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Antimicrobial Agents and Chemotherapy, February 2009, p. 843-844, Vol. 53, No. 2
0066-4804/09/$08.00+0 doi:10.1128/AAC.00999-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Codetection of blaOXA-23-Like Gene (blaOXA-133) and blaOXA-58 in Acinetobacter radioresistens: Report from the SENTRY Antimicrobial Surveillance Program 

LETTER
We read with great interest the report from Poirel et al. (
7)
describing
Acinetobacter radioresistens as a source of
blaOXA-23-like
genes. During the 2006 SENTRY Antimicrobial Surveillance Program,
the occurrence of acquired class D carbapenemases and metallo-β-lactamases
in
Acinetobacter spp. from the Asia-Pacific region was evaluated
(
4). In this study, one
A. radioresistens strain (251-39C; identified
by 16S rRNA gene sequencing) showing decreased susceptibility
to penicillins and imipenem was observed (Manipal, India). However,
since
blaOXA-23-like genes from all
A. radioresistens strains
described by Poirel et al. (
7) were silent and chromosome borne
and did not confer a resistance phenotype, we were intrigued
by the elevated MICs displayed by the isolate 251-39C. Therefore,
further screening for class D carbapenemase (
6,
10) detected
blaOXA-58 in addition to the intrinsic
blaOXA-23-like gene.
Flanking sequences of both blaOXA genes were characterized by PCR using primers targeting ISAba1, -2, or -3 or a degenerate primer approach (5, 9). The upstream region of the blaOXA-23-like gene showed the highest identity with a putative O-sialoglycoprotein endopeptidase gene detected in the Acinetobacter baumannii strain AYE (CU459141); no putative promoter was located in this region. Sequencing analysis of the blaOXA-23-like gene revealed a new gene, named blaOXA-133. The putative amino acid sequence displayed the most identity with OXA-102 (99.6%; one amino acid substitution difference [Leu-5 Phe]). Other close variants were OXA-103 (98.5%), OXA-23 (97.4%), OXA-73 (97.1%), OXA-27 and -49 (96.7%), and OXA-105 (96.3% [data not shown]) (7). A truncated ATPase located downstream of blaOXA-133 was detected, consisting of the same genetic context as that reported previously (7). Sequencing confirmed the presence of blaOXA-58 and ISAba3 upstream, thus providing a promoter region.
Plasmid analysis demonstrated nine plasmid bands (ca. 54, 35, 14, 5.6, 4.0, 3.0, 2.8, 2.5, and 2.4 kb) and a blaOXA-58-specific probe hybridized with the 54-, 35-, and 5.6-kb bands (5). It is worthwhile to mention that the 4.0-kb and smaller plasmid bands may represent different forms of at least two distinct plasmids. However, blaOXA-58 was considered to be carried by three different plasmids, since they showed greater size differences. Further experiments should be performed to determine the exact number of plasmid DNAs carried by isolate 251-39C. Curing experiments were performed to investigate whether β-lactam MICs would decrease after removing blaOXA-58-carrying plasmids (3). Curing was confirmed by a negative PCR result for blaOXA-58. Index and cured strains were tested for susceptibility by the broth microdilution method (2) and Etest (AB BioDisk, Solna, Sweden). The cured A. radioresistens isolate became susceptible and showed MICs for penicillins and carbapenems between 128- and 16-fold and 4- to 32-fold lower than the index strain, respectively (Table 1).
In addition, we evaluated the transcriptional levels of
blaOXA-133 and
blaOXA-58 by using quantitative real-time PCR. RNA was extracted
using the RNeasy mini kit (Qiagen GmbH, Hilden, Germany). Relative
quantification of target gene expression (
blaOXA-133 and
blaOXA-58)
was performed in triplicate by normalization to an endogenous
reference (16S rRNA). Quantitative real-time PCR demonstrated
that
blaOXA-133 was transcribed at very low levels (mean threshold
cycle = 34.74), ca. 1,500-fold lower than those for
blaOXA-58 (mean threshold cycle = 24.00). Although the index strain harbored
the chromosomal
blaOXA-133, the loss of β-lactam resistance
displayed by the cured strain suggests OXA-58 as the main β-lactam
resistance mechanism (
8), possibly enhanced by multiple gene
copies and increased production of enzyme (
1). Detection of
blaOXA-58 in the index strain, highly disseminated in
A. baumannii (
4), indicates the occurrence of DNA exchange between these
two species (
7). Furthermore, our findings emphasize the ability
of
blaOXA-58 mobilization.

Nucleotide sequence accession number.
The nucleotide sequences of the
blaOXA-133-carrying
A. radioresistens clinical isolate described in this paper have been submitted
to the EMBL/GenBank/DNA Data Bank of Japan sequence databases
and assigned the accession number EU571228.

FOOTNOTES

Published ahead of print on 17 November 2008.


REFERENCES
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5 - Mendes, R. E., M. Castanheira, M. A. Toleman, H. S. Sader, R. N. Jones, and T. R. Walsh. 2007. Characterization of an integron carrying blaIMP-1 and a new aminoglycoside resistance gene, aac(6')-31, and its dissemination among genetically unrelated clinical isolates in a Brazilian hospital. Antimicrob. Agents Chemother. 51:2611-2614.[Abstract/Free Full Text]
6 - Mendes, R. E., K. A. Kiyota, J. Monteiro, M. Castanheira, S. S. Andrade, A. C. Gales, A. C. Pignatari, and S. Tufik. 2007. Rapid detection and identification of metallo-β-lactamase-encoding genes by multiplex real-time PCR assay and melt curve analysis. J. Clin. Microbiol. 45:544-547.[Abstract/Free Full Text]
7 - Poirel, L., S. Figueiredo, V. Cattoir, A. Carattoli, and P. Nordmann. 2008. Acinetobacter radioresistens as a silent source of carbapenem resistance for Acinetobacter spp. Antimicrob. Agents Chemother. 52:1252-1256.[Abstract/Free Full Text]
8 - Poirel, L., S. Marque, C. Heritier, C. Segonds, G. Chabanon, and P. Nordmann. 2005. OXA-58, a novel class D β-lactamase involved in resistance to carbapenems in Acinetobacter baumannii. Antimicrob. Agents Chemother. 49:202-208.[Abstract/Free Full Text]
9 - Poirel, L., and P. Nordmann. 2006. Genetic structures at the origin of acquisition and expression of the carbapenem-hydrolyzing oxacillinase gene blaOXA-58 in Acinetobacter baumannii. Antimicrob. Agents Chemother. 50:1442-1448.[Abstract/Free Full Text]
10 - Woodford, N., M. J. Ellington, J. M. Coelho, J. F. Turton, M. E. Ward, S. Brown, S. G. Amyes, and D. M. Livermore. 2006. Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int. J. Antimicrob. Agents 27:351-353.[CrossRef][Medline]
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Rodrigo E. Mendes*
JMI Laboratories 345 Beaver Kreek Centre, Suite A North Liberty, Iowa 52317
Jan M. Bell
John D. Turnidge
Women's and Children's Hospital Adelaide, Australia
Mariana Castanheira
Lalitagauri M. Deshpande
Ronald N. Jones
JMI Laboratories North Liberty, Iowa
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* Phone: (319) 665-3370 Fax: (319) 655-3371 E-mail: rodrigo-mendes{at}jmilabs.com |
Antimicrobial Agents and Chemotherapy, February 2009, p. 843-844, Vol. 53, No. 2
0066-4804/09/$08.00+0 doi:10.1128/AAC.00999-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.