34 Antimicrobial resistance / International Journal of Infectious Diseases 101(S1) (2021) 8–119

analysed by comparing population coverage of participating and and meropenem) and were multidrug-resistant (MDR). Almost
non-participating pathology service providers. all carbapenem-resistant A. baumannii harboured the acquired
Results: The system is simple in structure and operation but blaOXA-23 carbapenemase gene, with one isolate (AC1633) co-
could be improved by standardising data collection from laborato- harbouring the blaNDM-1 and blaOXA-58 genes and another isolate
ries. The data management process facilitates system flexibility, but (S190) co-harbouring the blaOXA-23 and the blaCARB-16 carbenicil-
platform limitations are a barrier to the simplicity, flexibility and linase gene. Interestingly, one blaOXA-23 -positive isolate (S32) was
acceptability of the system. Acceptability was reduced by the inabil- carbapenem susceptible and harboured the global regulatory gene
ity to support nuanced clinical and public health decision-making, soxR, known to negatively affect antibiotic resistance. Core genome
although enhanced by timely data provision. Future challenges phylogenetic analyses revealed that majority of isolates from 2011
to stability include sustainable governance, funding and human and 2012 were closely related and belonged to the ST195 sequence-
resourcing. Data completeness was high and validity good, though type of the Global Clonal 2 (GC2) lineage. However, the ST195 clone
could be improved through quality assurance. The system was was no longer predominant in 2015 and was not detected at all
found to be sensitive, with an average 94.9% agreement between in the 2016 isolates that were sequenced. A. baumannii isolates
HOTspots data and local susceptibility data. Three major pathol- in 2015 and 2016 were genetically more varied and belonged to
ogy service providers, who service public and private, hospital and diverse sequence-types, some of which were novel. These results
community populations, have contributed data, establishing high suggest the endemicity of the ST195 clone in the hospital during
quality representativeness of the system. 2011–2012. The reason for the non-prevalence of the ST195 clone
Conclusion: HOTspots’ strength lies in its provision of timely, in 2015 and 2016 is unknown.
representative and accurate antimicrobial susceptibility data to end Conclusion: Whole genome sequencing of the Terengganu A.
users in northern Australia. Recommendations to enhance the sys- baumannii isolates indicated a likely endemic spread of the ST195
tem include standardising data collection, upgrading the platform clone in the hospital from 2011–2012.
and working with end users to build more nuanced clinical and pub-
lic health decision-making support. Sustainable governance and https://doi.org/10.1016/j.ijid.2020.09.123
resourcing are essential to achieving this aim. Successful imple-
mentation of HOTspots into regional surveillance activities will 0081
innovate the way health services receive and act on changing pat-
Methicillin-resistant coagulase positive
terns of antimicrobial resistance.
Staphylococcus aureus and Staphylococcus
pseudintermedius circulating in dogs in
https://doi.org/10.1016/j.ijid.2020.09.122 Bangladesh
0080 E.A. Rana 1,∗ , M.Z. Islam 2 , T. Das 1 , A. Dutta 1 , A.
Ahad 1 , P.K. Biswas 1 , H. Barua 1
Whole genome sequencing of Acinetobacter
baumannii hospital isolates from Terengganu, 1 Chattogram Veterinary and Animal sciences
Malaysia: Prevalence of the GC2 ST195 clone in University, Department of Microbiology and
2011–2012 Veterinary Public Health, Chattogram, Bangladesh
2 Harvard Medical School, Microbiology and
A.G. Alattraqchi 1 , N.I.A. Rahman 1 , S. Ismail 1 ,
Immunobiology, Boston, United States
D.W. Cleary 2 , S. Clarke 3 , C.C. Yeo 4,∗
1 Background: The emergence of methicillin-resistant Staphylo-
Universiti Sultan Zainal Abidin, Faculty of
coccus aureus (MRSA) and Staphylococcus pseudintermedius (MRSP)
Medicine, Kuala Terengganu, Malaysia
2 University of Southampton, Faculty of Medicine have a significant health impact on occupational peoples and pet
owners. As there is a lack of knowledge on the carriage frequency of
and Institute for Life Sciences, Southampton, United
these two organisms in dogs in Bangladesh, we conducted a cross-
Kingdom
3 University of Southampton, Infectious Diseases sectional study to determine the prevalence and risk factor (s) of S.
aureus, S. pseudintermedius, MRSA, and MRSP in clinically healthy
Epidemiology Unit, Southampton, United Kingdom
4 Universiti Sultan Zainal Abidin, Medical Campus, and sick dogs.
Methods and materials: A total of 358 swab samples were col-
Faculty of Medicine, Kuala Terengganu, Malaysia
lected from different body sites of 150 dogs admitted to a university
Background: Acinetobacter baumannii is one of the pathogens teaching hospital through January to July 2018. Standard bacterio-
well-noted for causing outbreaks of nosocomial infection. It is logical methods were followed for the isolation and identification
notorious for its ability to develop resistance to all classes of antimi- of S. aureus and S. pseudintermedius and, which was further con-
crobial compounds, including carbapenems, which are the drugs of firmed by the presence of the nuc and pse genes, respectively. The
choice for the treatment of Acinetobacter infections. In this study, isolates were tested for the susceptibility to a panel of 14 antimicro-
we characterised and performed whole genome sequencing (WGS) bials. Isolates displayed resistance to cefoxitin and oxacillin were
on 46 retrospective isolates of A. baumannii obtained from the main screened further for the presence of the mecA gene to identify MRSA
tertiary hospital in the state of Terengganu, Malaysia over a five- and MRSP. The risk factors were investigated using multivariable
year period (2011–2016). logistic regression model.
Methods and materials: Antimicrobial susceptibility of the Results: The prevalence of S. aureus and S. psudintermedius in
non-repetitive A. baumannii isolates (n = 46) were determined by dogs were 16% (95% confidence interval (CI), 11–23%) and 49%
disc diffusion. Genomic DNA was extracted using the GeneAid Bac- (95% CI, 41–57%), respectively. Notably, all staphylococcal isolates
terial Genomic DNA kit and WGS was performed on an Illumina showed resistance to ≥3 classes of antimicrobials (multi-drug resis-
platform. Sequences were assembled using SPAdes 3.12 and phy- tant; MDR). The prevalence of MRSA and MRSP was 8.67% (95% CI,
logenetic analyses were performed using ROARY. 5.02 to 14.38) and 6% (95% CI, 3.04 to 11.16), respectively. Dogs with
Results: The majority of the 46 A. baumannii isolates were dermatitis (odds ratio [OR], 12.24; 95% CI, 3.12 to 57.33; p < 0.001)
resistant to carbapenems (73.9% were resistant to both imipenem and with the history of antibiotic use (OR 8.73; 95% CI, 2.23 to 43.10;
 Antimicrobial resistance / International Journal of Infectious Diseases 101(S1) (2021) 8–119 35

p < 0.001) more frequently carried MRSA while the presence of oti- 0083
tis (OR 14.22; 95% CI, 1.64 to 103.58; p < 0.008) and oral lesions
(OR 9.48; 95% CI, 1.14 to 64.82; p < 0.002) were identified as the cupA1/cupA5 gene overexpressed at
significant risk factors for the carriage of MRSP in dogs. subinhibitory concentration of carbapenem in
Conclusion: The detection of chromosome mediated mec-A biofilm forming Pseudomonas aeruginosa:
gene within the S. aureus and S. pseudintermedius isolates from dogs Transcriptomic study from India
is an emerging finding in veterinary hospital as well as significant C. Deshamukhya 1,∗ , A. Bhattacharjee 1 , B.J. Das 1 ,
concern for human medicine. D. Paul 1 , D. Dhar Chanda 2
1 Assam University, Department of Microbiology,
https://doi.org/10.1016/j.ijid.2020.09.124
Silchar, India
0082 2 Silchar Medical College and Hospital, Microbiology,

Silchar, India
Genetic determinant of multi-drug resistance
Acinetobacter baumannii at Dr. George Mukhari Background: Pseudomonas aeruginosa, an opportunistic
Academic Hospital, Pretoria, South Africa pathogen associated with hospital infections is a potent biofilm
forming bacteria. A new class of genes termed the chaperone/usher
N.-D. Nogbou, D.T. Phofa, M. Nchabeleng, A.
(cup) encoding fimbrial subunit, chaperone and outer membrane
Musyoki ∗
usher protein have been identified which facilitates biofilm
Sefako Makgatho Health Sciences University, formation in Pseudomonas aeruginosa independent of the Type
Microbiological Pathology, Pretoria, South Africa IV pili. Since antibiotics at low concentrations can change bio-
logical response in bacteria; therefore in the present study the
Background: Antimicrobial resistance is now globally rec- response of cupA1 and cupA5 genes was studied at a sub-inhibitory
ognized as the greatest threat to human health. Acinetobacter concentration of carbapenem to check if it influences biofilm
baumanniis’ (A. baumannii) clinical importance has been driven formation.
by its ability to obtain and transmit antimicrobial resistance Methods and materials: Four clinical isolates of Pseudomonas
factors. In South Africa, A. baumannii is a leading cause of aeruginosa harboring blaOXA-48 &blaNDM associated with hospital
Healthcare-Associated Infections (HAI). In this study, we investi- infection were selected for the study. All the isolates had MIC above
gated the genetic determinants of multi-drug resistant A. baumannii breakpoint against imipenem and meropenem. The isolates were
(MDRAB) at a teaching hospital in Pretoria, South Africa. cultured overnight in fresh Luria Bertani broth with and without
Methods and materials: Hundred non-repetitive isolates of A. 2 ␮g/mL carbapenem (imipenem, meropenem) stress respectively.
baumannii were collected for the study at Dr. George Mukhari Total RNA was isolated from the overnight cultures grown to log
Tertiary Laboratory (DGMTL). Antimicrobial susceptibility testing phase using RNeasy kit (Qiagen, India); cDNA was prepared using
was performed using the VITEK2 system (bioMerieux, France). the Quanti Tect Reverse Transcription kit (Qiagen, India) and was
Manchanda et al., multi-drug classification criteria were used to then subjected to quantitative real-time PCR to estimate the rela-
ascertained the multi-drug profile of isolates, using disk diffusion tive expression of cupA1 and cupA5 genes in the study isolates using
method. The prevalence of common resistance-associated genes the Ct method.
and AdeABC efflux pump system associated genes were inves- Results: The transcriptional analysis of cupA1 and cupA5 genes
tigated using conventional PCR reaction. Genetic relatedness of in the isolates revealed that the expression levels of the genes in all
isolates was then determined using rep-PCR. of the four isolates under normal condition i.e. without any antibi-
Results: Seventy (70) of 100 isolates collected were confirmed to otic pressure were lower than the expression level in control strain
be multi-drug resistant and were blaOXA51 positive. Phenotypically, Pseudomonas aeruginosa ATCC 278533 (RQ=1). Whereas, overex-
the isolates were resistant to almost all tested antibiotics. However, pression of the genes was observed in all the isolates when these
one isolate showed intermediate susceptibility to tigecycline while were treated with 2 ␮g/mL imipenem and meropenem respec-
the rest and all were susceptible to also colistin. Oxacillinase encod- tively. The expression of cupA5 gene increased multiple folds under
ing gene blaOXA-23 was the most detected at 99% and only 1% was meropenem stress in all the isolates.
positive for blaOXA-40 . The polymerase chain reaction of metallo- Conclusion: The results of the present study imply that car-
betalactamase (MBL) encoding gene showed that MBL blaVIM was bapenem at a concentration below the lethal dose increases the
the most frequently detected at 86% and blaSIM-1 at 3% was the least expression of cupA1 and cupA5 genes which facilitates biofilm for-
detected. Out of 70 isolates, 56 isolates had the required gene com- mation. Thus from the present study, it can be concluded that
bination for an active efflux pump. The most prevalent clone was imipenem and meropenem at sub-inhibitory concentration favours
clone A at 69% of the isolates. the biofilm forming ability in clinical strains of P. aeruginosa estab-
Conclusion: Regarding treatment; colistin and tigecycline are lishing infection and thus complicating antibiotic therapies which
the most effective against strains encountered at DGMTL. The major may further lead to treatment failure.
genotypic determinants for drug resistances are for oxacillinase:
blaOXA-51 (100%) and blaOXA-23 (99%). The study reports for the first
https://doi.org/10.1016/j.ijid.2020.09.126
time, blaOXA-40 and blaSIM-1 detection in A. baumannii in South Africa.

https://doi.org/10.1016/j.ijid.2020.09.125