bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda
Abstract Background Between January 2015 and July 2017, we investigated the frequency of carbapenem resistant Acinetobacter baumannii (CRAB) and carbapenem resistant Pseudomonas aeruginosa (CRPA) at the Mulago Hospital intensive care unit (ICU) in Kampala, Uganda. Carbapenemase production and carbap...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-10-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4510-5 |
| _version_ | 1818208000973733888 |
|---|---|
| author | Dickson Aruhomukama Christine F. Najjuka Henry Kajumbula Moses Okee Gerald Mboowa Ivan Sserwadda Richard Mayanja Moses L. Joloba David P. Kateete |
| author_facet | Dickson Aruhomukama Christine F. Najjuka Henry Kajumbula Moses Okee Gerald Mboowa Ivan Sserwadda Richard Mayanja Moses L. Joloba David P. Kateete |
| author_sort | Dickson Aruhomukama |
| collection | DOAJ |
| description | Abstract Background Between January 2015 and July 2017, we investigated the frequency of carbapenem resistant Acinetobacter baumannii (CRAB) and carbapenem resistant Pseudomonas aeruginosa (CRPA) at the Mulago Hospital intensive care unit (ICU) in Kampala, Uganda. Carbapenemase production and carbapenemase gene carriage among CRAB and CRPA were determined; mobility potential of carbapenemase genes via horizontal gene transfer processes was also studied. Methods Clinical specimens from 9269 patients were processed for isolation of CRAB and CRPA. Drug susceptibility testing was performed with the disk diffusion method. Carriage of carbapenemase genes and class 1 integrons was determined by PCR. Conjugation experiments that involved bla VIM positive CRAB/CRPA (donors) and sodium azide resistant Escherichia coli J53 (recipient) were performed. Results The 9269 specimens processed yielded 1077 and 488 isolates of Acinetobacter baumannii and Pseudomonas aeruginosa, respectively. Of these, 2.7% (29/1077) and 7.4% (36/488) were confirmed to be CRAB and CRPA respectively, but 46 were available for analysis (21 CRAB and 25 CRPA). Majority of specimens yielding CRAB and CRPA were from the ICU (78%) while 20 and 2% were from the ENT (Ear Nose & Throat) Department and the Burns Unit, respectively. Carbapenemase assays performed with the MHT assay showed that 40 and 33% of CRPA and CRAB isolates respectively, were carbapenemase producers. Also, 72 and 48% of CRPA and CRAB isolates respectively, were metallo-beta-lactamase producers. All the carbapenemase producing isolates were multidrug resistant but susceptible to colistin. bla VIM was the most prevalent carbapenemase gene, and it was detected in all CRAB and CRPA isolates while bla OXA-23 and bla OXA-24 were detected in 29 and 24% of CRAB isolates, respectively. Co-carriage of bla OXA-23 and bla OXA-24 occurred in 14% of CRAB isolates. Moreover, 63% of the study isolates carried class 1 integrons; of these 31% successfully transferred bla VIM to E. coli J53. Conclusions CRAB and CRPA prevalence at the Mulago Hospital ICU is relatively low but carbapenemase genes especially bla VIM and bla OXA-23 are prevalent among them. This requires strengthening of infection control practices to curb selection and transmission of these strains in the hospital. |
| first_indexed | 2024-12-12T04:37:52Z |
| format | Article |
| id | doaj.art-463b08764bb64a1389b76d7ae43af282 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T04:37:52Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-463b08764bb64a1389b76d7ae43af2822022-12-22T00:37:55ZengBMCBMC Infectious Diseases1471-23342019-10-011911810.1186/s12879-019-4510-5bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, UgandaDickson Aruhomukama0Christine F. Najjuka1Henry Kajumbula2Moses Okee3Gerald Mboowa4Ivan Sserwadda5Richard Mayanja6Moses L. Joloba7David P. Kateete8Department of Medical Microbiology, College of Health Sciences, Makerere UniversityDepartment of Medical Microbiology, College of Health Sciences, Makerere UniversityDepartment of Medical Microbiology, College of Health Sciences, Makerere UniversityDepartment of Medical Microbiology, College of Health Sciences, Makerere UniversityDepartment of Medical Microbiology, College of Health Sciences, Makerere UniversityDepartment of Medical Microbiology, College of Health Sciences, Makerere UniversityDepartment of Immunology & Molecular Biology, College of Health Sciences, Makerere UniversityDepartment of Medical Microbiology, College of Health Sciences, Makerere UniversityDepartment of Medical Microbiology, College of Health Sciences, Makerere UniversityAbstract Background Between January 2015 and July 2017, we investigated the frequency of carbapenem resistant Acinetobacter baumannii (CRAB) and carbapenem resistant Pseudomonas aeruginosa (CRPA) at the Mulago Hospital intensive care unit (ICU) in Kampala, Uganda. Carbapenemase production and carbapenemase gene carriage among CRAB and CRPA were determined; mobility potential of carbapenemase genes via horizontal gene transfer processes was also studied. Methods Clinical specimens from 9269 patients were processed for isolation of CRAB and CRPA. Drug susceptibility testing was performed with the disk diffusion method. Carriage of carbapenemase genes and class 1 integrons was determined by PCR. Conjugation experiments that involved bla VIM positive CRAB/CRPA (donors) and sodium azide resistant Escherichia coli J53 (recipient) were performed. Results The 9269 specimens processed yielded 1077 and 488 isolates of Acinetobacter baumannii and Pseudomonas aeruginosa, respectively. Of these, 2.7% (29/1077) and 7.4% (36/488) were confirmed to be CRAB and CRPA respectively, but 46 were available for analysis (21 CRAB and 25 CRPA). Majority of specimens yielding CRAB and CRPA were from the ICU (78%) while 20 and 2% were from the ENT (Ear Nose & Throat) Department and the Burns Unit, respectively. Carbapenemase assays performed with the MHT assay showed that 40 and 33% of CRPA and CRAB isolates respectively, were carbapenemase producers. Also, 72 and 48% of CRPA and CRAB isolates respectively, were metallo-beta-lactamase producers. All the carbapenemase producing isolates were multidrug resistant but susceptible to colistin. bla VIM was the most prevalent carbapenemase gene, and it was detected in all CRAB and CRPA isolates while bla OXA-23 and bla OXA-24 were detected in 29 and 24% of CRAB isolates, respectively. Co-carriage of bla OXA-23 and bla OXA-24 occurred in 14% of CRAB isolates. Moreover, 63% of the study isolates carried class 1 integrons; of these 31% successfully transferred bla VIM to E. coli J53. Conclusions CRAB and CRPA prevalence at the Mulago Hospital ICU is relatively low but carbapenemase genes especially bla VIM and bla OXA-23 are prevalent among them. This requires strengthening of infection control practices to curb selection and transmission of these strains in the hospital.http://link.springer.com/article/10.1186/s12879-019-4510-5Carbapenem resistant AcinetobacterCarbapenem resistant Pseudomonas aeruginosaCarbapenemase genesClass 1 integronsConjugationIntensive care unit |
| spellingShingle | Dickson Aruhomukama Christine F. Najjuka Henry Kajumbula Moses Okee Gerald Mboowa Ivan Sserwadda Richard Mayanja Moses L. Joloba David P. Kateete bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda BMC Infectious Diseases Carbapenem resistant Acinetobacter Carbapenem resistant Pseudomonas aeruginosa Carbapenemase genes Class 1 integrons Conjugation Intensive care unit |
| title | bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda |
| title_full | bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda |
| title_fullStr | bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda |
| title_full_unstemmed | bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda |
| title_short | bla VIM- and bla OXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda |
| title_sort | bla vim and bla oxa mediated carbapenem resistance among acinetobacter baumannii and pseudomonas aeruginosa isolates from the mulago hospital intensive care unit in kampala uganda |
| topic | Carbapenem resistant Acinetobacter Carbapenem resistant Pseudomonas aeruginosa Carbapenemase genes Class 1 integrons Conjugation Intensive care unit |
| url | http://link.springer.com/article/10.1186/s12879-019-4510-5 |
| work_keys_str_mv | AT dicksonaruhomukama blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT christinefnajjuka blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT henrykajumbula blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT mosesokee blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT geraldmboowa blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT ivansserwadda blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT richardmayanja blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT mosesljoloba blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda AT davidpkateete blavimandblaoxamediatedcarbapenemresistanceamongacinetobacterbaumanniiandpseudomonasaeruginosaisolatesfromthemulagohospitalintensivecareunitinkampalauganda |