Abstract
Over the past 10 years, dissemination of Carbapenem-Resistant Acinetobacter baumannii (CRAB) has led to an increase in the prevalence of Carbapenem-resistant Gram negative bacteria in the Iran. Carbapenems are used as a first choice drug for treatment of Acinetobacter baumannii infections. Extensive resistance to Carbapenemes, has become a major challenge for treatment of Acinetobacter baumannii infections. Infections caused by CRAB have limited treatment options and have been associated with high mortality rates in worldwide. Resistance to Carbapenemes first was reported in 1991 than its distribution was observed worldwide. Recent studies have revealed that 98% of Acinetobacter baumannii isolates in different Tehran hospitals are resistant to Carbapenemes (Imipenem and Meropenem). While the rate of resistance to Carbapenemes was reported to be 52/5% in 2009. Several mechanisms are involved in developing of CRAB. These mechanisms include the enzymatic hydrolysis mediated by the oxacillinases of Ambler class D OXA-type, Carbapenem hydrolyzing-β-lactamases of molecular class B and sometimes alteration of Penicillin-Binding Proteins (PBP) or increased activity efflux pumps [1]. Metallo-β-Lactamases (MBL) and oxacillinases are found to be more frequent. So far the oxacillinase genes such as blaOXA-23-like, blaOXA-24-like, blaOXA-51-like and blaOXA-58 like also MBLs such as Seoul metallo-β-lactamase Imipenemase (SIM), Sno Paolo metallo (SPM), New Delhi Metallo-β-lactamase (NDM), Verona Integron-encoded Metallo-β-lactamases (VIM) and Imipenemase (IMP) have been reported in Acinetobacter baumannii isolates. There have been numerous studies performed aiming to identify these mechanisms in Iran [2].
Citation
Adibhesami H, Farahani A, Asadi A and Afshar D. Carbapenem-Resistant Acinetobacter baumannii: Epidemiology and Prevention in Iran. SM J Biol. 2015; 1(1): 1002.