Wide Dissemination of GES-Type Carbapenemases in Acinetobacter baumannii Isolates in Kuwait

Acinetobacter baumannii is an opportunistic pathogen that is an important source of nosocomial infections. Production of ex-tended-spectrum -lactamases (ESBLs) of the GES type in A. baumannii has been increasingly reported, and some of these GES-type enzymes possess some carbapenemase activity. Our aim was to analyze the resistance determinants and the clonal relation-ships of carbapenem-nonsusceptible A. baumannii clinical isolates recovered from hospitals in Kuwait. A total of 63 isolates were analyzed, and all were found to be positive for blaGES-type genes. One isolate harbored the blaGES-14 gene encoding an ESBL with significant carbapenemase activity, whereas the other isolates harbored the blaGES-11 ESBL gene. Thirty-three isolates cohar-bored the blaOXA-23 and blaGES-11 genes. Analyses of the genetic locations indicated that the blaGES-11/-14 genes were plasmid lo-cated. It is noteworthy that the blaOXA-23 and blaGES-11 genes were colocated onto a single plasmid. Nine different pulsotypes were observed among the 63 isolates. This study showed the emergence of GES-type ESBLs in A. baumannii in Kuwait, further suggesting that the Middle East region might be a reservoir for carbapenemase-producing A. baumannii. Acinetobacter baumannii is an opportunistic pathogen that is animportant causative agent of nosocomial infections, such as pneumonia, septicemia, urinary tract infections, and wound in-fections (1).Multidrug-resistant (MDR)A. baumannii isolates are increasingly reported worldwide and are often a source of noso-comial infections. Treatment of infections due to this microor