title: Elevated prevalence of multidrug-resistant Acinetobacter baumannii with extensive genetic diversity in the largest burn centre of northeast Iran.
abstract: The emergence and spread of multidrug-resistant (MDR) Acinetobacter baumannii isolates is now frequently associated with nosocomial infections. The aim of this study was to evaluate the genetic relatedness and patterns of antimicrobial resistance amongst A. baumannii isolated from a burn centre at a teaching hospital in Iran.
  
  
  
  A total of 54 A. baumannii isolates were collected from burn wound infections of hospitalised patients. Antimicrobial susceptibility of the isolates was determined, and genotyping analysis was performed by repetitive extragenic palindromic PCR (rep-PCR). PCR assay was performed to investigate the distribution of β-lactamase, aminoglycoside-modifying enzyme and efflux pump genes.
  
  
  
  Etest results revealed that the most active antimicrobial agent was colistin (100% susceptibility), followed by tigecycline (96.3%). The blaOXA-51and blaADCgenes were detected in all of the isolates, but blaOXA-58-likewas not detected. The prevalence of blaTEM, blaIMP, blaVIM, blaOXA-23-likeand blaOXA-24-likegenes was 64.8%, 70.4%, 70.4%, 66.7% and 68.5%, respectively. ISAba1 was detected upstream of blaOXA-23-likeand blaADCin 66.7% and 77.8% of isolates, respectively. This study showed a high level of distribution of adeB (72.2%), aphA6 (81.5%), aacC1 (85.2%), aadA1 (59.3%), aadB (31.5%), tetB (70.4%) and aphA1 (29.6%) in A. baumannii strains. Based on rep-PCR analysis, four clusters (I-IV) were defined.
  
  
  
  The elevated prevalence of MDR A. baumannii strains in this burn centre suggests that local antibiotic prescription policies should be precisely revised. Moreover, strict infection control procedures to prevent further dissemination need to be prioritised immediately.
authors.affiliation: Department of Biology, Neyshabur Branch, Islamic Azad University, Neyshabur, Razavi Khorasan, Iran.
authors.forename: Nazanin
authors.initials: N
authors.lastname: Sarhaddi
authors.affiliation: Antimicrobial Resistance Research Center, Avicenna Research Institute, 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, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Farsiani
authors.affiliation: HIV/AIDS, HTLV and Viral Hepatitis Research Center, Iranian Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran.
authors.forename: Arman
authors.initials: A
authors.lastname: Mosavat
authors.affiliation: Department of Biology, Neyshabur Branch, Islamic Azad University, Neyshabur, Razavi Khorasan, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Dolatabadi
authors.affiliation: Department of Microbiology and Virology, School of Medicine, Kurdistan University of Medical Sciences,Sanandaj, Iran.
authors.forename: Himen
authors.initials: H
authors.lastname: Salimizand
authors.affiliation: Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: AmelJS@mums.ac.ir.
authors.forename: Saeid
authors.initials: S
authors.lastname: Amel Jamehdar
mesh_terms: D000151:Acinetobacter Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics* / Q000472:pathogenicity; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D002053:Burn Units; D002056:Burns / Q000150:complications / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003091:Colistin; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis; D052978:Disk Diffusion Antimicrobial Tests / Q000379:methods; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000235:genetics*; D005260:Female; D005798:Genes, Bacterial / Q000235:genetics; D014644:Genetic Variation / Q000235:genetics*; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D016133:Polymerase Chain Reaction / Q000379:methods; D015995:Prevalence; D000078304:Tigecycline / Q000494:pharmacology; D014946:Wound Infection / Q000382:microbiology; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D000078304:Tigecycline; D001618:beta-Lactamases; D003091:Colistin
keywords: Acinetobacter baumannii; Burns; Iran; Multidrug resistance; PCR; rep-PCR