Frequency of OXA-Type Carbapenemases among Carbapenem-Resistant Acinetobacter baumannii in Clinical Isolates from Adult Intensive Care Unit in India

Abstract

Abstract Purpose   Acinetobacter baumannii is a highly virulent bacteria in modern health care, with a high ability to acquire antimicrobial resistance. Carbapenemases production appears to be the most common mechanism involved in drug resistance to carbapenem. As the prevalence of carbapenem-resistant A. baumannii was high in intensive care unit (ICU) patients, this study was designed to find the frequency of oxacillinases ( OXA ) genes including OXA-23 , OXA-24 , OXA-51 , and OXA-58 . Materials and Methods  A clinical specimen was collected from patients admitted to the adult ICU. DNA was isolated from carbapenem-resistant A. baumannii and amplified using conventional polymerase chain reaction technique and gel electrophoresis for visualization of results. Results  The frequency of the OXA-23 gene was high with 87.5%, followed by OXA-51 gene with 73.2%. All 56 isolates were negative for the OXA-24 and OXA-58 genes. We also found that both OXA-23 and OXA-51 genes coexisted in 40 (71.4%) isolates. No significant difference was found between drug-resistant genes ( OXA-23 and OXA-51 ) and clinical outcomes. The relationship between the presence of OXA gene was compared between survivors and nonsurvivors, which was found out to be nonsignificant. The presence of OXA genes showed no significant increase in the length of hospital stay. The significant association between acute physiology and chronic health evaluation IV scores and clinical outcome was calculated, and it was evident in the comparison of the discharged and died groups. Conclusion  Early detection of these drug-resistant genes by molecular methods is essential in decreasing the spread of carbapenem-resistant A. baumannii .