First report of blaNDM-1-producing Acinetobacter baumannii isolated in Lebanon from civilians wounded during the Syrian war

Objectives: The emergence of carbapenem-resistant Acinetobacter baumannii has been observed worldwide. We describe the first detection of A. baumannii carrying the bla(NDM-1) gene in Lebanon, isolated from Syrian patients wounded during the civil war. Methods: Four carbapenem-resistant A. baumannii strains isolated in 2012 in the Tripoli Government Hospital, Lebanon, from civilians wounded during the Syrian war, were analysed. Susceptibility was determined by disk diffusion testing, and resistance to carbapenems was confirmed by Etest. The presence of bla(OXA-23-like), bla(OXA-24-like), bla(OXA-58-like), bla(OXA-143-like), and bla(NDM) was investigated by PCR. Clonal relationships were studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and bla(OXA-51) sequence-based typing. Results: All isolates harboured the bla(NDM-1) gene and were negative for other tested carbapenemases. They all belonged to the sequence type 85 and formed a single cluster by PFGE. Finally, bla(OXA-51-like) gene sequencing revealed the presence of the bla(OXA-94) variant in all four isolates. Conclusion: These findings show that Syria constitutes a reservoir for NDM-1-producing bacteria. These results also highlight the need for effective measures to stop the threatening spread of such strains. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.