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Sharrone Azzel Jussil, Mohd Zaki Mohd Zaili, Shu Meng Goh, Muhammad Fazril Mohamad Razif, Jualang Azlan Gansau and Lucky Poh Wah Goh

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IDENTIFICATION OF RESISTANCE GENES IN CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) ISOLATES FROM HOSPITAL IN SABAH

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Abstract 

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Carbapenem-resistant Acinetobacter baumannii (CRAB) has been recognized as an urgent public healthcare infectious disease and its incidence rates are concerning. Hence, this study is aimed to identify the prevalence of selected resistance genes and analyze the association between the presence of these genes and the antibiotic resistance levels. A total of 204 A. baumannii. isolates were collected from Queen Elizabeth Hospital Kota Kinabalu and 127 isolates labelled as ‘β-lactams, carbapenemase’ were chosen for further analysis. DNA extractions were performed using a modified phenol-chloroform method and PCR was performed to detect the presence of blaOXA-23, blaOXA-58 and blaTEM genes. Positive PCR results were sent for DNA sequencing for confirmation. The prevalence of CRAB isolates was 62.3% (n = 127). The presence of blaOXA-23, blaOXA-58 and blaTEM were 100% (n = 127), 3.94% (n = 5) and 51.97% (n = 66) respectively. All CRAB isolates pose high antibiotic resistance (≥80%) for ampicillin/sulbactam, piperacillin/tazobactam and cefepime. Furthermore, cefotaxime, ceftazidime, ceftriaxone, imipenem and meropenem showed 100% resistance. The Spearman’s correlation test was statistically significant (p <0.05) between blaOXA-58 and ampicillin/sulbactam, demonstrating weak negative relationship due to absence of strong promoters and blaTEM shows weak positive relationship between ampicillin/sulbactam, amikacin, gentamicin, ciprofloxacin and trimethoprim/sulfamethoxazole which highlights the potential risks of blaTEM’s adaptive resistance. Thus, blaOXA-23 is the most prevalent and significant carbapenem gene. This study supports the development of targeted diagnostics and monitoring of the spread of antibiotic resistance genes, thereby helps to reduce CRAB transmission locally.

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