Abstract
Acinetobacter baumannii is a nosocomial pathogen that frequently causes healthcare-acquired infections. The global spread of multidrug-resistant (MDR) strains with its ability to survive in the environment for extended periods imposes a pressing public health threat. Two MDR A. baumannii outbreaks occurred in 2012 and 2014 in a companion animal intensive care unit (caICU) in the Netherlands. Whole-genome sequencing (WGS) was performed on dog clinical isolates (n = 6), environmental isolates (n = 5), and human reference strains (n = 3) to investigate if the isolates of the two outbreaks were related. All clinical isolates shared identical resistance phenotypes displaying multidrug resistance. Multi-locus Sequence Typing (MLST) revealed that all clinical isolates belonged to sequence type ST2. The core genome MLST (cgMLST) results confirmed that the isolates of the two outbreaks were not related. Comparative genome analysis showed that the outbreak isolates contained different gene contents, including mobile genetic elements associated with antimicrobial resistance genes (ARGs). The time-measured phylogenetic reconstruction revealed that the outbreak isolates diverged approximately 30 years before 2014. Our study shows the importance of WGS analyses combined with molecular clock investigations to reduce transmission of MDR A. baumannii infections in companion animal clinics.
Highlights
Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen commonly associated with nosocomial infections and poses a critical threat in healthcare settings
The Multi-locus Sequence Typing (MLST) analysis using the Pasteur scheme revealed that all outbreak isolates and one surface isolate from the ICU treatment table belonged to the same sequence type (ST2)
antimicrobial susceptibility tests (ASTs) results can be found in Supplementary Table S1, and the epidemiological features of the two outbreaks are visualized in Supplementary Figure S1
Summary
Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen commonly associated with nosocomial infections and poses a critical threat in healthcare settings. A. baumannii has an 86-kb resistance island carrying 45 different genes associated with antimicrobial resistance [9], and its propensity to rapidly acquire resistance genes from other bacterial species and develop resistance during the middle of treatment may limit therapeutic options [10]. This threat prompted the World Health Organization (WHO) to prioritize the research and development pipelines to discover new antimicrobials for carbapenem-resistant A. baumannii in 2017 [11]
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