TY - JOUR
TI - Large-scale WGS of carbapenem-resistant Acinetobacter baumannii isolates reveals patterns of dissemination of ST clades associated with antibiotic resistance.
AU - Frenk, Sammy
AU - Temkin, Elizabeth
AU - Lurie-Weinberger, Mor N.
AU - Keren-Paz, Alona
AU - Rov, Reut
AU - Rakovitsky, Nadya
AU - Wullfhart, Liat
AU - Nutman, Amir
AU - Daikos, George L.
AU - Skiada, Anna
AU - Durante-Mangoni, Emanuele
AU - Dishon Benattar, Yael
AU - Bitterman, Roni
AU - Yahav, Dafna
AU - Daitch, Vered
AU - Bernardo, Mariano
AU - Iossa, Domenico
AU - Zusman, Oren
AU - Friberg, Lena E.
AU - Mouton, Johan W.
AU - Theuretzbacher, Ursula
AU - Leibovici, Leonard
AU - Geffen, Yuval
AU - Gershon, Rina
AU - Paul, Mical
AU - Carmeli, Yehuda
JO - The Journal of antimicrobial chemotherapy
PY - 2022
VL - null
TODO - null
SP - dkac010
PB - 
SN - null
TODO - 10.1093/jac/dkac010
TODO - null
TODO - OBJECTIVES: To describe the population genetics and antibiotic resistance gene distribution of carbapenem-resistant Acinetobacter baumannii (CRAB) isolates causing  infections in three Mediterranean countries. METHODS: Isolates were collected during  the 2013-17 AIDA clinical trial in six hospitals in Israel, Greece and Italy. WGS,  bioinformatic characterization and antibiotic resistance profiling were performed.  RESULTS: In the 247 CRAB isolates characterized in this study, ST distribution  varied by country: 29/31 (93.5%) Greek isolates, 34/41 (82.9%) Italian isolates and  70/175 (40.0%) Israeli isolates belonged to ST2. The identified ST2 isolates  included eight distinct clades: 2C, 2D and 2H were significantly more common in  Italy, while 2F was unique to Greece. The uncommon ST3 was not present among Greek  isolates and constituted only 5/41 (12%) Italian isolates. On the other hand, it was  much more common among Israeli isolates: 78/175 (44.6%) belonged to ST3. The vast  majority of isolates, 240/247 (97.2%), were found to harbour acquired  carbapenemases, primarily blaOXA-23. The chromosomal oxaAb (blaOXA-51-like) and ampC  genes characteristic of this organism were also ubiquitous. Most (96.4%) ST3  isolates carried a broad-host-range plasmid IncP1α. CONCLUSIONS: The geographical  differences in CRAB populations support the theory that clonal spread of CRAB leads  to endemicity in hospitals and regions. The close association between antibiotic  resistance genes and clades, and between plasmids and STs, suggest that de novo  creation of MDR A. baumannii is rare. The clustering of antibiotic resistance genes  and plasmids that is unique to each clade/ST, and nearly uniform within clades/STs,  suggests that horizontal transmission is rare but crucial to the clade’s/ST’s  success.
ER -