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Clonal expansion of colistin-resistant Acinetobacter baumannii isolates in Cape Town, South Africa

2019; Elsevier BV; Volume: 91; Linguagem: Inglês

10.1016/j.ijid.2019.11.021

1878-3511

Yolandi Snyman, Andrew Whitelaw, Sandra Reuter, Angela Dramowski, Motlatji Reratilwe Bonnie Maloba, Mae Newton-Foot,

Escherichia coli research studies

ObjectivesTo describe colistin-resistant Acinetobacter baumannii isolates in Cape Town, South Africa.MethodsA. baumannii isolates identified on Vitek 2 Advanced Expert System were collected from Tygerberg Hospital referral laboratory between 2016 and 2017. Colistin resistance was confirmed using broth microdilution and SensiTest. mcr-1–5 were detected using PCR and strain typing was performed by rep-PCR. Whole genome sequencing (WGS) was performed on a subset of isolates to identify chromosomal colistin resistance mechanisms and strain diversity using multilocus sequence typing (MLST) and pairwise single nucleotide polymorphism analyses.ResultsTwenty-six colistin-resistant and six colistin-susceptible A. baumannii were collected separately based on Vitek susceptibility; 20/26 (77%) were confirmed colistin-resistant by broth microdilution. Four colistin-resistant isolates were isolated in 2016 and 16 in 2017, from five healthcare facilities. Thirteen colistin-resistant isolates and eight colistin-susceptible isolates were identical by rep-PCR and MLST (ST1), all from patients admitted to a tertiary hospital during 2017. The remaining colistin-resistant isolates were unrelated.ConclusionsAn increase in colistin-resistant A. baumannii isolates from a tertiary hospital in 2017 appears to be clonal expansion of an emerging colistin-resistant strain. This strain was not detected in 2016 or from other hospitals. Identical colistin-susceptible isolates were also isolated, suggesting relatively recent acquisition of colistin resistance.