Prevalence, Antimicrobial Susceptibility, and Distribution of Virulence Genes Involved in Biofilm Formation in Multidrug-Resistant Acinetobacter baumannii Isolated from Shahrekord Medical Centers, Chaharmahal and Bakhtiari, Iran

Ghadiri, Amirhossein; Doosti, Abbas; Shakhsi-Niaei, Mostafa

doi:10.30699/ijmm.17.1.73

year 17, Issue 1 (January - February 2023) Iran J Med Microbiol 2023, 17(1): 73-80 | Back to browse issues page

‎ 10.30699/ijmm.17.1.73

Mendeley

Zotero

RefWorks

Ghadiri A, Doosti A, Shakhsi-Niaei M. Prevalence, Antimicrobial Susceptibility, and Distribution of Virulence Genes Involved in Biofilm Formation in Multidrug-Resistant Acinetobacter baumannii Isolated from Shahrekord Medical Centers, Chaharmahal and Bakhtiari, Iran. Iran J Med Microbiol 2023; 17 (1) :73-80
URL: http://ijmm.ir/article-1-1784-en.html

Prevalence, Antimicrobial Susceptibility, and Distribution of Virulence Genes Involved in Biofilm Formation in Multidrug-Resistant Acinetobacter baumannii Isolated from Shahrekord Medical Centers, Chaharmahal and Bakhtiari, Iran

Amirhossein Ghadiri¹

, Abbas Doosti

², Mostafa Shakhsi-Niaei³

1- Department of Biology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
2- Biotechnology Research Center, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran , abbasdoosti@yahoo.com
3- Department of Genetics, Faculty of Basic Sciences, Shahrekord University, Shahrekord, Iran

Abstract: (1964 Views)

Background and Aim: The ability to form biofilms is an effective way for Acinetobacter baumannii to survive in stressful conditions. The aim of this study was to investigate the prevalence, antimicrobial susceptibility, and distribution of virulence genes involved in biofilm formation in multidrug-resistant Acinetobacter baumannii isolated from Shahrekord medical centers in Chaharmahal and Bakhtiari Province, Iran.
Materials and Methods: In this study, 150 samples from Shahrekord medical centers in Chaharmahal and Bakhtiari Province were isolated and identified using biochemical tests. Then, the antimicrobial susceptibility of A. baumannii isolates was determined using these antibiotics, Ampicillin/Sulbactam, Doxycycline, Ceftazidime, Ciprofloxacin, Erythromycin, Trimethoprim/ Sulfamethoxazole, Gentamicin, Colistin, Imipenem, and Amikacin. Finally, the rate of biofilm formation and the frequency of virulence genes associated with biofilm formation (bap, ompA, csuA, csuE, epsA, bfmS, bfmR, pgaA, pgaD, and surA) were evaluated.
Results: Out of 150 samples, 90 were identified as A. baumannii. The results of antimicrobial susceptibility testing showed that there was the highest resistance rate to Ciprofloxacin and Imipenem (100%), followed by Ceftazidime (90%) and Ampicillin/ Sulbactam (77.77%). The highest frequency of virulence genes associated with biofilm formation was related to bap (100%), ompA (100%), and pgaA/ pgaD (98%).
Conclusion: Biofilm formation significantly reduces susceptibility to antibiotic agents. Evaluation of biofilm formation showed that all isolates could produce biofilm; hence, they are very important for public health. Therefore, it is necessary to determine antibiotic susceptibility, biofilm formation capacity and the frequency of biofilm-related virulence genes in the clinical setting.

Keywords: Acinetobacter baumannii, Antibiotic resistance, Biofilm, Virulence genes

Full-Text [PDF 541 kb] (426 Downloads) | | Full-Text (HTML) (435 Views)

Type of Study: Original Research Article | Subject: Antibiotic Resistance
Received: 2022/06/13 | Accepted: 2022/08/11 | ePublished: 2023/01/20

References

1. Ayoub Moubareck C, Hammoudi Halat D. Insights into Acinetobacter baumannii: A Review of Microbiological, Virulence, and Resistance Traits in a Threatening Nosocomial Pathogen. Antibiotics. 2020;9(3):119. [DOI:10.3390/antibiotics9030119] [PMID] [PMCID]

2. Vrancianu CO, Gheorghe I, Czobor IB, Chifiriuc MC. Antibiotic Resistance Profiles, Molecular Mechanisms and Innovative Treatment Strategies of Acinetobacter baumannii. Microorganisms. 2020;8(6):935. [DOI:10.3390/microorganisms8060935] [PMID] [PMCID]

3. Nasr P. Genetics, epidemiology, and clinical manifestations of multidrug-resistant Acinetobacter baumannii. J Hosp Infect. 2020;104(1):4-11. [DOI:10.1016/j.jhin.2019.09.021] [PMID]

4. Qi L, Li H, Zhang C, Liang B, Li J, Wang L, et al. Relationship between antibiotic resistance, biofilm formation, and biofilm-specific resistance in Acinetobacter baumannii. Front Microbiol. 2016;7:483. [DOI:10.3389/fmicb.2016.00483] [PMID] [PMCID]

5. Who WHO. Priority Pathogens List for R&D of New Antibiotics. WHO, Geneva, Switzerland; 2017.

6. Weinberg S, Villedieu A, Bagdasarian N, Karah N, Teare L, Elamin W. Control and management of multidrug resistant Acinetobacter baumannii: A review of the evidence and proposal of novel approaches. Infect Prev in Pract. 2020;2(3):100077-85. [DOI:10.1016/j.infpip.2020.100077] [PMID] [PMCID]

7. Yang C-H, Su P-W, Moi S-H, Chuang L-Y. Biofilm formation in Acinetobacter Baumannii: genotype-phenotype correlation. Molecules. 2019;24(10):1849. [DOI:10.3390/molecules24101849] [PMID] [PMCID]

8. Lee C-R, Lee JH, Park M, Park KS, Bae IK, Kim YB, et al. Biology of Acinetobacter baumannii: pathogenesis, antibiotic resistance mechanisms, and prospective treatment options. Front Cell Infect Microbiol. 2017;7:55. [DOI:10.3389/fcimb.2017.00055]

9. Wang Y-C, Huang T-W, Yang Y-S, Kuo S-C, Chen C-T, Liu C-P, et al. Biofilm formation is not associated with worse outcome in Acinetobacter baumannii bacteraemic pneumonia. Sci Rep. 2018;8(1):1-10. [DOI:10.1038/s41598-018-25661-9] [PMID] [PMCID]

10. Gedefie A, Demsis W, Ashagrie M, Kassa Y, Tesfaye M, Tilahun M, et al. Acinetobacter baumannii biofilm formation and its role in disease pathogenesis: a review. Infect Drug Resist. 2021;14:3711-9. [DOI:10.2147/IDR.S332051] [PMID] [PMCID]

11. Liu C, Chang Y, Xu Y, Luo Y, Wu L, Mei Z, et al. distribution of virulence-associated genes and antimicrobial susceptibility in clinical Acinetobacter baumannii isolates. Oncotarget. 2018;9(31):21663. [DOI:10.18632/oncotarget.24651] [PMID] [PMCID]

12. Chmielarczyk A, Pilarczyk-Żurek M, Kamińska W, Pobiega M, Romaniszyn D, Ziółkowski G, et al. Molecular Epidemiology and Drug Resistance of Acinetobacter baumannii Isolated from Hospitals in Southern Poland: ICU as a Risk Factor for XDR Strains. Microb Drug Resist. 2016;22(4):328-35. [DOI:10.1089/mdr.2015.0224] [PMID]

13. CLSI. Performance Standards for Antimicrobial Susceptibilly Testing, Clinical and Laboratory Standars Institute. Wayne, PA, USA; 2019.

14. Zeighami H, Valadkhani F, Shapouri R, Samadi E, Haghi F. Virulence characteristics of multidrug resistant biofilm forming Acinetobacter baumannii isolated from intensive care unit patients. BMC Infect Dis. 2019;19(1):1-9. [DOI:10.1186/s12879-019-4272-0] [PMID] [PMCID]

15. Al-Shamiri MM, Zhang S, Mi P, Liu Y, Xun M, Yang E, et al. Phenotypic and genotypic characteristics of Acinetobacter baumannii enrolled in the relationship among antibiotic resistance, biofilm formation and motility. Microb Pathog. 2021;155:104922. [DOI:10.1016/j.micpath.2021.104922] [PMID]

16. Mozafari H, Mirkalantari S, Sadeghi Kalani B, Amirmozafari N. Prevalence Determination of Virulence Related and Biofilm Formation Genes in Acinetobacter baumannii Isolates from Clinical Respiratory Samples in Imam Khomeini Hospital, Tehran, Iran in 2018. Iran J Med Microbiol. 2021;15(3):266-80. [DOI:10.30699/ijmm.15.3.266]

17. Almasaudi SB. Acinetobacter spp. as nosocomial pathogens: Epidemiology and resistance features. Saudi J Biol Sci. 2018;25(3):586-96. [DOI:10.1016/j.sjbs.2016.02.009] [PMID] [PMCID]

18. Asif M, Alvi IA, Rehman SU. Insight into Acinetobacter baumannii: pathogenesis, global resistance, mechanisms of resistance, treatment options, and alternative modalities. Infect Drug Resist. 2018(11):1249-60. [DOI:10.2147/IDR.S166750] [PMID] [PMCID]

19. Gonzalez-Villoria AM, Valverde-Garduno V. Antibiotic-Resistant Acinetobacter baumannii Increasing Success Remains a Challenge as a Nosocomial Pathogen. J Pathog. 2016;2016:7318075. [DOI:10.1155/2016/7318075] [PMID] [PMCID]

20. Sarafan Sadeghi A, Ansari N, Khademi F, Mir Nejad R, Zamanzad B. Drug Resistance Patterns and Genotyping of Acinetobacter baumannii Strains Isolated from Patients Admitted to Shahrekord Teaching Hospitals Using REP-PCR. J Ardabil Univ Med Sci. 2019;19(1):30-40. [DOI:10.29252/jarums.19.1.30]

21. Shirmohammadlou N, Zeighami H, Haghi F, Kashefieh M. Resistance pattern and distribution of carbapenemase and antiseptic resistance genes among multidrug-resistant Acinetobacter baumannii isolated from intensive care unit patients. J Med Microbiol. 2018;67(10):1467-73. [DOI:10.1099/jmm.0.000826] [PMID]

22. SILVA A, Costa JS, Lima J, FARIAS FJ. Cavalcanti IM, Maciel MA. Investigation of the association of virulence genes and biofilm production with infection and bacterial colonization processes in multidrug-resistant Acinetobacter spp. Anais da Academia Brasileira de Ciências. 2021(93). [DOI:10.1590/0001-3765202120210245] [PMID]

23. Porbaran M, Habibipour R. Relationship between biofilm regulating operons and various β-Lactamase enzymes: analysis of the clinical features of infections caused by non-fermentative gram-negative bacilli (NFGNB) from Iran. J Pure Appl Microbiol. 2020;14(3):1723-36. [DOI:10.22207/JPAM.14.3.11]

24. Amin M, Navidifar TA-O, Shooshtari FS, Rashno M, Savari M, Jahangirmehr F, et al. Association Between Biofilm Formation, Structure, and the Expression Levels of Genes Related to biofilm formation and Biofilm-Specific Resistance of Acinetobacter baumannii Strains Isolated from Burn Infection in Ahvaz, Iran. Infect Drug Resist. 2019(12):3867-81. [DOI:10.2147/IDR.S228981] [PMID] [PMCID]

25. Tavakol M, Momtaz H, Mohajeri P, Shokoohizadeh L, Tajbakhsh E. Genotyping and distribution of putative virulence factors and antibiotic resistance genes of Acinetobacter baumannii strains isolated from raw meat. Antimicrob Resist Infect Control. 2018(1):1. [DOI:10.1186/s13756-018-0405-2] [PMID] [PMCID]

26. Fallah F, Noori M, Hashemi A, Goudarzi H, Karimi A, Erfanimanesh S, et al. prevalence of blaNDM, blaPER, blaVEB, blaIMP, and blaVIM Genes among Acinetobacter baumannii Isolated from Two Hospitals of Tehran, Iran. Scientifica. 2014;2014:245162. [DOI:10.1155/2014/245162] [PMID] [PMCID]

27. Aksoy MD, Çavuşlu Ş, Tuğrul HM. Investigation of Metallo Beta Lactamases and Oxacilinases in Carbapenem Resistant Acinetobacter baumannii Strains Isolated from Inpatients. Balkan Med J. 2015;32(1):79-83. [DOI:10.5152/balkanmedj.2015.15302] [PMID] [PMCID]

28. Mlynarcik P, Roderova M, Kolar M. Primer Evaluation for PCR and its Application for Detection of Carbapenemases in Enterobacteriaceae. Jundishapur J Microbiol. 2016;9(1):e29314. [DOI:10.5812/jjm.29314] [PMID] [PMCID]

29. Thummeepak R, Kongthai P, Leungtongkam U, Sitthisak S. Distribution of virulence genes involved in biofilm formation in multidrug resistant Acinetobacter baumannii clinical isolates. Int Microbiol. 2016;19(2):121-9.

30. Sung J. Molecular Characterization and Antimicrobial Susceptibility of Biofilm-forming Acinetobacter baumannii Clinical Isolates from Daejeon, Korea. Korean J Clin Lab Sci. 2018;50:100-9. [DOI:10.15324/kjcls.2018.50.2.100]

31. Monem S, Furmanek-Blaszk B, Łupkowska A, Kuczyńska-Wiśnik D, Stojowska-Swędrzyńska K, Laskowska E. Mechanisms protecting Acinetobacter baumannii against multiple stresses triggered by the host immune response, antibiotics and outside-host environment. Int J Mol Sci. 2020;21(15):5498-528. [DOI:10.3390/ijms21155498] [PMID] [PMCID]

32. Fallah A, Rezaee MA, Hasani A, Barhaghi MHS, Kafil HS. Frequency of bap and cpaA virulence genes in drug resistant clinical isolates of Acinetobacter baumannii and their role in biofilm formation. Iran J Basic Med Sci. 2017;20(8):849-55.

33. Bardbari AM, Arabestani MR, Karami M, Keramat F, Alikhani MY, Bagheri KP. Correlation between ability of biofilm formation with their responsible genes and MDR patterns in clinical and environmental Acinetobacter baumannii isolates. Microb Pathog. 2017;108:122-8. [DOI:10.1016/j.micpath.2017.04.039] [PMID]

34. Choi Alexis HK, Slamti L, Avci Fikri Y, Pier Gerald B, Maira-Litrán T. The pgaABCD Locus of Acinetobacter baumannii Encodes the Production of Poly-β-1-6-N-Acetylglucosamine, Which Is Critical for Biofilm Formation. J Bacteriol. 2009;191(19):5953-63. [DOI:10.1128/JB.00647-09] [PMID] [PMCID]

35. Pakharukova N, Tuittila M, Paavilainen S, Malmi H, Parilova O, Teneberg S, et al. Structural basis for Acinetobacter baumannii biofilm formation. Proc Natl Acad Sci. 2018;115(21):5558-63. [DOI:10.1073/pnas.1800961115] [PMID] [PMCID]

36. Farrow IJ, Wells G, Pesci E. Desiccation tolerance in Acinetobacter baumannii is mediated by the two-component response regulator BfmR. PloS One. 2018;13(10):e0205638. [DOI:10.1371/journal.pone.0205638] [PMID] [PMCID]