Original Article

Incidence of drug resistance and expression of blaOXA-51 and adeA genes among Acinetobacter baumannii strains isolated from hospitalized patients at a government hospital in Irbid, Jordan

Abstract

Background and Objectives: Acinetobacter baumannii (A. baumannii) is an opportunistic bacterial pathogen principally related with hospital-acquired infections. This study aimed to isolate and identify A. baumannii strains, investigate their resistance to various antibiotics, and characterize A. baumannii at the molecular level.
Materials and Methods: A total of 100 samples were obtained from various hospital departments, including the intensive care unit (ICU), emergency room, kidney dialysis and surgery units. The incidence of drug resistance was studied using the Vitek 2 Compact system and further using molecular techniques such as polymerase chain reaction to analyze the genes responsible for resistance.
Results: The study exhibited a high prevalence of multidrug-resistant (MDR) A. baumannii isolates, especially in ICU patients. The males were the predominant group, accounting for 60% whereas females were 40%. The most frequent samples were from urine (43%) and skin (24%). Majority of samples were from the ICU (42%) and emergency departments (20%). The tested isolates exhibited the highest resistance (66%) to oxacillin, whereas the maximum sensitivity (52%) was recorded for Erythromycin. Molecular analysis revealed the occurrence of resistance genes blaOXA-23, blaOXA-24, blaOXA-51, and blaOXA-58, which contribute to carbapenem resistance.
Conclusion: The findings emphasize that A. baumannii remains a formidable nosocomial pathogen, and there is pressing requirement for enhanced infection control procedures and antibiotic stewardship. Through improved molecular observation, judicious use of antibiotics and improved infection control practices, healthcare providers can alleviate the impact of MDR A. baumannii infections and improve the prognosis for affected patients in Jordan and beyond.

1. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008; 21: 538-582.
2. Antunes LC, Visca P, Towner KJ. Acinetobacter baumannii: evolution of a global pathogen. Pathog Dis 2014; 71: 292-301.
3. AlFaris EaM, Al-Karablieh N, Odat NA, Rafei R. Carbapenem-resistant Acinetobacter baumannii from Jordan: Complicated Carbapenemase Combinations. Jordan J Biol Sci 2024; 17: 355-361.
4. Jiang Y, Ding Y, Wei Y, Jian C, Liu J, Zeng Z. Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit. Front Microbiol 2022; 13: 1045206.
5. Torres HA, Vázquez EG, Yagüe G, Gómez JG. Multidrug resistant Acinetobacter baumanii: clinical update and new highlights. Rev Esp Quimioter 2010; 23: 12-19.
6. 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: 3711-3719.
7. Duan Z, Li X, Li S, Zhou H, Hu L, Xia H, et al. Nosocomial surveillance of multidrug-resistant Acinetobacter baumannii: a genomic epidemiological study. Microbiol Spectr 2024; 12(2): e0220723.
8. Perez F, Hujer AM, Hujer KM, Decker BK, Rather PN, Bonomo RA. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2007; 51: 3471-3484.
9. CLSI (2024). Performance Standards for Antimicrobial Susceptibility Testing. 34th ed. CLSI supplement M100. Clinical and Laboratory Standards Institute.
10. Jia W, Li C, Zhang H, Li G, Liu X, Wei J. Prevalence of genes of OXA-23 carbapenemase and AdeABC efflux pump associated with multidrug resistance of Acinetobacter baumannii isolates in the ICU of a comprehensive hospital of Northwestern China. Int J Environ Res Public Health 2015; 12: 10079-10092.
11. Hou C, Yang F. Drug-resistant gene of blaOXA-23, blaOXA-24, blaOXA-51 and blaOXA-58 in Acinetobacter baumannii. Int J Clin Exp Med 2015; 8: 13859-13863.
12. Howard A, O'Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: an emerging opportunistic pathogen. Virulence 2012; 3: 243-250.
13. Aldali JA. Acinetobacter baumannii: A multidrug-resistant pathogen, has emerged in Saudi Arabia. Saudi Med J 2023; 44: 732-744.
14. Bertini A, Poirel L, Mugnier PD, Villa L, Nordmann P, Carattoli A. Characterization and PCR-based replicon typing of resistance plasmids in Acinetobacter baumannii. Antimicrob Agents Chemother 2010; 54: 4168-4177.
15. Dijkshoorn L, Nemec A, Seifert H. An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol 2007; 5: 939-951.
16. Karampatakis T, Antachopoulos C, Tsakris A, Roilides E. Molecular epidemiology of carbapenem-resistant Acinetobacter baumannii in Greece: an extended review (2000–2015). Future Microbiol 2017; 12: 801-815.
17. Ayoub Moubareck C, Hammoudi Halat D. Insights into Acinetobacter baumannii: A review of microbiological, Virulence, and resistance traits in a threatening nosocomial pathogen. Antibiotics (Basel) 2020; 9: 119.
18. Diep DTH, Tuan HM, Ngoc KM, Vinh C, Dung TTN, Phat VV, et al. The clinical features and genomic epidemiology of carbapenem-resistant Acinetobacter baumannii infections at a tertiary hospital in Vietnam. J Glob Antimicrob Resist 2023; 33: 267-275.
19. Al-Tamimi M, Albalawi H, Alkhawaldeh M, Alazzam A, Ramadan H, Altalalwah M, et al. Multidrug-resistant Acinetobacter baumannii in Jordan. Microorganisms 2022; 10: 849.
20. Wong MH, Chan BK, Chan EW, Chen S. Over-Expression of ISAba1-Linked Intrinsic and Exogenously Acquired OXA Type Carbapenem-Hydrolyzing-Class D-ß-Lactamase-Encoding Genes Is Key Mechanism Underlying Carbapenem Resistance in Acinetobacter baumannii. Front Microbiol 2019; 10: 2809.
21. Nguyen M, Joshi SG. Carbapenem resistance in Acinetobacter baumannii, and their importance in hospital-acquired infections: a scientific review. J Appl Microbiol 2021; 131: 2715-2738.
22. Słoczyńska A, Wand ME, Bock LJ, Tyski S, Laudy AE. Efflux-related carbapenem resistance in Acinetobacter baumannii is associated with two-vomponent regulatory efflux systems' alteration and insertion of ΔAbaR25-Type island fragment. Int J Mol Sci 2023; 24: 9525.
23. Tacconelli E, Carrara E, Savoldi A, Harbarth S, Mendelson M, Monnet DL, et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect Dis 2018; 18: 318-327.
24. Harding CM, Hennon SW, Feldman MF. Uncovering the mechanisms of Acinetobacter baumannii virulence. Nat Rev Microbiol 2018; 16: 91-102.
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IssueVol 17 No 5 (2025) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijm.v17i5.19881
Keywords
Acinetobacter baumannii Electrophoresis Agar gel Carbapenemase Drug resistance Efflux pump Erythromycin Oxacillin

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How to Cite
1.
Maytah A, AlKofahi O, Al-Groom R, Ahmad Khan MS, Dababneh BF, Da’meh A, Alsarayereh R, Alhawarat F, AlSaraireh G, Ahmad Al Shqairat H. Incidence of drug resistance and expression of blaOXA-51 and adeA genes among Acinetobacter baumannii strains isolated from hospitalized patients at a government hospital in Irbid, Jordan. Iran J Microbiol. 2025;17(5):725-733.