感染症と治療ジャーナル

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Frequency of OXA-Type Carbapenemases among Carbapenem Resistant Acinetobacter baumannii in Clinical Isolates from Adult Intensive Care Unit in India

Shanmugapriya Seshatri, Jaykaran Charan, Vibhor Tak, Vijaya Lakshmi Nag, Sneha Ambwani, Shoban Babu Varthya

Purpose: Acinetobacter baumannii is a highly virulent bacterium in modern healthcare, with a high ability to acquire antimicrobial resistance. Carbapenemases production appears to be the most common mechanism involved in drug resistance to carbapenem. As the prevalence of carbapenem resistant Acinetobacter baumannii was high in ICU patients, this study was designed to find the frequency of OXA genes including OXA 23, OXA 24, OXA 51, and OXA 58.

Methods: A clinical specimen was collected from patients admitted to the adult intensive care unit. DNA was isolates from Carbapenem resistant Acinetobacter baumannii and amplified using conventional PCR technique and gel electrophoresis for visualization of results.

Results: The frequency of the OXA 23 gene was high with 87.5%, followed by OXA 51 gene with 73.2%. All 56 isolates were negative for the OXA 24 and OXA 58 genes. We also found that both OXA 23 and OXA 51 genes coexisted in 40 (71.4%) isolates. No significant difference was found between drug resistance genes (OXA 23 and OXA 51) and clinical outcomes. The relationship between the presences of OXA gene was compared between survivors and non-survivors, which was found out to be non-significant. The presence of OXA genes showed no significant increase in the length of hospital stay. Association of APACHE IV scores with clinical outcome were calculated, and was found out to be significant in discharge vs. expired group.

Conclusion: Early detection of these drug resistant genes by molecular methods is essential in decreasing the spread of carbapenem resistant Acinetobacter baumannii.