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rahmani
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Samira
authors.initials: S
authors.lastname: Gharesi
authors.affiliation: Department of Microbiology, School of Medicine, Bushehr University of Medical Sciences Bushehr, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Aziemzadeh
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Bahador
keywords: MLST; MLVA; antimicrobial resistance; integron; international clone