title: Dissemination of carbapenem-resistant Acinetobacter baumannii in patients with burn injuries.
abstract: BACKGROUND
  Carbapenem-resistant Acinetobacter baumannii has emerged as an important cause of infection in burn patients. This study aimed to characterize the antimicrobial susceptibility pattern, determine the prevalence of oxacillinase and metallo-beta-lactamase (MBL) genes, and type the A. baumannii isolates obtained from burn patients.
  
  
  METHODS
  During a 1-year period, a total of 40 nonduplicated isolates of A. baumannii were obtained from burn patients who were hospitalized in the Taleghani Burn Hospital in Ahvaz, in the southwest of Iran. Testing for antimicrobial susceptibility was carried out by disk diffusion and E-test. To screen MBL production, a double disk synergy and MBL E-test were performed. The presence of blaOXA-23-like, blaOXA-24-like, blaOXA-51-likeand blaOXA-58-like, blaVIM, blaIMPand blaSPM, and blaNDMwas sought by polymerase chain reaction (PCR). Repetitive extragenic palindromic sequence-based PCR was carried out for determination of isolates clonality.
  
  
  RESULTS
  Overall, 92.5% of isolates were carbapenem-resistant. Polymyxin B, colistin, and ampicillin-sulbactam were the most effective agents in vitro, with a susceptibility rate of 100%, 97.5%, and 72.5%, respectively. According to the double disk synergy and E-test, 55.6% and 97.3% of isolates were MBL producers, respectively. Furthermore, 70% of isolates harbored blaOXA-23-likeand 20% were positive for blaOXA-24-like.However, no encoding genes were detected for blaVIM, blaIMPand blaSPM, blaNDM, and blaOXA-58-like. Repetitive extragenic palindromic sequence-based PCR revealed that carbapenem-resistant isolates belonged to four clones, including A, B, C, and D; the predominant clones were B and C.
  
  
  CONCLUSIONS
  The rate of carbapenem resistance was high, and it appeared that blaOXA-23-likeand blaOXA-24-likecontributed to the carbapenem resistance of A. baumannii isolates. This result suggests that the two predominant clones of A. baumannii were spread among burn patients. In order to prevent future dissemination of resistant isolates among burn patients, an effective infection control plan is necessary.
authors.affiliation: Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Electronic address: Shojasaeed@gmail.com.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoja
authors.affiliation: Infectious and Tropical Diseases Research Centre, Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Moosavian
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Rostami
authors.affiliation: Infectious and Tropical Diseases Research Centre, Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Farahani
authors.affiliation: Department of Microbiology, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Peymani
authors.affiliation: Infectious and Tropical Diseases Research Centre, Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Khadijeh
authors.initials: K
authors.lastname: Ahmadi
authors.affiliation: Infectious and Tropical Diseases Research Centre, Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Ebrahimifard
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D002056:Burns / Q000382:microbiology*; D015780:Carbapenems / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests
chemical_list: D015780:Carbapenems
keywords: Acinetobacter baumannii; burns; carbapenem- resistant