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Molecular characterization of MDR clinical isolates of A. baumannii from three neighbouring countries in south-eastern Europe.

In the last decade, Acinetobacter baumannii has emerged as a major relevant nosocomial pathogen in the most European countries. Multidrug-resistant (MDR) clinical isolates represent a major problem in the epidemiological and therapeutic sense and challenge for clinicians. Surveillance of carbapenem-and MDR resistant isolates of A. baumannii in Croatia is continuously monitored since in the last decade the percentage of carbapenem-resistant isolates reached 97%. Along Croatia, neighbouring countries Bosnia and Herzegovina and Serbia also recorded a significant increase in the incidence and prevalence of carbapenem-resistant isolates of A. baumannii. The aim of this pilot study is to compare the genotype resemblance and resistance mechanism of MDR clinical isolates of A. baumannii in region of southeastern Europe. In total, 12 clinical isolates of carbapenem-resistant A. baumannii were collected from three different hospitals in neighbouring countries: Croatia, Bosnia and Herzegovina, and Serbia. Four isolates originated from University Hospital of Split, Croatia and were isolated from the tracheal and bronchoalveolar aspirates of patients from adult and paediatric Intensive Care Units in different outbreaks periods from 2009-2018. Two isolates were collected from University Hospital Mostar, Bosnia and Herzegovina in the beginning of 2018. Six isolates came from different wards of Clinical Centre of Vojvodina, one hospital in university-affiliated medical centre Novi Sad, Serbia and were collected from blood cultures during 2017 and 2018. All collected isolates shared high level of resistance to carbapenems with MIC >32mg/L to both imipenem and meropenem. Beside the carbapenem-resistance, isolates were uniformly resistant to gentamicin and ciprofloxacin, but susceptible to colistin. The relatedness of collected A. baumannii isolates was assessed by using pulsed-field gel electrophoresis (PFGE) and displayed diversity of genotyping profiles. The multiplex PCR confirmed the presence of blaOXA-40-like genes in half (6/12) of the collected isolates from neighbouring countries, beside the presence of blaOXA-23 gene. These are the first results of a pilot study on MDR clinical isolates of A. baumannii originating from three neighbouring countries in south-eastern Europe.

Acinetobacter baumannii, Croatia, Bosnia and Herzegovina, Serbia

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