Multidrug‑resistant Acinetobacter baumannii strains with NDM‑1: Molecular characterization and in vitro efficacy of meropenem‑based combinations
Acinetobacter baumannii is an important cause of hospital-acquired, multidrug-resistant (MDR) infections occurring worldwide. Anti-microbial combination regimens may be the only feasible treatment option for affected patients. In the present study, the efficacy of the combined therapy of meropenem w...
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| Veröffentlicht in: | Experimental and therapeutic medicine 2019-10, Vol.18 (4), p.2924-2932 |
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| creator | Wang, Jingjing Ning, Yongzhong Li, Shu Wang, Yun Liang, Jinhua Jin, Chunming Yan, Hairun Huang, Yongcun |
| description | Acinetobacter baumannii is an important cause of hospital-acquired, multidrug-resistant (MDR) infections occurring worldwide. Anti-microbial combination regimens may be the only feasible treatment option for affected patients. In the present study, the efficacy of the combined therapy of meropenem with colistin, ampicillin-sulbactam, tazobactam and vancomycin against clinical strains of MDR A. baumannii was determined. Anti-microbial susceptibility testing was performed and resistance genes were characterized by a multiplex polymerase chain reaction (PCR)-reverse line blot assay. The genetic background of New Delhi metallo-[beta]-lactamase 1 (NDM-1) was analysed by primer walking. The presence of NDM-1 was detected using the modified Hodge test and the EDTA-combined disk test. To screen for synergistic drug effects, the fractional inhibitory concentration index was calculated using a checkerboard assay. The results of the PCR as well as the sequence analyses suggested that NDM-1 was located downstream of the ISAba125 element. In addition, a synergistic effect was determined for meropenem + vancomycin, meropenem + tazobactam and meropenem + ampicillin + sulbactam in two strains each, and in four strains for meropenem + colistin. A total of five A. baumannii strains with resistance to numerous antibiotics and carrying numerous resistance genes were identified. In the strains of A. baumannii, the NDM-1 gene was integrated in a transposon structure with a copy of the ISAba125 insertion sequence. However, the genetic background was not identical among the different species and strains. The genetic variability of NDM-1 may facilitate the rapid dissemination of this gene. In conclusion, meropenem may enhance the efficacy of antibiotics in A. baumannii strains with NDM-1-associated MDR. Key words: Acinetobacter baumannii, New Delhi metallo-[beta]-lactamase 1, multidrug-resistant, metallo-[beta]-lactamase, antimicrobial effect |
| doi_str_mv | 10.3892/etm.2019.7927 |
| format | Article |
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Anti-microbial combination regimens may be the only feasible treatment option for affected patients. In the present study, the efficacy of the combined therapy of meropenem with colistin, ampicillin-sulbactam, tazobactam and vancomycin against clinical strains of MDR A. baumannii was determined. Anti-microbial susceptibility testing was performed and resistance genes were characterized by a multiplex polymerase chain reaction (PCR)-reverse line blot assay. The genetic background of New Delhi metallo-[beta]-lactamase 1 (NDM-1) was analysed by primer walking. The presence of NDM-1 was detected using the modified Hodge test and the EDTA-combined disk test. To screen for synergistic drug effects, the fractional inhibitory concentration index was calculated using a checkerboard assay. The results of the PCR as well as the sequence analyses suggested that NDM-1 was located downstream of the ISAba125 element. In addition, a synergistic effect was determined for meropenem + vancomycin, meropenem + tazobactam and meropenem + ampicillin + sulbactam in two strains each, and in four strains for meropenem + colistin. A total of five A. baumannii strains with resistance to numerous antibiotics and carrying numerous resistance genes were identified. In the strains of A. baumannii, the NDM-1 gene was integrated in a transposon structure with a copy of the ISAba125 insertion sequence. However, the genetic background was not identical among the different species and strains. The genetic variability of NDM-1 may facilitate the rapid dissemination of this gene. In conclusion, meropenem may enhance the efficacy of antibiotics in A. baumannii strains with NDM-1-associated MDR. Key words: Acinetobacter baumannii, New Delhi metallo-[beta]-lactamase 1, multidrug-resistant, metallo-[beta]-lactamase, antimicrobial effect</description><identifier>ISSN: 1792-0981</identifier><identifier>EISSN: 1792-1015</identifier><identifier>DOI: 10.3892/etm.2019.7927</identifier><identifier>PMID: 31572535</identifier><language>eng</language><publisher>Athens: Spandidos Publications</publisher><subject>Ampicillin ; Analysis ; Antibacterial agents ; Antibiotics ; Antimicrobial agents ; Bacteria ; Beta lactamases ; Care and treatment ; Cephalothin ; Disease susceptibility ; Drug resistance ; EDTA ; Genes ; Genetic aspects ; Gram-negative bacteria ; Health aspects ; Hospital patients ; Imipenem ; Infection ; Laboratories ; Medical research ; Meropenem ; Microbial drug resistance ; Multidrug resistant organisms ; Penicillins ; Polymerase chain reaction ; Public health ; Ribosomal DNA ; Studies ; Sulbactam ; Tazobactam ; Tigecycline ; Transposons ; Urine ; Vancomycin</subject><ispartof>Experimental and therapeutic medicine, 2019-10, Vol.18 (4), p.2924-2932</ispartof><rights>COPYRIGHT 2019 Spandidos Publications</rights><rights>Copyright Spandidos Publications UK Ltd. 2019</rights><rights>Copyright: © Wang et al. 2019</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-21116dc799ff24487294d9addec9dfc430627c233194ee205a79a6321ef8ccc73</citedby><cites>FETCH-LOGICAL-c389t-21116dc799ff24487294d9addec9dfc430627c233194ee205a79a6321ef8ccc73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755477/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755477/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids></links><search><creatorcontrib>Wang, Jingjing</creatorcontrib><creatorcontrib>Ning, Yongzhong</creatorcontrib><creatorcontrib>Li, Shu</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Liang, Jinhua</creatorcontrib><creatorcontrib>Jin, Chunming</creatorcontrib><creatorcontrib>Yan, Hairun</creatorcontrib><creatorcontrib>Huang, Yongcun</creatorcontrib><title>Multidrug‑resistant Acinetobacter baumannii strains with NDM‑1: Molecular characterization and in vitro efficacy of meropenem‑based combinations</title><title>Experimental and therapeutic medicine</title><description>Acinetobacter baumannii is an important cause of hospital-acquired, multidrug-resistant (MDR) infections occurring worldwide. Anti-microbial combination regimens may be the only feasible treatment option for affected patients. In the present study, the efficacy of the combined therapy of meropenem with colistin, ampicillin-sulbactam, tazobactam and vancomycin against clinical strains of MDR A. baumannii was determined. Anti-microbial susceptibility testing was performed and resistance genes were characterized by a multiplex polymerase chain reaction (PCR)-reverse line blot assay. The genetic background of New Delhi metallo-[beta]-lactamase 1 (NDM-1) was analysed by primer walking. The presence of NDM-1 was detected using the modified Hodge test and the EDTA-combined disk test. To screen for synergistic drug effects, the fractional inhibitory concentration index was calculated using a checkerboard assay. The results of the PCR as well as the sequence analyses suggested that NDM-1 was located downstream of the ISAba125 element. In addition, a synergistic effect was determined for meropenem + vancomycin, meropenem + tazobactam and meropenem + ampicillin + sulbactam in two strains each, and in four strains for meropenem + colistin. A total of five A. baumannii strains with resistance to numerous antibiotics and carrying numerous resistance genes were identified. In the strains of A. baumannii, the NDM-1 gene was integrated in a transposon structure with a copy of the ISAba125 insertion sequence. However, the genetic background was not identical among the different species and strains. The genetic variability of NDM-1 may facilitate the rapid dissemination of this gene. In conclusion, meropenem may enhance the efficacy of antibiotics in A. baumannii strains with NDM-1-associated MDR. Key words: Acinetobacter baumannii, New Delhi metallo-[beta]-lactamase 1, multidrug-resistant, metallo-[beta]-lactamase, antimicrobial effect</description><subject>Ampicillin</subject><subject>Analysis</subject><subject>Antibacterial agents</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Bacteria</subject><subject>Beta lactamases</subject><subject>Care and treatment</subject><subject>Cephalothin</subject><subject>Disease susceptibility</subject><subject>Drug resistance</subject><subject>EDTA</subject><subject>Genes</subject><subject>Genetic aspects</subject><subject>Gram-negative bacteria</subject><subject>Health aspects</subject><subject>Hospital patients</subject><subject>Imipenem</subject><subject>Infection</subject><subject>Laboratories</subject><subject>Medical research</subject><subject>Meropenem</subject><subject>Microbial drug resistance</subject><subject>Multidrug resistant organisms</subject><subject>Penicillins</subject><subject>Polymerase chain reaction</subject><subject>Public health</subject><subject>Ribosomal DNA</subject><subject>Studies</subject><subject>Sulbactam</subject><subject>Tazobactam</subject><subject>Tigecycline</subject><subject>Transposons</subject><subject>Urine</subject><subject>Vancomycin</subject><issn>1792-0981</issn><issn>1792-1015</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptUk1v1DAUjBCIVqVH7pa4cMkSfySOOSCtWqBIXbjA2XLs511Xib3YTlE58Re48AP5JXXaFagIv8N7smfGGr2pque4WdFekFeQpxVpsFhxQfij6hiXXuMGt48PcyN6fFSdpnTVlNN2uO_bp9URxS0nLW2Pq1-beczOxHn7-8fPCMmlrHxGa-085DAonSGiQc2T8t45lHJUzif0zeUd-ni-KST8Gm3CCHoeVUR6p-Idx31X2QWPlDfIeXTtcgwIrHVa6RsULJoghj14mIrEoBIYpMM0OH9HS8-qJ1aNCU4P_aT68u7t57OL-vLT-w9n68taF_-5JhjjzmguhLWEsZ4TwYxQxoAWxmpGm45wTSjFggGQplVcqI4SDLbXWnN6Ur25193PwwRGgy8GR7mPblLxRgbl5MMX73ZyG65lx9uW8UXg5UEghq8zpCwnlzSMo_IQ5iQJEYJzjFlfoC_-gV6FOfpiTxJattMz2tG_qK0aQTpvQ_lXL6Jy3TWMYkYwK6jVf1ClDExOBw_WlfsHhPqeoGNIKYL94xE3csmSLFmSS5bkkiV6C5sawCM</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Wang, Jingjing</creator><creator>Ning, Yongzhong</creator><creator>Li, Shu</creator><creator>Wang, Yun</creator><creator>Liang, Jinhua</creator><creator>Jin, Chunming</creator><creator>Yan, Hairun</creator><creator>Huang, Yongcun</creator><general>Spandidos Publications</general><general>Spandidos Publications UK Ltd</general><general>D.A. 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Anti-microbial combination regimens may be the only feasible treatment option for affected patients. In the present study, the efficacy of the combined therapy of meropenem with colistin, ampicillin-sulbactam, tazobactam and vancomycin against clinical strains of MDR A. baumannii was determined. Anti-microbial susceptibility testing was performed and resistance genes were characterized by a multiplex polymerase chain reaction (PCR)-reverse line blot assay. The genetic background of New Delhi metallo-[beta]-lactamase 1 (NDM-1) was analysed by primer walking. The presence of NDM-1 was detected using the modified Hodge test and the EDTA-combined disk test. To screen for synergistic drug effects, the fractional inhibitory concentration index was calculated using a checkerboard assay. The results of the PCR as well as the sequence analyses suggested that NDM-1 was located downstream of the ISAba125 element. In addition, a synergistic effect was determined for meropenem + vancomycin, meropenem + tazobactam and meropenem + ampicillin + sulbactam in two strains each, and in four strains for meropenem + colistin. A total of five A. baumannii strains with resistance to numerous antibiotics and carrying numerous resistance genes were identified. In the strains of A. baumannii, the NDM-1 gene was integrated in a transposon structure with a copy of the ISAba125 insertion sequence. However, the genetic background was not identical among the different species and strains. The genetic variability of NDM-1 may facilitate the rapid dissemination of this gene. In conclusion, meropenem may enhance the efficacy of antibiotics in A. baumannii strains with NDM-1-associated MDR. Key words: Acinetobacter baumannii, New Delhi metallo-[beta]-lactamase 1, multidrug-resistant, metallo-[beta]-lactamase, antimicrobial effect</abstract><cop>Athens</cop><pub>Spandidos Publications</pub><pmid>31572535</pmid><doi>10.3892/etm.2019.7927</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Ampicillin Analysis Antibacterial agents Antibiotics Antimicrobial agents Bacteria Beta lactamases Care and treatment Cephalothin Disease susceptibility Drug resistance EDTA Genes Genetic aspects Gram-negative bacteria Health aspects Hospital patients Imipenem Infection Laboratories Medical research Meropenem Microbial drug resistance Multidrug resistant organisms Penicillins Polymerase chain reaction Public health Ribosomal DNA Studies Sulbactam Tazobactam Tigecycline Transposons Urine Vancomycin |
| title | Multidrug‑resistant Acinetobacter baumannii strains with NDM‑1: Molecular characterization and in vitro efficacy of meropenem‑based combinations |
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