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Nosocomial infection caused by  Acinetobacter baumannii  is of great concern due to its increasing resistance to most antimicrobials. In this study, 54 nonrepeat isolates of  A. baumannii  from the main tertiary hospital in Terengganu, Malaysia, were analyzed for their antibiograms and genotypes. Out of the 54 isolates, 39 (72.2%) were multidrug resistant (MDR) and resistant to carbapenems whereas 14 (25.9%) were categorized as extensive drug resistant (XDR) with additional resistance to polymyxin B, the drug of “last resort.” Pulsed-field gel electrophoresis analyses showed that the polymyxin-resistant isolates were genetically diverse while the carbapenem-resistant isolates were clonally related. The 14 XDR isolates were further investigated for mutations in genes known to mediate polymyxin resistance, namely,  pmrCAB , and the lipopolysaccharide biosynthesis genes,  lpxA ,  lpxC ,  lpxD,  and  lpsB . All 14 isolates had a P102H mutation in  pmrA  with no mutation detected in  pmrC  and  pmrB . No mutation was detected in  lpxA  but each polymyxin-resistant isolate had 2–4 amino acid substitutions in  lpxD  and 1-2 substitutions in  lpxC . Eight resistant isolates also displayed a unique H181Y mutation in  lpsB . The extent of polymyxin resistance is of concern and the novel mutations discovered here warrant further investigations.

isrn microbiology

Prevalence and Genetic Characterization of Carbapenem- and Polymyxin-Resistant<i>Acinetobacter baumannii</i>Isolated from a Tertiary Hospital in Terengganu, Malaysia

Prevalence and Genetic Characterization of Carbapenem- and Polymyxin-ResistantAcinetobacter baumanniiIsolated from a Tertiary Hospital in Terengganu, Malaysia