Species identification and molecular characterization of Acinetobacter spp. blood culture isolates from Norway

Objectives: The study investigated the species distribution, antibiotic susceptibility patterns and genotypic resistance characteristics of 113 consecutive blood culture isolates of Acinetobacter species collected between 2005 and 2007 throughout Norway. Methods: Species identification was performed by partial rpoB sequence analysis, and verified by 16S rDNA and recA sequence analyses. Susceptibility testing was performed by agar disc diffusion and Etest. Distribution of OXA carbapenemase genes and epidemic clonality of Acinetobacter baumannii isolates were detected by PCR assays. Analyses of blaOXA-51-like variants and quinolone resistance-determining regions (QRDRs) were done by sequencing. Results: The most prevalent species in the collection were Acinetobacter genomic species (gen. sp.) 13TU (46.9%) and Acinetobacter gen. sp. 3 (19.5%), followed by A. baumannii (8.8%) and Acinetobacter lwoffii/Acinetobacter gen. sp. 9 (7.1%). Carbapenem resistance was observed in one blaOXA-23-like-positive A. baumannii isolate. Quinolone resistance was detected in five isolates from the Acinetobacter calcoaceticus-A. baumannii complex, of which two had point mutations in the QRDRs, including one novel ParC mutation. None of the A. baumannii isolates belonged to European/international clones I, II or III. Six blaOXA-51-like variants, including two novel variants, were identified. Conclusions: Acinetobacter gen. sp. 13TU and Acinetobacter gen. sp. 3 were predominant in Norwegian blood cultures, in contrast to in other countries where A. baumannii has dominated. The study demonstrated the importance of genotypic identification to determine the exact epidemiology of non-baumannii Acinetobacter species.