Author name:
رعـد عبد العباس حمزة الهرموش
Supervisor name:
ايمان محمد جار الله
Abstract:
للفترة من اذار 2014 الى اذار 2015 تم جمع 1300 عينة سريرية مختلفة (عينات ادرار ومسحات جروح وحروق وعينات دم ومسحات من الفم والاذن والعيون بالاضافة لعينات البراز والقشع) من اثنين من مستشفيات محافظة بابل (مستشفى الحلة التعليمي ومستشفى بابل التعليمي للنسائية و| During the period between March 2014 and March 2015, a total of 1300 clinical specimens (urine, wounds, burns, blood, throat, ear, eye, stool, and sputum) were collected from two hospitals in Babylon province; Al - Hillah Teaching Hospital, and Babylon Hospital for Maternity and Pediatric. All specimens were cultured and 10 Acinetobacter baumannii isolates were obtained from clinical specimens in a percentage of (0.76%) distributed in blood 1 (0.6%), urine 2 (1%), wound infection 1 (0.75%), burn 5 (0.85%) and throat 1 (2%). This study was conducted to determine the occurrence of carbapenem resistant A. baumannii isolates obtained from Hillah hospitals. Isolates were identified according to API20E system and further confirmed using PCR technique. Antibiotics susceptibility was assayed by using disks diffusion method according to CLSI recommendations. All isolates revealed positive results with rapid iodometric test indicting the ability of beta lactamase production. Phenotypic detection of carbapenemase production was performed using the imipenem - EDTA disk and modified Hodeg's test (MHT). Then isolates were subjected to monoplex PCR targeting blaOXA - 51, blaOXA - 23, blaOXA - 24, blaOXA - 58, blaIMP, blaSIM blaNDM - 1, blaNDM - 2 and blaVIM genes, as well as, efflux pumps genes. One of the identified isolates (10%) was found to be imipenem, meropenem and ertapenem resistant, this isolate gave positive result with the imipenem - EDTA disk and (60%) of isolates were positive to MHT. PCR experiments showed ; all isolates were harbored blaOXA - 51 gene, four (40%) isolates were harbored blaOXA - 23 gene, three (30%) isolates were harbored blaOXA - 24 gene, four (40%) isolates were harbored blaOXA - 58 gene, five (50%) isolates were harbored blaIMP gene, six (60%) isolates were harbored blaSIM gene, two (20%) isolates were harbored blaNDM - 1 gene, four (40%) isolates were harbored blaNDM - 2 gene, while none of these isolates harbored blaVIM gene. The present findings suggest that emergence of (OXA - 23, OXA - 24, OXA - 58, IMP, SIM, NDM - 1, NDM - 2) carbapenemase producing A. baumannii clinical isolates in Hillah City hospitals. Also there are indicative appearance of efflux pump genes ; (50%) for Ade - A and Ade - B each other, (40%) for Ade - C, (80%) for all of Ade - R and Ade - S, (100%) for all of Ade - I and Ade - J, and (50%) for Ade - Y. All isolates of A. baumannii appear as MDR, while only one appear to be as PDR. The trans - mobility of resistant genes was examined by trans - conjugation experiment ; the results indicated that only blaIMP and blaOXA - 23 genes were transferred horizontally in the current study. In attempting to investigate any blaNDM gene variation the results showed some different than NCBI - Blast A. baumannii blaNDM - 1 and blaNDM - 2 it may as a unique genotyping.These results revealed that carbapenemase producing A. baumannii were detected in both phenotypic and genotypic methods (PCR). This underlies the importance of their accurate identifications and reporting to prevent the emergence of complete resistance to the most potent drugs against A. baumannii in Babylon province.
