Archives of Clinical Infectious Diseases

Published by: Kowsar

Distribution and Expression of Efflux Pump Gene and Antibiotic Resistance in Acinetobacter baumannii

Parisa Mobasseri 1 , Leila Azimi 2 , Mitra Salehi 1 , Farzaneh Hosseini 1 and Fatemeh Fallah 2 , *
Authors Information
1 Department of Microbiology, North Tehran Branch, Islamic Azad University, Tehran, Iran
2 Pediatric Infections Research Center, Research Institute For Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Article information
  • Archives of Clinical Infectious Diseases: October 2018, 13 (5); e67143
  • Published Online: August 19, 2018
  • Article Type: Research Article
  • Received: February 5, 2018
  • Accepted: April 29, 2018
  • DOI: 10.5812/archcid.67143

To Cite: Mobasseri P, Azimi L, Salehi M, Hosseini F, Fallah F . Distribution and Expression of Efflux Pump Gene and Antibiotic Resistance in Acinetobacter baumannii, Arch Clin Infect Dis. 2018 ; 13(5):e67143. doi: 10.5812/archcid.67143.

Copyright © 2018, Archives of Clinical Infectious Diseases. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Amin IM, Richmond GE, Sen P, Koh TH, Piddock LJ, Chua KL. A method for generating marker-less gene deletions in multidrug-resistant Acinetobacter baumannii. BMC Microbiol. 2013;13:158. doi: 10.1186/1471-2180-13-158. [PubMed: 23848834]. [PubMed Central: PMC3717142].
  • 2. Maragakis LL, Perl TM. Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options. Clin Infect Dis. 2008;46(8):1254-63. doi: 10.1086/529198. [PubMed: 18444865].
  • 3. Costello SE, Gales AC, Morfin-Otero R, Jones RN, Castanheira M. Mechanisms of resistance, clonal expansion, and increasing prevalence of acinetobacter baumannii strains displaying elevated tigecycline MIC values in Latin America. Microb Drug Resist. 2016;22(4):253-8. doi: 10.1089/mdr.2015.0168. [PubMed: 26716768].
  • 4. Rumbo C, Gato E, Lopez M, Ruiz de Alegria C, Fernandez-Cuenca F, Martinez-Martinez L, et al. Contribution of efflux pumps, porins, and beta-lactamases to multidrug resistance in clinical isolates of Acinetobacter baumannii. Antimicrob Agents Chemother. 2013;57(11):5247-57. doi: 10.1128/AAC.00730-13. [PubMed: 23939894]. [PubMed Central: PMC3811325].
  • 5. Su XZ, Chen J, Mizushima T, Kuroda T, Tsuchiya T. AbeM, an H+-coupled Acinetobacter baumannii multidrug efflux pump belonging to the MATE family of transporters. Antimicrob Agents Chemother. 2005;49(10):4362-4. doi: 10.1128/AAC.49.10.4362-4364.2005. [PubMed: 16189122]. [PubMed Central: PMC1251516].
  • 6. Nikasa P, Abdi-Ali A, Rahmani-Badi A, Al-Hamad A. In vitro evaluation of proton motive force-dependent efflux pumps among multidrug resistant acinetobacter baumannii isolated from patients at Tehran Hospitals. Jundishapur J Microbiol. 2013;6(7). doi: 10.5812/jjm.6792.
  • 7. Yoon EJ, Courvalin P, Grillot-Courvalin C. RND-type efflux pumps in multidrug-resistant clinical isolates of Acinetobacter baumannii: major role for AdeABC overexpression and AdeRS mutations. Antimicrob Agents Chemother. 2013;57(7):2989-95. doi: 10.1128/AAC.02556-12. [PubMed: 23587960]. [PubMed Central: PMC3697384].
  • 8. Lin MF, Lin YY, Tu CC, Lan CY. Distribution of different efflux pump genes in clinical isolates of multidrug-resistant Acinetobacter baumannii and their correlation with antimicrobial resistance. J Microbiol Immunol Infect. 2017;50(2):224-31. doi: 10.1016/j.jmii.2015.04.004. [PubMed: 26055688].
  • 9. Fernando D, Zhanel G, Kumar A. Antibiotic resistance and expression of resistance-nodulation-division pump- and outer membrane porin-encoding genes in Acinetobacter species isolated from Canadian hospitals. Can J Infect Dis Med Microbiol. 2013;24(1):17-21. doi: 10.1155/2013/696043. [PubMed: 24421787]. [PubMed Central: PMC3630023].
  • 10. Bratu S, Landman D, Martin DA, Georgescu C, Quale J. Correlation of antimicrobial resistance with beta-lactamases, the OmpA-like porin, and efflux pumps in clinical isolates of Acinetobacter baumannii endemic to New York City. Antimicrob Agents Chemother. 2008;52(9):2999-3005. doi: 10.1128/AAC.01684-07. [PubMed: 18591275]. [PubMed Central: PMC2533509].
  • 11. Huang L, Sun L, Xu G, Xia T. Differential susceptibility to carbapenems due to the AdeABC efflux pump among nosocomial outbreak isolates of Acinetobacter baumannii in a Chinese hospital. Diagn Microbiol Infect Dis. 2008;62(3):326-32. doi: 10.1016/j.diagmicrobio.2008.06.008. [PubMed: 18687557].
  • 12. Lin L, Ling BD, Li XZ. Distribution of the multidrug efflux pump genes, adeABC, adeDE and adeIJK, and class 1 integron genes in multiple-antimicrobial-resistant clinical isolates of Acinetobacter baumannii-Acinetobacter calcoaceticus complex. Int J Antimicrob Agents. 2009;33(1):27-32. doi: 10.1016/j.ijantimicag.2008.06.027. [PubMed: 18790612].
  • 13. Ruzin A, Keeney D, Bradford PA. AdeABC multidrug efflux pump is associated with decreased susceptibility to tigecycline in Acinetobacter calcoaceticus-Acinetobacter baumannii complex. J Antimicrob Chemother. 2007;59(5):1001-4. doi: 10.1093/jac/dkm058. [PubMed: 17363424].
  • 14. Amoah Barnie P. Development of efflux pumps and inhibitors (EPIs) in A. baumanii. Clin Microbiol. 2014;3(1). doi: 10.4172/2327-5073.1000135.
  • 15. Bonnin RA, Nordmann P, Poirel L. Screening and deciphering antibiotic resistance in Acinetobacter baumannii: a state of the art. Expert Rev Anti Infect Ther. 2013;11(6):571-83. doi: 10.1586/eri.13.38. [PubMed: 23750729].
  • 16. Higgins PG, Wisplinghoff H, Stefanik D, Seifert H. Selection of topoisomerase mutations and overexpression of adeB mRNA transcripts during an outbreak of Acinetobacter baumannii. J Antimicrob Chemother. 2004;54(4):821-3. doi: 10.1093/jac/dkh427. [PubMed: 15355942].
  • 17. Wieczorek P, Sacha P, Hauschild T, Zorawski M, Krawczyk M, Tryniszewska E. Multidrug resistant Acinetobacter baumannii--the role of AdeABC (RND family) efflux pump in resistance to antibiotics. Folia Histochem Cytobiol. 2008;46(3):257-67. doi: 10.2478/v10042-008-0056-x. [PubMed: 19056528].
  • 18. Coyne S, Courvalin P, Perichon B. Efflux-mediated antibiotic resistance in Acinetobacter spp. Antimicrob Agents Chemother. 2011;55(3):947-53. doi: 10.1128/AAC.01388-10. [PubMed: 21173183]. [PubMed Central: PMC3067115].
  • 19. Magnet S, Courvalin P, Lambert T. Resistance-nodulation-cell division-type efflux pump involved in aminoglycoside resistance in Acinetobacter baumannii strain BM4454. Antimicrob Agents Chemother. 2001;45(12):3375-80. doi: 10.1128/AAC.45.12.3375-3380.2001. [PubMed: 11709311]. [PubMed Central: PMC90840].
  • 20. Vila J, Marti S, Sanchez-Cespedes J. Porins, efflux pumps and multidrug resistance in Acinetobacter baumannii. J Antimicrob Chemother. 2007;59(6):1210-5. doi: 10.1093/jac/dkl509. [PubMed: 17324960].
  • 21. Rosenfeld N, Bouchier C, Courvalin P, Perichon B. Expression of the resistance-nodulation-cell division pump AdeIJK in Acinetobacter baumannii is regulated by AdeN, a TetR-type regulator. Antimicrob Agents Chemother. 2012;56(5):2504-10. doi: 10.1128/AAC.06422-11. [PubMed: 22371895]. [PubMed Central: PMC3346617].
  • 22. Coyne S, Rosenfeld N, Lambert T, Courvalin P, Perichon B. Overexpression of resistance-nodulation-cell division pump AdeFGH confers multidrug resistance in Acinetobacter baumannii. Antimicrob Agents Chemother. 2010;54(10):4389-93. doi: 10.1128/AAC.00155-10. [PubMed: 20696879]. [PubMed Central: PMC2944555].
  • 23. Szejbach A, Mikucka A, Bogiel T, Gospodarek E. Usefulness of phenotypic and genotypic methods for metallo-beta-lactamases detection in carbapenem-resistant Acinetobacter baumannii strains. Med Sci Monit Basic Res. 2013;19:32-6. doi: 10.12659/MSMBR.883744. [PubMed: 23333953]. [PubMed Central: PMC3638691].
  • 24. Clinical and Laboratory Standards Institute (CLSI) . Performance standards for antimicrobial susceptibility testing. 21th information supplement. M100-S. Wayne PA: CLSI; 2016.
  • 25. Nowak J, Schneiders T, Seifert H, Higgins PG. The Asp20-to-Asn substitution in the response regulator AdeR leads to enhanced efflux activity of AdeB in Acinetobacter baumannii. Antimicrob Agents Chemother. 2016;60(2):1085-90. doi: 10.1128/AAC.02413-15. [PubMed: 26643347]. [PubMed Central: PMC4750716].
  • 26. De Gregorio E, Roscetto E, Iula VD, Martinucci M, Zarrilli R, Di Nocera PP, et al. Development of a real-time PCR assay for the rapid detection of Acinetobacter baumannii from whole blood samples. New Microbiol. 2015;38(2):251-7. [PubMed: 25938750].
  • 27. Owlia P, Azimi L, Gholami A, Asghari B, Lari AR. ESBL- and MBL-mediated resistance in Acinetobacter baumannii: a global threat to burn patients. Infez Med. 2012;20(3):182-7. [PubMed: 22992558].
  • 28. Fazeli H, Taraghian A, Kamali R, Poursina F, Nasr Esfahani B, Moghim S. Molecular identification and antimicrobial resistance profile of acinetobacter baumannii isolated from nosocomial infections of a teaching hospital in Isfahan, Iran. Avicenna J Clin Microb Infec. 2014;1(3). doi: 10.17795/ajcmi-21489.
  • 29. Zhao SY, Jiang DY, Xu PC, Zhang YK, Shi HF, Cao HL, et al. An investigation of drug-resistant Acinetobacter baumannii infections in a comprehensive hospital of East China. Ann Clin Microbiol Antimicrob. 2015;14:7. doi: 10.1186/s12941-015-0066-4. [PubMed: 25643932]. [PubMed Central: PMC4328433].
  • 30. Cortivo GD, Gutberlet A, Ferreira JA, Ferreira LE, Deglmann RC, Westphal GA, et al. Antimicrobial resistance profiles and oxacillinase genes in carbapenem-resistant Acinetobacter baumannii isolated from hospitalized patients in Santa Catarina, Brazil. Rev Soc Bras Med Trop. 2015;48(6):699-705. doi: 10.1590/0037-8682-0233-2015. [PubMed: 26676494].
  • 31. Deng M, Zhu MH, Li JJ, Bi S, Sheng ZK, Hu FS, et al. Molecular epidemiology and mechanisms of tigecycline resistance in clinical isolates of Acinetobacter baumannii from a Chinese university hospital. Antimicrob Agents Chemother. 2014;58(1):297-303. doi: 10.1128/AAC.01727-13. [PubMed: 24165187]. [PubMed Central: PMC3910737].
  • 32. Srinivasan VB, Rajamohan G, Pancholi P, Stevenson K, Tadesse D, Patchanee P, et al. Genetic relatedness and molecular characterization of multidrug resistant Acinetobacter baumannii isolated in central Ohio, USA. Ann Clin Microbiol Antimicrob. 2009;8:21. doi: 10.1186/1476-0711-8-21. [PubMed: 19531268]. [PubMed Central: PMC2705342].
  • 33. Ardebili A, Talebi M, Azimi L, Rastegar Lari A. Effect of efflux pump inhibitor carbonyl cyanide 3-chlorophenylhydrazone on the minimum inhibitory concentration of ciprofloxacin in Acinetobacter baumannii clinical isolates. Jundishapur J Microbiol. 2014;7(1). e8691. doi: 10.5812/jjm.8691. [PubMed: 25147654]. [PubMed Central: PMC4138672].
  • 34. Sun JR, Perng CL, Lin JC, Yang YS, Chan MC, Chang TY, et al. AdeRS combination codes differentiate the response to efflux pump inhibitors in tigecycline-resistant isolates of extensively drug-resistant Acinetobacter baumannii. Eur J Clin Microbiol Infect Dis. 2014;33(12):2141-7. doi: 10.1007/s10096-014-2179-7. [PubMed: 24939621].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments