Journal of global antimicrobial resistance · 2025
Genomic insights of the co-existence of blaOXA-23, blaOXA-91, blaNDM-1 harboring carbapenem-resistant Acinetobacter Baumannii isolates from the intensive care units environment in Shanghai.
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Wang Xiao, Zhao Bing, Zhou Yuqing, Zhang Yue, Xu Tongsheng, Zhuang Yuan, Chen Min, Hao Lipeng, Shen Yifeng, Feng Jun
Аннотация
OBJECTIVES: This study assessed the transmission, prevalence and genomic characteristics of carbapenem-resistant Acinetobacter Baumannii (CARB) isolated from object surfaces and healthcare workers' hands in seven hospitals of Shanghai in 2019 (pre-COVID pandemic) and 2023 (post-COVID pandemic).
METHODS: CRAB isolates were tested for antimicrobial susceptibility using the broth microdilution method and whole-genome sequencing. Antimicrobial resistance genes, Multilocus Sequence Typing (MLST), polysaccharide capsule and plasmid migration were evaluated based on tools such as VFDB database, PubMLST, Kaptive, MOB-suite, etc. RESULTS: Of 3,156 samples collected, 130 strains of CRAB were isolated. The prevalence of CRAB in the ICU setting was significantly lower in 2023 (2.44%) than in 2019 (5.60%). Objects that come into direct contact with patients served as a primary source (43.85%). CRAB isolates exhibited higher resistance to β-lactamase antibiotics but lower to minocycline (2.31%), tigecycline (3.08%) and polymyxin B (2.31%). Five ST_Pasteur and eleven ST_Oxford were identified, predominantly ST2_Pasteur (93.6%) and ST208_Oxford (40%). Two novel sequence types (STs) named ST3329 and ST3331 were found in the surface of objects such as door handles. Notably, two CARB isolates (designated 2023-AB023 and 2023-AB033) co-harboring the blaOXA-23, blaOXA-91, blaNDM-1 were found to be high genomic similarity to DETAB-R21 previously isolated from an ICU patient's oral swab with high environmental adaptability, reported in August 2022 in Zhejiang Province of China.
CONCLUSIONS: The resistance rate of CRAB was slightly lower in 2023 compared to 2019. However, the emergence of pan-drug-resistant CRAB, along with the coexistence of carbapenemase-producing strains (OXA-23, OXA-51-like, and NDM-1) in 2023, underscore the dynamic progression of antimicrobial resistance (AMR) in this pathogen. These findings suggest a potential epidemiological shift characterized by clonal diversification alongside persistent carbapenemase-driven resistance mechanisms.
METHODS: CRAB isolates were tested for antimicrobial susceptibility using the broth microdilution method and whole-genome sequencing. Antimicrobial resistance genes, Multilocus Sequence Typing (MLST), polysaccharide capsule and plasmid migration were evaluated based on tools such as VFDB database, PubMLST, Kaptive, MOB-suite, etc. RESULTS: Of 3,156 samples collected, 130 strains of CRAB were isolated. The prevalence of CRAB in the ICU setting was significantly lower in 2023 (2.44%) than in 2019 (5.60%). Objects that come into direct contact with patients served as a primary source (43.85%). CRAB isolates exhibited higher resistance to β-lactamase antibiotics but lower to minocycline (2.31%), tigecycline (3.08%) and polymyxin B (2.31%). Five ST_Pasteur and eleven ST_Oxford were identified, predominantly ST2_Pasteur (93.6%) and ST208_Oxford (40%). Two novel sequence types (STs) named ST3329 and ST3331 were found in the surface of objects such as door handles. Notably, two CARB isolates (designated 2023-AB023 and 2023-AB033) co-harboring the blaOXA-23, blaOXA-91, blaNDM-1 were found to be high genomic similarity to DETAB-R21 previously isolated from an ICU patient's oral swab with high environmental adaptability, reported in August 2022 in Zhejiang Province of China.
CONCLUSIONS: The resistance rate of CRAB was slightly lower in 2023 compared to 2019. However, the emergence of pan-drug-resistant CRAB, along with the coexistence of carbapenemase-producing strains (OXA-23, OXA-51-like, and NDM-1) in 2023, underscore the dynamic progression of antimicrobial resistance (AMR) in this pathogen. These findings suggest a potential epidemiological shift characterized by clonal diversification alongside persistent carbapenemase-driven resistance mechanisms.