Abstract:
Background: Multidrug-resistant Gram-negative bacterial infections are recognized as one of the major threats to
global health. In this study, we describe for the first time blaNDM-1 gene carrying organisms from Ethiopia consisting
of three Acinetobacter baumannii isolates from patients in Jimma.
Methods: Besides phenotypic antimicrobial susceptibility testing, molecular strain typing and sequencing was
performed to describe the phylogenetic relation of the Ethiopian isolates in detail in relation to published isolates
from all over the globe.
Results and discussion: Three multi-resistant, blaNDM-1-positive Acinetobacter baumannii isolates, most likely a local
clonal diffusion, were isolated. Two of the three isolates described within this study were untreatable with the
locally available antimicrobials and were only susceptible to polymyxin B and amikacin. The genome sequences
confirmed the isolates to be distinct from the outbreak strains reported from Kenya, the only other characterized
blaNDM-1 positive Acinetobacter baumannii strains in East Africa so far. Up to date, no other bacterial species were
found to harbour the gene cassette in Jimma and conjugation to E. coli was not successful under laboratory
conditions. However, natural transmission to other bacteria seems likely, given the evident lack of hygienic
precautions due to limited resource settings.
Conclusions: The detected isolates could solely be the tip of the iceberg regarding the presence of NDM-1
producing organisms in the region, as only a limited number of bacterial isolates were evaluated so far and until
recently, susceptibility testing and isolation of bacteria could hardly be performed in clinical patient care. These
multi-drug resistant organisms pose a serious threat to antimicrobial treatments in Jimma, Ethiopia.
