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Multidrug resistance in the nosocomial pathogen Acinetobacter baumannii limits therapeutic options and impacts on clinical care. Resistance against carbapenems, a group of last-resort antimicrobials for treating multidrug-resistant (MDR) A. baumannii infections, is associated with the expression (and over-expression) of carbapenemases encoded by the blaOXA genes. The aim of this study was to determine the prevalence of antimicrobial-resistant A. baumannii associated with infection in three hospitals in southern Vietnam and to characterize the genetic determinants associated with resistance against carbapenems. We recovered a total of 160 A. baumannii isolates from clinical samples collected in three hospitals in southern Vietnam from 2012 to 2014. Antimicrobial resistance was common; 119/160 (74 %) of isolates were both MDR and extensively drug resistant (XDR). High-level imipenem resistance (>32 µg ml-1) was determined for 109/117 (91.6 %) of the XDR imipenem-nonsusceptible organisms, of which the majority (86.7 %) harboured the blaOXA-51 and blaOXA-23 genes associated with an ISAba1 element. Multiple-locus variable number tandem repeat analysis segregated the 160 A. baumannii into 107 different multiple-locus variable number tandem repeat analysis types, which described five major clusters. The biggest cluster was a clonal complex composed mainly of imipenem-resistant organisms that were isolated from all three of the study hospitals. Our study indicates a very high prevalence of MDR/XDR A. baumannii causing clinically significant infections in hospitals in southern Vietnam. These organisms commonly harboured the blaOXA-23 gene with ISAba1 and were carbapenem resistant; this resistance phenotype may explain their continued selection and ongoing transmission within the Vietnamese healthcare system.

Original publication

DOI

10.1099/jmm.0.000418

Type

Journal article

Journal

Journal of medical microbiology

Publication Date

01/2017

Volume

66

Pages

46 - 53

Addresses

1​Diagnostic Department, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.

Keywords

Humans, Acinetobacter baumannii, Acinetobacter Infections, Cross Infection, Carbapenems, Imipenem, beta-Lactamases, Bacterial Proteins, DNA, Bacterial, Anti-Bacterial Agents, Prevalence, Cluster Analysis, Longitudinal Studies, Drug Resistance, Multiple, Bacterial, Tandem Repeat Sequences, Phenotype, Adult, Aged, Aged, 80 and over, Middle Aged, Hospitals, Vietnam, Female, Male, Young Adult, Molecular Epidemiology, Multilocus Sequence Typing