Wide spread of OXA-23-producing carbapenem-resistant Acinetobacter baumannii belonging to clonal complex II in different hospitals in Lebanon.
OBJECTIVE
To investigate the molecular epidemiology of Acinetobacter baumannii strains isolated from different hospitals in Lebanon.


METHODS
A total of 119 non-duplicate Acinetobacter strains were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and partial rpoB gene sequencing. Antibiotic susceptibility testing was performed by disc diffusion method and all identified carbapenem-resistant isolates were investigated by PCR assays for the presence of the carbapenemase-encoding genes. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used for molecular typing.


RESULTS
Of the 119 A. baumannii isolates, 76.5% were resistant to carbapenems. The most common carbapenemase was the OXA-23-type, found in 82 isolates. The study of population structure using MLST revealed the presence of 30 sequence types (STs) including 18 new ones, with ST2 being the most commonly detected, accounting for 61% of the isolates typed. PFGE performed on all strains of ST2 identified a major cluster of 53 isolates, in addition to three other minor clusters and ten unique profiles.


CONCLUSIONS
This study highlights the wide dissemination of highly related OXA-23-producing carbapenem-resistant A. baumannii belonging to the international clone II in Lebanon. Thus, appropriate infection control measures are recommended in order to control the geographical spread of this clone in this country.
Laboratoire Microbiologie Santé et Environnement (LMSE), Ecole Doctorale des Sciences et de Technologie et Faculté de Santé Publique, Université Libanaise, Tripoli, Lebanon; ATOMycA, InsermAtip-Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University of Angers, Angers, France.
Ahmad
A
Al Atrouni
Laboratoire Microbiologie Santé et Environnement (LMSE), Ecole Doctorale des Sciences et de Technologie et Faculté de Santé Publique, Université Libanaise, Tripoli, Lebanon.
Monzer
M
Hamze
Department of Clinical Laboratory, Makassed General Hospital, Beirut, Lebanon.
Tamima
T
Jisr
Laboratoire de Bactériologie, Institut de Biologie en Santé - Centre Hospitalier Universitaire Angers, 4 rue Larrey, 49933 Angers cedex, France.
Carole
C
Lemarié
ATOMycA, InsermAtip-Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University of Angers, Angers, France; Laboratoire de Bactériologie, Institut de Biologie en Santé - Centre Hospitalier Universitaire Angers, 4 rue Larrey, 49933 Angers cedex, France.
Matthieu
M
Eveillard
ATOMycA, InsermAtip-Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University of Angers, Angers, France; Laboratoire de Bactériologie, Institut de Biologie en Santé - Centre Hospitalier Universitaire Angers, 4 rue Larrey, 49933 Angers cedex, France.
Marie-Laure
ML
Joly-Guillou
ATOMycA, InsermAtip-Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University of Angers, Angers, France; Laboratoire de Bactériologie, Institut de Biologie en Santé - Centre Hospitalier Universitaire Angers, 4 rue Larrey, 49933 Angers cedex, France. Electronic address: makempf@chu-angers.fr.
Marie
M
Kempf
D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D015780:Carbapenems / Q000494:pharmacology; D016521:Electrophoresis, Gel, Pulsed-Field; D006761:Hospitals; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D016133:Polymerase Chain Reaction; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; C466679:beta-lactamase OXA-23; D001618:beta-Lactamases; C063912:carbapenemase
Acinetobacter baumannii; Carbapenem resistance; Clonal complex II; Lebanon; OXA-23