High Frequency of AdeA, AdeB and AdeC Genes among Acinetobacter baumannii Isolates
Background: Efflux pumps are involved in resistance of Acinetobacter baumannii isolates to antimicrobial agents. AdeABC efflux pump is one of the RND superfamily efflux pump and consists of adeA (membrane fusion), adeB (multidrug transporter) and adeC (outer membrane) genes. In this study, the frequency of adeA, adeB and adeC genes among A. baumannii isolates with resistance to erythromycin, trimethoprim, meropenem and imipenem was investigated.
Methods: Overall, 79 strains of A. baumannii were isolated from patients admitted to two major hospitals in Tehran during 2016. Antibiotic susceptibility testing was determined by disc diffusion and microdilution methods according to Clinical and Laboratory Standards Institute (CLSI) guideline. The presence of adeA, adeB and adeC genes was also determined using Multiplex PCR assay.
Results: The highest and the lowest resistance among A. baumannii isolates were to trimethoprim (93%) and erythromycin (53%), respectively. The frequency of adeA, adeB and adeC genes was 96.2%, 96.2% and 91.1 % respectively. There was a significant relationship between imipenem resistance and presence of efflux pump genes (P<0.05).
Conclusion: According to the high prevalence of the AdeABC efflux system genes, it may involve in resistance of clinical isolates of A. baumannii to imipenem, especially.
Abbott, I., G. M. Cerqueira, S. Bhuiyan and A. Y. Peleg (2013). "Carbapenem resistance in Acinetobacter baumannii: laboratory challenges, mechanistic insights and therapeutic strategies." Expert review of anti-infective therapy 11(4): 395-409.
Ardebili, A., M. Talebi, L. Azimi and A. R. Lari (2014). "Effect of efflux pump inhibitor Carbonyl Cyanide 3-Chlorophenylhydrazone on the minimum inhibitory concentration of ciprofloxacin in Acinetobacter baumannii clinical isolates." Jundishapur journal of microbiology 7(1). e8691
Bergogne-Berezin, E. and K. Towner (1996). "Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features." Clinical microbiology reviews 9(2): 148.
Bouvet, P. and P. Grimont (1987). Identification and biotyping of clinical isolates of Acinetobacter. Annales de l'Institut Pasteur/Microbiologie, Elsevier.
Bratu, S., D. Landman, D. A. Martin, C. Georgescu and J. Quale (2008). "Correlation of antimicrobial resistance with β-lactamases, the OmpA-like porin, and efflux pumps in clinical isolates of Acinetobacter baumannii endemic to New York City." Antimicrobial agents and chemotherapy 52(9): 2999-3005.
Chastre, J. and J.-L. Trouillet (2000). Problem pathogens (Pseudomonas aeruginosa and Acinetobacter). Seminars in respiratory infections.
Corbella, X., M. Pujol, J. Ayats, M. Sendra, C. Ardanuy, M. A. Dominguez, J. Liñares, J. Ariza and F. Gudiol (1996). "Relevance of digestive tract colonization in the epidemiology of nosocomial infections due to multiresistant Acinetobacter baumannii." Clinical infectious diseases 23(2): 329-334.
Coyne, S., P. Courvalin and B. Périchon (2011). "Efflux-mediated antibiotic resistance in Acinetobacter spp." Antimicrobial agents and chemotherapy 55(3): 947-953.
Falagas, M., S. Kasiakou and A. Michalopoulos (2004). "Antimicrobial resistance of Acinetobacter spp. in Europe." Clinical Microbiology and Infection 10(12): 1106-1107.
Gales, A. C., R. Jones, K. Forward, J. Linares, H. S. Sader and J. Verhoef (2001). "Emerging importance of multidrug-resistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients: geographic patterns, epidemiological features, and trends in the SENTRY Antimicrobial Surveillance Program (1997–1999)." Clinical Infectious Diseases 32(2): 104-113.
Gholami, M., A. Hashemi, M. Hakemi-Vala, H. Goudarzi and M. Hallajzadeh (2015). "Efflux pump inhibitor phenylalanine-arginine Β-naphthylamide effect on the minimum inhibitory concentration of imipenem in Acinetobacter baumannii strains isolated from hospitalized patients in Shahid Motahari Burn Hospital, Tehran, Iran." Jundishapur journal of microbiology 8(10). e19048.
Gootz, T. D. and A. Marra (2008). "Acinetobacter baumannii: an emerging multidrug-resistant threat." Expert review of anti-infective therapy 6(3): 309-325.
Hou, P. F., X. Y. Chen, G. F. Yan, Y. P. Wang and C. M. Ying (2012). Study of the correlation of imipenem resistance with efflux pumps AdeABC, AdeIJK, AdeDE and AbeM in clinical isolates of Acinetobacter baumannii." Chemotherapy 58(2): 152-158.
Houang, E. T., Y. Chu, C. Leung, K. Chu, J. Berlau, K. Ng and A. Cheng (2001). "Epidemiology and Infection Control Implications ofAcinetobacter spp. in Hong Kong." Journal of clinical microbiology 39(1): 228-234.
Huang, J., J. Huang, F. Yu, X. Wang and G. Li (2010). "AdeABC efflux pump: Less important role in Acinetobacter baumannii against carbapenems." African Journal of Microbiology Research 4(20): 2148-2152.
JaponiNejad, A. R., M. Sofian and E. Ghaznavi-Rad (2014). "Molecular detection of AdeABC efflux pump genes in clinical isolates of Acinetobacter baumannii and their contribution in imipenem resistance." ISMJ 17(5): 815-823.
Jia, W., C. Li, H. Zhang, G. Li, X. Liu and J. Wei (2015). "Prevalence of genes of OXA-23 carbapenemase and AdeABC efflux pump associated with multidrug resistance of Acinetobacter baumannii isolates in the ICU of a comprehensive hospital of Northwestern China." International journal of environmental research and public health 12(8): 10079-10092.
Lee, Y., J. H. Yum, C.-K. Kim, D. Yong, E. H. Jeon, S. H. Jeong, J. Y. Ahn and K. Lee (2010). "Role of OXA-23 and AdeABC efflux pump for acquiring carbapenem resistance in an Acinetobacter baumannii strain carrying the blaOXA-66 gene." Annals of Clinical & Laboratory Science 40(1): 43-48.
Lin, M.-F., K.-C. Chang, C.-Y. Lan, J. Chou, J.-W. Kuo, C.-K. Chang and M.-L. Liou (2011). "Molecular epidemiology and antimicrobial resistance determinants of multidrug-resistant Acinetobacter baumannii in five proximal hospitals in Taiwan." Japanese journal of infectious diseases 64(3): 222-227.
Magnet, S., P. Courvalin and T. Lambert (2001). "Resistance-nodulation-cell division-type efflux pump involved in aminoglycoside resistance in Acinetobacter baumannii strain BM4454." Antimicrobial agents and chemotherapy 45(12): 3375-3380.
Manikal, V. M., D. Landman, G. Saurina, E. Oydna, H. Lal and J. Quale (2000). "Endemic carbapenem-resistant Acinetobacter species in Brooklyn, New York: citywide prevalence, interinstitutional spread, and relation to antibiotic usage." Clinical infectious diseases 31(1): 101-106.
Marchand, I., L. Damier-Piolle, P. Courvalin and T. Lambert (2004). "Expression of the RND-type efflux pump AdeABC in Acinetobacter baumannii is regulated by the AdeRS two-component system." Antimicrobial agents and chemotherapy 48(9): 3298-3304.
Perez, F., A. M. Hujer, K. M. Hujer, B. K. Decker, P. N. Rather and R. A. Bonomo (2007). "Global challenge of multidrug-resistant Acinetobacter baumannii." Antimicrobial agents and chemotherapy 51(10): 3471-3484.
Ranjbar, R., N. Sadeghifard, A. Ahmadi, M. Izadi, J. Zaeimi-Yazdi, A. Ghasemi, M. Qurbanalizadgan and A. Rostamzad (2007). "Antimicrobial Susceptibility and AP-PCR Typing of Acine¬ tobac-ter Spp. Strains." Iranian Journal of Public Health 36(4): 50-56.
Sadeghifard, N., R. Ranjbar, J. Zaeimi, M. Y. Alikhani, S. Ghafouryan, M. Raftari, A. S. Abdulamir, A. Delpisheh, R. Mohebi and F. A. Bakar (2010). "Antimicrobial susceptibility, plasmid profiles, and RAPD-PCR typing of Acinetobacter bacteria." Asian Biomedicine 4(6): 901-911.
Schreckenberger, P. C. (2006). "Acinetobacter, Achromobacter, Chryseobacterium, Moraxella, and other nonfermentative gram-negative rods." Manual of clinical microbiology: 791-793.
Seifert, H., L. Dijkshoorn, P. Gerner-Smidt, N. Pelzer, I. Tjernberg and M. Vaneechoutte (1997). "Distribution of Acinetobacter species on human skin: comparison of phenotypic and genotypic identification methods." Journal of clinical microbiology 35(11): 2819-2825.
Szabó, D., F. Silveira, A. M. Hujer, R. A. Bonomo, K. M. Hujer, J. W. Marsh, C. R. Bethel, Y. Doi, K. Deeley and D. L. Paterson (2006). "Outer membrane protein changes and efflux pump expression together may confer resistance to ertapenem in Enterobacter cloacae." Antimicrobial agents and chemotherapy 50(8): 2833-2835.
Traub, W. and B. Leonhard (1994). "Serotyping of Acinetobacter-baumannii and genospecies-3-an update." medical microbiology letters 3(3): 120-127.
Urban, C., S. Segal-Maurer and J. J. Rahal (2003). "Considerations in control and treatment of nosocomial infections due to multidrug-resistant Acinetobacter baumannii." Clinical Infectious Diseases 36(10): 1268-1274.
Van Bambeke, F., E. Balzi and P. M. Tulkens (2000). "Antibiotic efflux pumps." Biochemical pharmacology 60(4): 457-470.
Wieczorek, P., P. Sacha, T. Hauschild, M. Zórawski, M. Krawczyk and E. Tryniszewska (2008). "Multidrug resistant Acinetobacter baumannii--the role of AdeABC (RND family) efflux pump in resistance to antibiotics." Folia histochemica et cytobiologica 46(3): 257-267.
Wong, E., M. Yusof, M. Mansor, D. Anbazhagan, S. Ong and S. Sekaran (2009). "Disruption of adeB gene has a greater effect on resistance to meropenems than adeA gene in Acinetobacter spp. isolated from University Malaya Medical Centre." Singapore medical journal 50(8): 822-826.
Yedekci, S., B. Erac and M. H. Limoncu (2012). "Detection of the efflux pump mediated quinolone resistance in ESBl positive Escherichia coli and Klebsiella pneumoniae isolates by phe-arg-βeta-naphthylamide." Turk J Pharm Sci 9(1): 67-74.