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. 2023 May 12:16:2939-2952.
doi: 10.2147/IDR.S407577. eCollection 2023.

Genomic Determinants of Pathogenicity and Antimicrobial Resistance of Nosocomial Acinetobacter baumannii Clinical Isolates of Hospitalized Patients (2019-2021) from a Sentinel Hospital in Hangzhou, China

Chenxing Wei #  1 , Jian Chen #  1 , Tanveer Muhammad Anwar #  2 , Lingling Huang  1 , Wenjie Yang  3 , Xueyan Dong  1 , Qiong Chen  1 , Min Yue  2   4   5 , Daojun Yu  1   3
Affiliations

Genomic Determinants of Pathogenicity and Antimicrobial Resistance of Nosocomial Acinetobacter baumannii Clinical Isolates of Hospitalized Patients (2019-2021) from a Sentinel Hospital in Hangzhou, China

Chenxing Wei et al. Infect Drug Resist. .

Abstract

Purpose: Acinetobacter baumannii (A. baumannii or AB) is one of the most opportunistic, nosocomial pathogens threatening public healthcare across countries. A. baumannii has become a primary growing concern due to its exceptional ability to acquire antimicrobial resistance (AMR) to multiple antimicrobial agents which is increasingly reported and more prevalent every year. Therefore, there is an urgent need to evaluate the AMR knowledge of A. baumannii for effective clinical treatment of nosocomial infections. This study aimed to investigate the clinical distribution AMR phenotypes and genotypes, and genomic characteristics of A. baumannii isolates recovered from hospitalized patients of different clinical departments of a sentinel hospital to improve clinical practices.

Methods: A total of 123 clinical isolates were recovered from hospitalized patients of different clinical departments during 2019-2021 to analyze AMR patterns, and further subjected to whole-genome sequencing (WGS) investigations. Multi-locus sequence typing (MLST), as well as the presence of antimicrobial-resistant genes (ARGs), virulence factor genes (VFGs) and insertion sequences (ISs) were also investigated from WGS data.

Results: The results highlighted that A. baumannii clinical isolates had shown a high AMR rate, particularly from the intensive care unit (ICU), towards routinely used antimicrobials, ie, β-lactams and fluoroquinolones. ST2 was the most prevalent ST in the clinical isolates, it was strongly associated to the resistance of cephalosporins and carbapenems, with blaOXA-23 and blaOXA-66 being the most frequent determinants; moreover, high carrier rate of VFGs was also observed such as all strains containing the ompA, adeF, pgaC, lpsB, and bfmR genes.

Conclusion: Acinetobacter baumannii clinical isolates are mostly ST2 with high rates of drug resistance and carrier of virulence factors. Therefore, it requires measurements to control its transmission and infection.

Keywords: Acinetobacter baumannii; antimicrobial resistance; genetic determinants; virulence factors; whole-genome sequencing.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of antimicrobial resistance (AMR) pattern of 123 Acinetobacter baumannii clinical isolates.
Figure 2
Figure 2
The presence of antimicrobial resistance genes (ARGs) of 123 Acinetobacter baumannii clinical isolates.
Figure 3
Figure 3
Multi-locus sequence typing (MLST) and minimum spanning tree (MST) population analysis of 123 Acinetobacter baumannii clinical isolates from the different clinical departments.
Figure 4
Figure 4
Comparison of antimicrobial resistance phenotypes and genotypes, STs and VFGs between isolates from different clinical departments.
Figure 5
Figure 5
Phylogenetic analysis and heat map of the detection of ARGs and VFGs among the 123 Acinetobacter baumannii clinical isolates.
See this image and copyright information in PMC

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