Ann Lab Med.  2014 Nov;34(6):433-438. 10.3343/alm.2014.34.6.433.

Correlation of Ciprofloxacin Resistance with the AdeABC Efflux System in Acinetobacter baumannii Clinical Isolates

• Ardebili A
• Lari AR
• Talebi M

• KMID: 2129568
• DOI: http://doi.org/10.3343/alm.2014.34.6.433

Abstract

BACKGROUND
Acinetobacter baumannii is one of the most important pathogens capable of colonization in burn patients, leading to drug-resistant wound infections. This study evaluated the distribution of the AdeABC efflux system genes and their relationship to ciprofloxacin resistance in A. baumannii isolates collected from burn patients.
METHODS
A total of 68 A. baumannii clinical strains were isolated from patients hospitalized in Motahari Burns Center in Tehran, Iran. Ciprofloxacin susceptibility was tested by the disk diffusion and agar dilution methods. PCR amplification of the adeRS-adeB drug efflux genes was performed for all resistant and susceptible isolates. To assess the role of the drug efflux pump in ciprofloxacin susceptibility, carbonyl cyanide 3-chlorophenylhydrazone (CCCP) was used as an efflux pump inhibitor (EPI).
RESULTS
Approximately 95.6% of the Acinetobacter isolates were resistant to ciprofloxacin, with minimum inhibitory concentration (MIC) values ranging from 4 to > or =128 microg/mL. The susceptibility of 86.1% of the resistant isolates increased by factors of 2 to 64 in the presence of CCCP. All resistant isolates were positive for the adeRS-adeB genes, and 73.2% of them had mutations in the AdeRS regulatory system.
CONCLUSIONS
The results showed that AdeABC genes are common in A. baumannii, which might be associated with ciprofloxacin non-susceptibility, as indicated by the observed linkage to the presence of the genes essential for the activity of the AdeABC, several single mutations occurring in the adeRS regulatory system, and an increase of ciprofloxacin susceptibility in the presence of a CCCP EPI.

Keyword

Acinetobacter baumannii; Ciprofloxacin; Burns; Efflux pump genes; Resistance

MeSH Terms

ATP-Binding Cassette Transporters/antagonists & inhibitors/genetics/*metabolism
Acinetobacter Infections/diagnosis/microbiology
Acinetobacter baumannii/*drug effects/genetics/isolation & purification
Anti-Bacterial Agents/*pharmacology
Bacterial Proteins/antagonists & inhibitors/genetics/*metabolism
Base Sequence
Ciprofloxacin/*pharmacology
DNA, Bacterial/chemistry/genetics/metabolism
Drug Resistance, Bacterial
Humans
Hydrazones/pharmacology
Microbial Sensitivity Tests
Mutation
Polymerase Chain Reaction
Anti-Bacterial Agents
Bacterial Proteins
Ciprofloxacin
DNA, Bacterial
Hydrazones

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