Journal of Microbiology

The Microbiological Society of Korea (한국미생물학회)
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Outbreaks of Imipenem-Resistant Acinetobacter baumannii Producing Carbapenemases in Korea

  • Jeong Seok-Hoon (Department of Laboratory Medicine, College of Medicine, Kosin University) ;
  • Bae Il-Kwon (Department of Laboratory Medicine, College of Medicine, Kosin University) ;
  • Park Kwang-Ok (Department of Laboratory Medicine, College of Medicine, Kosin University) ;
  • An Young-Jun (Department of Biological Sciences, School of Biotechnology and Environmental Engineering, Myongji University) ;
  • Sohn Seung-Ghyu (Department of Biological Sciences, School of Biotechnology and Environmental Engineering, Myongji University) ;
  • Jang Seon-Ju (Department of Biological Sciences, School of Biotechnology and Environmental Engineering, Myongji University) ;
  • Sung Kwang-Hoon (Department of Biological Sciences, School of Biotechnology and Environmental Engineering, Myongji University) ;
  • Yang Ki-Suk (Department of Biological Sciences, School of Biotechnology and Environmental Engineering, Myongji University) ;
  • Lee Kyung-Won (Research Institute of Bacterial Resistance, Yonsei University College of Medicine) ;
  • Young Dong-Eun (Research Institute of Bacterial Resistance, Yonsei University College of Medicine) ;
  • Lee Sang-Hee (Department of Biological Sciences, School of Biotechnology and Environmental Engineering, Myongji University)
  • Published : 2006.08.01
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Abstract

Among 53 Acinetobacter baumannii isolates collected in 2004, nine imipenem-resistant isolates were obtained from clinical specimens taken from patients hospitalized in Busan, Korea. Nine carbapenemase-producing isolates were further investigated in order to determine the mechanisms underlying resistance. These isolates were then analyzed via antibiotic susceptibility testing, microbiological tests of carbapenemase activity, pI determination, transconjugation test, enterobacterial repetitive consensus (ERIC)-PCR, and DNA sequencing. One outbreak involved seven cases of infection by A. baumannii producing OXA-23 ${\beta}-lactamase$, and was found to have been caused by a single ERIC-PCR clone. During the study period, the other outbreak involved two cases of infection by A. baumannii producing IMP-1 ${\beta}-lactamase$. The two clones, one from each of the outbreaks, were characterized via a modified cloverleaf synergy test and an EDTA-disk synergy test. The isoelectric focusing of the crude bacterial extracts detected nitrocefin-positive bands with pI values of 6.65 (OXA-23) and 9.0 (IMP-1). The PCR amplification and characterization of the amplicons via direct sequencing showed that the clonal isolates harbored $bla_{IMP-1}$ or $bla_{oxA-23}$ determinants. The two clones were characterized by a multidrug resistance phenotype that remained unaltered throughout the outbreak. This resistance encompassed penicillins, extended-spectrum cephalosporins, carbapenems, monobactams, and aminoglycosides. These results appear to show that the imipenem resistance observed among nine Korean A. baumannii isolates could be attributed to the spread of an IMP-lor OXA-23-producing clone. Our microbiological test of carbapenemase activity is a simple method for the screening of clinical isolates producing class D carbapenemase and/or class B $metallo-{\beta}-lactamase$, in order both to determine their clinical impact and to prevent further spread.

Keywords

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