The clinical features and genomic epidemiology of carbapenem-resistant Acinetobacter baumannii infections at a tertiary hospital in Vietnam

Diep, Duong Thi Hong; Tuấn, Huỳnh Minh; Ngoc, Kha My; Vinh, Chau; Dung, Trần Thị Ngọc; Phat, Voong Vinh; Nguyen, Quynh; Tam, Dong Thi Hoai; Niên, Lâm Vĩnh; Duyen, Bui Thi Hanh; Phung, Cao Thi; Bac, Nguyen Hoang; Tran, Tuan Diep; Thwaites, Guy; Rabaa, Maia A.; Thanh, Duy Pham

doi:10.1016/j.jgar.2023.04.007

Cited by 5 publications

(5 citation statements)

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“…Several risk factors enhance the likelihood of CRAB carriers during pregnancy, aligning with findings from the general population ( Alsultan et al, 2013 ; Ren et al, 2019 ; Diep et al, 2023 ). AMA has previously been shown to increase the risk of adverse pregnancy outcomes, maternal death, and maternal complications, such as GDM ( Alsultan et al, 2013 ; Laopaiboon et al, 2014 ; Fink et al, 2023 ), and was suggested as an independent risk factor for CRAB carriers.…”

Section: Discussionsupporting

confidence: 69%

“…As a pivotal pathogen of global concern, carbapenem-resistant Acinetobacter baumannii (CRAB) is intrinsically linked with severe, sometimes fatal, infections, prompting wide-ranging epidemiological research ( Li et al, 2020 ; Cavallo et al, 2023 ; Diep et al, 2023 ). Efforts to understand and track the epidemiology of AB have employed a variety of genotyping methods, revealing the pathogen’s sophisticated population dynamics.…”

Section: Introductionmentioning

confidence: 99%

“…Efforts to understand and track the epidemiology of AB have employed a variety of genotyping methods, revealing the pathogen’s sophisticated population dynamics. This includes exploring virulence traits such as capsular polysaccharide (KL) and the lipooligosaccharide outer core (OCL), which are substantively connected to AB’s pathogenic properties ( Deng et al, 2020 ; Li et al, 2020 ; Diep et al, 2023 ). The technological progress in whole-genome sequencing (WGS) has enriched genotyping capabilities, enabling more nuanced analysis through core genome multilocus sequence typing (cgMLST) or single nucleotide typing (SNP) for detailed typing and evolutionary studies.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors and genetic characteristics of the carriage of hypervirulent and carbapenem-resistant Acinetobacter baumannii among pregnant women

Zheng,

Li,

Wang

et al. 2024

Front. Microbiol.

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BackgroundCarbapenem-resistant Acinetobacter baumannii (CRAB) and its emerging evolutionary branch toward hypervirulence have been neglected in pregnancy.MethodsFrom September 2020 to August 2021, an active surveillance culture program encompassed 138 randomly selected pregnant women, with five subjected to sample collection at two different time points. The clinical characterization was explored through statistical analysis. Whole-genome sequencing, a Galleria mellonella infection model, and a global database were used to investigate the genetic characterization, pathogenicity, evolutionary history, and phylogenetic relationships of the isolates.ResultsOf the 41 CRAB isolates obtained, they were divided into four ClustersRS and an orphan pattern. ClusterRS 1 (n = 31), with eight complex types in pregnancy, was also the dominant ClusterRS globally, followed by ClusterRS 13 (n = 5), identified as hypervirulent KL49 CRAB, exhibiting phylogeographical specificity to Guangdong. A maternal carriage CRAB rate of 26.09% (36/138) was revealed, with half of the isolates representing novel complex types, prominently including CT3071, as the first KL7 isolates identified in Shenzhen. Both KL49 and KL7 isolates were most commonly found in the same participant, suggesting potential intraspecific competition as a possible reason for CRAB infection without carriers during pregnancy. The independent risk factors for carriers were revealed for the first time, including advanced maternal age, gestational diabetes mellitus, and Group B Streptococcus infection.ConclusionThe significant carriage rate and enhanced virulence of CRAB during pregnancy emphasize the imperative for routine surveillance to forestall dissemination within this high-risk group, especially in Guangdong for ClusterRS 13 isolates.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors and genetic characteristics of the carriage of hypervirulent and carbapenem-resistant Acinetobacter baumannii among pregnant women

Zheng,

Li,

Wang

et al. 2024

Front. Microbiol.

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“…Infections caused by A. baumannii are associated with a notably high mortality rate, with an overall in-hospital mortality rate reaching 56%. 6 …”

Section: Introductionmentioning

confidence: 99%

“…Infections caused by A. baumannii are associated with a notably high mortality rate, with an overall in-hospital mortality rate reaching 56%. 6 A key factor to its success is the adaptable genome, rapidly mutating in response to stress, enabling its persistence in challenging environments, especially within healthcare settings. 7,8 The mechanisms of antimicrobial resistance primarily involve the regulation of antibiotic transport through bacterial membranes, alterations in antibiotic target sites, and enzyme modifications that result in the neutralization of antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of a Carbapenem-Resistant Acinetobacter baumannii Strain Causing Community-Acquired Pneumonia in a Young Healthy Women

Chen,

Xu,

Wang

2023

IDR

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Background Multidrug-resistant Acinetobacter baumannii rarely causes community-acquired pneumonia. Here, we report the clinical and genomic characteristics of a multidrug-resistant A. baumannii strain responsible for community-acquired pneumonia in a 31-year-old healthy young women. Methods A. baumannii strain W2LL was recovered from the alveolar lavage fluid sample of a hospitalized patient with pulmonary infection. Growth rate studies were conducted under various conditions, and virulence assessments were performed using Galleria Mellonella larvae. Whole Genome Sequencing (WGS) was carried out using Oxford Nanopore MinIon and Illumina HiSeq. In silico multilocus sequence typing (MLST), plasmid replicons, antimicrobial resistance genes, and virulence genes were determined using the BacWGSTdb webserver. Phylogenetic analysis between strain W2LL and other closely related A. baumannii genomes retrieved from NCBI database was performed. Results WGS identified strain W2LL as a rare sporadic lineage sequence type (ST) 1431. In addition to the detection of the β-lactamase gene ( bla OXA-98 ) on the chromosome, bla OXA-58 was found on a 92,034 bp plasmid. Antimicrobial susceptibility testing revealed this strain was resistant to cephalosporins and carbapenems, with initial treatment using cefoxitin proving ineffective. Subsequent treatment with piperacillin-sulbactam combined with levofloxacin led to gradual improvement. Compared to A. baumannii ATCC 17978, W2LL exhibited similar growth rates at 37°C and 42°C, as well as in the presence of zinc. However, strain W2LL exhibited higher virulence phenotype compared to ATCC 17978 in G. mellonella model. The closest relative of A. baumannii W2LL was CAM180_1, another isolate recovered from Cambodia, which differed by 191 SNPs. Conclusion W2LL is a rare ST1431 carbapenem-resistant A. baumannii strain recovered from a patient with no prior hospitalization or typical risk factors. This underscores the growing menace posed by carbapenem-resistant A. baumannii , no longer limited to hospitalized patients, potentially impacting the broader, younger population.

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Genomic epidemiology and resistant genes of Acinetobacter baumannii clinical strains in Vietnamese hospitals

Ha,

Huy,

Đac

et al. 2024

Journal of Medical Microbiology

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Introduction. Acinetobacter baumannii is a common cause of multidrug-resistant (MDR) nosocomial infections worldwide, including Vietnam. Hypothesis. Analysis of crucial genetic factors may link to epidemiological characteristics and antibiotic resistance of A. baumannii clinical strains in Vietnamese hospitals. Methodology. Fifty-one A. baumannii clinical strains from six different tertiary hospitals in Vietnam were analysed using whole genome sequencing (WGS), between 2017 and 2019. Results. Eleven sequence types (STs) were identified, including four STs reported for the first time in Vietnam based on the PubMLST database and three new STs not previously documented. ST1336, ST1260 and ST575 were found exclusively in Vietnam. These STs were widely distributed in all hospitals in Vietnam, with ST2 and ST571 being the most dominant. Resistant rates to eight antibiotics, belonging to four antibiotic groups, were very high (72.5–94.1 %) with high MIC values, while resistance to colistin was 29.4%. Fifty-one isolates were identified as MDR, with 100% (51/51) isolates carrying antimicrobial-resistant (AMR) genes, and 52 antibiotic-resistant genes were detected among these strains, including β-lactam (22 genes), chloramphenicol (5 genes), lincosamide (2 genes), aminoglycoside (11 genes), rifampicin (1 gene), quinolone (2 genes), sulfonamide and trimethoprim (4 genes) and tetracycline (5 genes) resistance. The most commonly found mobile structures carried partial or complete transposons: ISaba24/ISEc29/ISEc35 contains a series of antibiotic-resistant genes. Conclusion. The WGS results of the 51 strains of A. baumannii provided important information regarding the distribution of STs and associated antibiotic-resistant genes among A. baumannii strains.

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The clinical features and genomic epidemiology of carbapenem-resistant Acinetobacter baumannii infections at a tertiary hospital in Vietnam

Cited by 5 publications

References 51 publications

Risk factors and genetic characteristics of the carriage of hypervirulent and carbapenem-resistant Acinetobacter baumannii among pregnant women

Risk factors and genetic characteristics of the carriage of hypervirulent and carbapenem-resistant Acinetobacter baumannii among pregnant women

Characteristics of a Carbapenem-Resistant Acinetobacter baumannii Strain Causing Community-Acquired Pneumonia in a Young Healthy Women

Genomic epidemiology and resistant genes of Acinetobacter baumannii clinical strains in Vietnamese hospitals

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