PMID: 20635600Jul 20, 2010Paper

Rifampin resistance in carbapenem-resistant Acinetobacter baumannii in Siriraj Hospital, Thailand

Nepal Medical College Journal : NMCJ
Badri ThapaChertsak Dhiraputra

Abstract

There is a growing evidence on emergence of carbapenem-resistant Acinetobacter baumannii (CRAB) in Thailand and recent treatment guidelines recommend a combination therapy using carbapenem and/or polymyxin with rifampin. Rifampin would be added in a combination therapy. The susceptibility of this pathogen to rifampin is not known, so we studied the rifampin susceptibility and possible mechanisms of resistance used by CRAB. The disk diffusion test was performed on 111 clinical isolates using 5 microg rifampin disk following CLSI guidelines. The inhibition zone was interpreted based upon the recommendation for Staphylococcus aureus (inhibition zone < 20 mm = resistant). Polymerase chain reaction (PCR) using the primers specific for arr-2 encoding rifampin ADP-ribosyltransferase was performed in all isolates. The rpoB DNA sequences from two isolates, with or without arr-2, were compared. All isolates under study were rifampin resistant. Inhibition zone was < 14 mm for all isolates. The arr-2 was positive for 35 isolates (31.5%) and these isolates correlated with high level of resistance (inhibition zone < 10mm). The DNA sequences of rpoB genes in arr-2 negative isolate showed mutations L904S, P906R, K909N and M1262K that might hav...Continue Reading

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