Analysis of Plasmids and Restriction Fragment Length Polymorphisms of Acinetobacter baumannii Isolated from Hospitals- AL Jouf Region- KSA

Authors: Samy A. Selim, Nashwa I. Hagag

Abstract:

Abstract–The objectives of the current study are to determine the prevalence, etiological agents, drug susceptibility pattern and plasmid profile of Acinetobacter baumannii isolates from Hospital-Acquired Infections (HAI) at Community Hospital, Al Jouf Province, Saudi Arabia. A total of 1890 patients had developed infection during hospital admission and were included in the study. Among those who developed nosocomial infections, 15(9.4), 10(2.7) and 118 (12.7) had respiratory tract infection (RTI), blood stream infections (BSI) and urinary tract (UTI) respectively. A total of 268 bacterial isolates were isolated from nosocomial infection. S. aureus was reported in 23.5% for of the total isolates followed by Klebsiella pneumoniae (17.5%), E. coli (17.2%), P. aeruginosa (11.9%), coagulase negative staphylococcus (9%), A. baumannii (7.1%), Enterobacter spp. (3.4%), Citrobacter freundii (3%), Proteus mirabilis (2.6%), and Proteus vulgaris and Enterococcous faecalis (0.7%). Isolated organisms are multi-drug resistant, predominantly Gram-positive pathogens with a high incidence of methicillin-resistant S. aureus, extended spectrum beta lactamase and vancomycin resistant enterococci organisms. The RFLP (Fragment Length Polymorphisms) patterns of plasmid preparations from isolated A. baumannii isolates had altered RFLP patterns, possibly due to the presence of plasmid(s). Five A. baumannii isolates harbored plasmids all of which were not less than 2.71kbp in molecular weight. Hence, it showed that the gene coding for the isolates were located on the plasmid DNA while the remaining isolates which have no plasmid might showed gene coding for antibiotic resistance being located on chromosomal DNA. Nosocomial infections represent a current problem in Community Hospital, Al Jouf Province, Saudi Arabia. Problems associated with SSI include infection with multidrug resistant pathogens which are difficult to treat and are associated with increased mortality.

Keywords: Hospital-Acquired Infections, Acinetobacter baumannii, antibiotic resistance, plasmid profile, RFLP patterns, Al Jouf Province, Saudi Arabia

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1062914

References:

[1] J World Health Organization. Prevention of hospital-acquired infections: A practical guide. World Health Organization Department of Communicable Disease, Surveillance and Response, 2002; 2nd edition, 1-7.
[2] CDC guidelines for hand washing and hospital environmental control. Amer J Infect Control 1986;14:110-129.
[3] Larson EL. APIC guideline for handwashing and hand antisepsis in health care settings. Amer. J Infect. Control 1995; 23:251-269.
[4] Durmaz B, Durmaz R, Otlu B, et al. Nosocomial Infections in a New Medical Center, Turkey. Infect. Control. Hosp. Epidemiol. 2000; 21:534-536.
[5] Apostolopoulou E, Katsaris G. Socioeconomic Impact of Nosocomial Infections. Icus. Nurs. Web. J 2003; 1-9.
[6] Iwalokun BA, Oluwadun A, Adewale KA, et al. Bacteriologic and plasmid analysis of etiologic agents of conjunctivitis in Lagos, Nigeria. J. Ophthal. Inflamm. Infect. 2011; 1:95-103.
[7] Garner JS, Jarvis WR, Emori TG, et al. CDC definitions for nosocomial infections, 1988. Am. J Infect. Control. 1988; 16:128-40.
[8] Louie L, Goodfellow J, Mathieu P, et al. Rapid detection of methicillin-resistant staphylococci from blood culture bottles by using a multiplex PCR assay. J. Clin. Microbiol. 2002; 40:2786-90.
[9] Collee JR, Miles RS, Watt B. Tests for identification of bacteria. Practical Medical Microbiology Chirchill Livingstone, Newyork, NY: Colle JG, Marmion BP, Fraser AG, Simmons A 141 996; 131-149.
[10] NCCLS. Performance standards of antimicrobial susceptibility. NCCLS approved standard M100-59 National Committee for Clinical Laboratory Standard, Wayne, PA 2006.
[11] Zhou C, Yujun Y, Jong, AY. Mini-prep in ten minutes. Bio. Techniques, 1990; 8:172-173.
[12] Tullu MS, Deshmukh CT, Baveja SM. Bacterial profile and antimicrobial susceptibility pattern in catheter related nosocomial infections. J Postgrad. Med. 1998; 44: 7-13.
[13] Siempos II, Fragoulis KN, Falagas ME. World Wide Web resources on control of nosocomial infections. Crit. Care. 2007; 11.
[14] Hsueh PR, Chen ML, Sun CC, et al. Antimicrobial Drug Resistance in Pathogens Causing Nosocomial Infections at a University Hospital in Taiwan, 1981-1999. Emerg. Infect. Dis. 2002; 8:63-68.
[15] Abdel-Fattah MM. Surveillance of nosocomial infections at a Saudi Arabian military hospital for a one-year period. GMS German Medical Science 2005; 3:1-10.
[16] Dridi E, Chetoui A, Zaoui A. Investigation of the prevalence of nosocomial infection in a Tunisian regional hospital. Sante Publique. 2006; 18:187-194.
[17] Raka L, Zoutman D, Mulliqi G, et al. Prevalence of Nosocomial Infections in High-Risk Units in the University Clinical Center of Kosova. Infect. Control. Hosp. Epidemiol. 2006; 27:421-423.
[18] Jroundi I, Khoudri I, Azzouzi A, et al. Prevalence of hospital-acquired infection in a Moroccan university hospital. Am. J Infect. Control. 2007; 5:412-6.
[19] Dumpis U, Balode A, Vigante D, et al. Prevalence of nosocomial infections in two Latvian hospitals. Euro. Surveill. 2003; 8:73-78.
[20] Wu CJ, Lee HC, Lee NY, et al. Predominance of Gram-negative bacilli and increasing antimicrobial resistance in nosocomial bloodstream infections at a university hospital in southern Taiwan, 1996-2003. J Microbiol. Immunol. Infect. 2006; 39:135-43.
[21] Izquierdo-Cubas F, Zambrano A, Fr├│meta I, et al. National prevalence of nosocomial infections. Cuba 2004. J Hosp. Infect. 2008; 68:234-40.
[22] Savas L, Guvel S, Onlen Y, et al. Nosocomial Urinary Tract Infections: Micro-organisms, Antibiotic Sensitivities and Risk Factors. West Indian Med. J 2006;55:188- 193.
[23] Kehinde EO, Rotimi VO, Al-Hunayan A, et al. Bacteriology of urinary tract infection associated with indwelling J Ureteral Stents. J. Endourol. 2004; 18:891-896.
[24] Atif M, Bezzaoucha A, Mesbah S, et al. Evolution of nosocomial infection prevalence in an Algeria university hospital (2001 to 2005). Med. Mal. Infect. 2006; 36:423-428.
[25] Ben Jaballah N, Bouziri A, Kchaou W, et al. Epidemiology of nosocomial bacterial infections in a neonatal and pediatric Tunisian intensive care unit. Med. Mal. Infect. 2006; 36: 379-385.
[26] Garrabé E, Cavallo JD, Brisou P et al. Sensitivity to antibiotics of bacteria from nosocomial infections. Evolution in resuscitation services of military hospitals. Presse Med. 2000; 29:1497-1503.
[27] Bayram A, Balci I. Patterns of antimicrobial resistance in a surgical intensive care unit of a university hospital in Turkey. BMC Infect. Dis. 2006; 6.
[28] Mohanty S, Kapil A, Das BK, et al. Antimicrobial resistance profile of nosocomial uropathogens in a tertiary care hospital. Indian J Med. Sci. 2003; 57:148-154.
[29] Hryniewicz K, Szczypa K, Sulikowska A, et al. Antibiotic susceptibility of bacterial strains isolated from urinary tract infections in Poland. JAC 2001; 47:773-780.
[30] Jarvis WR, Martone WJ. Predominant pathogens in hospital infections. J Antimicrob. Chemother. 1992; 29:19-24.
[31] Dias Neto JA, Silva LD, Martins AC, et al. Prevalence and bacterial susceptibility of hospital acquired urinary tract infection. Acta Cir. Bras. 2003; 18:36-38.
[32] Wiik R, Hoff KA, Andersen K, Daae FL. Relationship between plasmids and phenotypes of presumptive strains of Vibrio anguillarum from different fish species. Appl. Environ. Microbiol. 1989; 55: 826-31