Emergence of armA Mediated Aminoglycoside Resistance in Multidrug-Resistant Acinetobacter baumannii in Pakistani Hospitals
Emergence of armA Mediated Aminoglycoside Resistance in Multidrug-Resistant Acinetobacter baumannii in Pakistani Hospitals
Aqsa Shahid1, Saima Muzammil1, Farhan Rasheed2,Bilal Aslam1, Muhammad Akhtar Ali3, Syed Zohaib Haider4, Masroor Ellahi Babar4, Muhammad Saeed1, Umair Waqas1 and Mohsin Khurshid1,*
ABSTRACT
The increasing reports of multidrug-resistant Acinetobacter baumannii associated infections especially in the healthcare settings are of global concern. The recent emergence of 16S rRNA methylases particularly armA is associated with a high-level resistance to the routinely used aminoglycosides in clinical settings. The current study aimed to screen the armA genes among the A. baumannii isolates collected from clinical specimens at the tertiary care hospitals of Lahore and Faisalabad,Pakistan. A total of 148 A. baumannii isolates were collected. The initial identification of bacterial isolates was performed by standard microbiological techniques, and API 20E and for final confirmation multiplex PCR was performed using genus and species-specific primers. The susceptibility to various antimicrobial agents including the aminoglycosides was determined by the Kirby-Bauer method and minimum inhibitory concentration (MIC) to aminoglycosides was evaluated by the broth microdilution method. Moreover, the armA genes were studied by PCR followed by Sanger sequencing. The isolates showed a high rate of resistance to cephalosporins, carbapenems, aminoglycosides, and fluoroquinolones whereas colistin and tigecycline were the most active antimicrobial agents against A. baumannii as none of the isolates was found resistant to these two drugs. Moreover, the armA was found in 25% (n=37) of A. baumannii isolates which showed a high level of resistance to aminoglycosides i.e., amikacin; ≥256µg/ml (Breakpoints; ≥64µg/ml) and gentamicin; ≥MIC 64µg/ml (Breakpoints; ≥16µg/ml). This study has described the presence of armA positive A. baumannii strains in Pakistan which poses serious clinical concern that can lead to therapeutic failures in near future.
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December 2021
Vol. 53, Iss. 6, Pages 2001-2521
