Molecular Epidemiology of Carbapenem-resistant Acinetobacter baumannii Isolates in a Senegalese University Teaching Hospital

Background: The emergence and spread of carbapenem-resistant Acinetobacter baumannii are critical in hospitals, particularly in intensive care units (ICUs), which represents a public health concern worldwide. In this study, we investigated the molecular epidemiology of multi-drug resistant A. baumannii (MDR-AB) in Dakar, Senegal.

Methods. The A. baumannii was isolated from Eosin Methylene Blue Agar culture and identified using API 20NE strip test and MALDI-TOF. The antimicrobial susceptibility testing was performed using the disk diffusion method. Simplex and multiplex-polymerase chain reactions with appropriate primers were used to detect and sequence the following β-lactamase genes: Two class D carbapenem hydrolyzing oxacillinases (blaOXA-51 and blaOXA-23), three class B metallo-β-lactamase genes (blaIMP, blaVIM and blaNDM), and five class A β-lactamase genes (blaPER, blaSHV, blaVEB, blaTEM, and blaGES).

Results: A total of 29 strains of MDR-AB were isolated from patients hospitalized at Aristide Le Dantec University teaching hospital in Dakar, Senegal. Among the 29 MDR-AB strains isolated, 11 (37.9%) were isolated from ICUs, 5 (17.2%) from pediatric surgery, and 13 (44.8%) from other departments. The MDR strains were isolated from urine and pus samples with 12 (41.4%) and 9 (31.0%), respectively. All isolates were positive for the A. baumannii specific gene blaOXA-51. The blaOXA-51 and blaOXA-23 genes coexisted in 26 (89.65%) of the strains. The blaIMP and blaVIM genes were not detected among the selected strains. Moreover1 (3.4%) strain elicited the gene coding for metallo-β-lactamase NDM-1. 2 (6.9%) isolates turned out to produce the penicillinase TEM-2.

Conclusions: Carbapenem resistance in Senegalese strains of A. baumannii is predominantly due to the worldwide disseminated gene blaOXA-23, with a subset of strains due to NDM-1 and TEM-2. Systemic molecular surveillance network should be established for further efficient monitoring of MDR strains in Senegal.