Abstract
Acinetobacterspp. has gained fame from their ability to resist difficult conditions and their constant development of antimicrobial resistance. This study aimed to investigate the prevalence, susceptibility testing, OXA carbapenemase-encoding genes, and RAPD-genotyping of multidrug resistantAcinetobacter baumanniiincriminated in hidden community-acquired infections in Egypt. The antimicrobial susceptibility testing was assessed phenotypically using Kirby-Bauer disk diffusion method. Also, Modified-Hodge test (MHT) was carried out to detect the carbapenemases production. Multiplex-PCR was used to detect the carbapenemase-encoding genes. Furthermore, the genetic relationship among the isolated strains was investigated using RAPD fingerprinting. The bacteriological examination revealed that, out of 200 Gram-negative non-fermentative isolates, 44 (22%) were identified phenotypically and biochemically asAcinetobacterspp. and 23 (11.5%) were molecularly confirmed asA.baumannii. The retrievedA.baumanniistrains were isolated from urine (69%), sputum (22%), and cerebrospinal fluid (csf) (9%). The isolatedA. baumanniistrains exhibited multidrug resistance and the production rates of carbapenemases were 56.5, 60.9, and 78.3% with meropenem, imipenem, and ertapenem disks, respectively. Thebla(OXA-24)-like genes were the most predominant among the tested strains (65.2%), followed bybla(OXA-23)(30.4%) andbla(OXA-58)(17.4%), in addition, the examined strains are harbored IMP, VIM, and NDM genes with prevalence of 60.9, 43.5, and 13%, respectively, while KPC and GES genes were not detected. RAPD-PCR revealed that the examined strains are clustered into 11 different genotypes at >= 90% similarity. Briefly, to the best of our knowledge, this study is the first report concerning community-associatedA. baumanniiinfections in Egypt. The high prevalence of hidden multidrug-resistant (MDR) and extensively drug-resistant (XDR)A.baumanniistrains associated with non-hospitalized patients raises an alarm for healthcare authorities to set strict standards to control the spread of such pathogens with high rates of morbidity and mortality.