Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak

ABSTRACT Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important opportunistic pathogen linked to a variety of nosocomial infections and hospital outbreaks worldwide. This study aimed at investigating and characterizing a CRAB outbreak at a large tertiary hospital in Lebanon. A total of...

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Autores principales:	Ghiwa Makke, Ibrahim Bitar, Tamara Salloum, Balig Panossian, Sahar Alousi, Harout Arabaghian, Matej Medvecky, Jaroslav Hrabak, Samar Merheb-Ghoussoub, Sima Tokajian
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2020
Materias:	A. baumannii CRAB Tn2006 pMAL-1 hospital outbreak Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/e8c96e8a1ae2466cb5bcf362cf77a27c
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spelling	oai:doaj.org-article:e8c96e8a1ae2466cb5bcf362cf77a27c2021-11-15T15:27:53ZWhole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak10.1128/mSphere.00934-192379-5042https://doaj.org/article/e8c96e8a1ae2466cb5bcf362cf77a27c2020-02-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00934-19https://doaj.org/toc/2379-5042ABSTRACT Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important opportunistic pathogen linked to a variety of nosocomial infections and hospital outbreaks worldwide. This study aimed at investigating and characterizing a CRAB outbreak at a large tertiary hospital in Lebanon. A total of 41 isolates were collected and analyzed using pulsed-field gel electrophoresis (PFGE). Whole-genome sequencing (WGS) was performed on all the isolates, and long-read PacBio sequencing was used to generate reference genomes. The multilocus sequence types (MLST), repertoire of resistance genes, and virulence factors were determined from the sequencing data. The plasmid content was analyzed both in silico and using the A. baumannii PCR-based replicon typing (AB-PBRT) method. Genome analysis initially revealed two clones, one carrying blaOXA-23 on Tn2006 (ST-1305, ST-195, and ST-218) and another carrying blaOXA-72 on pMAL-1 (ST-502 and ST-2059, a new ST), with the latter having two subclones, as revealed using the Bayesian transmission network. All isolates were extensively drug resistant (XDR). WGS analysis revealed the transmission pathways and demonstrated the diversity of CRAB isolates and mobile genetic elements in this health care setting. Outbreak detection using WGS and immediate implementation of infection control measures contribute to restraining the spread and decreasing mortality. IMPORTANCE Carbapenem-resistant Acinetobacter baumannii (CRAB) has been implicated in hospital outbreaks worldwide. Here, we present a whole-genome-based investigation of an extensively drug-resistant CRAB outbreak rapidly spreading and causing high incidences of mortality at numerous wards of a large tertiary hospital in Lebanon. This is the first study of its kind in the region. Two circulating clones were identified using a combination of molecular typing approaches, short- and long-read sequencing and Bayesian transmission network analysis. One clone carried blaOXA-23 on Tn2006 (ST-1305, ST-195, and ST-218), and another carried blaOXA-72 on a pMAL-1 plasmid (ST-502 and ST-2059, a new ST). A pMAL-2 plasmid was circulating between the two clones. The approaches implemented in this study and the obtained findings facilitate the tracking of outbreak scenarios in Lebanon and the region at large.Ghiwa MakkeIbrahim BitarTamara SalloumBalig PanossianSahar AlousiHarout ArabaghianMatej MedveckyJaroslav HrabakSamar Merheb-GhoussoubSima TokajianAmerican Society for MicrobiologyarticleA. baumanniiCRABTn2006pMAL-1hospital outbreakMicrobiologyQR1-502ENmSphere, Vol 5, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	A. baumannii CRAB Tn2006 pMAL-1 hospital outbreak Microbiology QR1-502
spellingShingle	A. baumannii CRAB Tn2006 pMAL-1 hospital outbreak Microbiology QR1-502 Ghiwa Makke Ibrahim Bitar Tamara Salloum Balig Panossian Sahar Alousi Harout Arabaghian Matej Medvecky Jaroslav Hrabak Samar Merheb-Ghoussoub Sima Tokajian Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak
description	ABSTRACT Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important opportunistic pathogen linked to a variety of nosocomial infections and hospital outbreaks worldwide. This study aimed at investigating and characterizing a CRAB outbreak at a large tertiary hospital in Lebanon. A total of 41 isolates were collected and analyzed using pulsed-field gel electrophoresis (PFGE). Whole-genome sequencing (WGS) was performed on all the isolates, and long-read PacBio sequencing was used to generate reference genomes. The multilocus sequence types (MLST), repertoire of resistance genes, and virulence factors were determined from the sequencing data. The plasmid content was analyzed both in silico and using the A. baumannii PCR-based replicon typing (AB-PBRT) method. Genome analysis initially revealed two clones, one carrying blaOXA-23 on Tn2006 (ST-1305, ST-195, and ST-218) and another carrying blaOXA-72 on pMAL-1 (ST-502 and ST-2059, a new ST), with the latter having two subclones, as revealed using the Bayesian transmission network. All isolates were extensively drug resistant (XDR). WGS analysis revealed the transmission pathways and demonstrated the diversity of CRAB isolates and mobile genetic elements in this health care setting. Outbreak detection using WGS and immediate implementation of infection control measures contribute to restraining the spread and decreasing mortality. IMPORTANCE Carbapenem-resistant Acinetobacter baumannii (CRAB) has been implicated in hospital outbreaks worldwide. Here, we present a whole-genome-based investigation of an extensively drug-resistant CRAB outbreak rapidly spreading and causing high incidences of mortality at numerous wards of a large tertiary hospital in Lebanon. This is the first study of its kind in the region. Two circulating clones were identified using a combination of molecular typing approaches, short- and long-read sequencing and Bayesian transmission network analysis. One clone carried blaOXA-23 on Tn2006 (ST-1305, ST-195, and ST-218), and another carried blaOXA-72 on a pMAL-1 plasmid (ST-502 and ST-2059, a new ST). A pMAL-2 plasmid was circulating between the two clones. The approaches implemented in this study and the obtained findings facilitate the tracking of outbreak scenarios in Lebanon and the region at large.
format	article
author	Ghiwa Makke Ibrahim Bitar Tamara Salloum Balig Panossian Sahar Alousi Harout Arabaghian Matej Medvecky Jaroslav Hrabak Samar Merheb-Ghoussoub Sima Tokajian
author_facet	Ghiwa Makke Ibrahim Bitar Tamara Salloum Balig Panossian Sahar Alousi Harout Arabaghian Matej Medvecky Jaroslav Hrabak Samar Merheb-Ghoussoub Sima Tokajian
author_sort	Ghiwa Makke
title	Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak
title_short	Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak
title_full	Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak
title_fullStr	Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak
title_full_unstemmed	Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak
title_sort	whole-genome-sequence-based characterization of extensively drug-resistant <named-content content-type="genus-species">acinetobacter baumannii</named-content> hospital outbreak
publisher	American Society for Microbiology
publishDate	2020
url	https://doaj.org/article/e8c96e8a1ae2466cb5bcf362cf77a27c
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Whole-Genome-Sequence-Based Characterization of Extensively Drug-Resistant <named-content content-type="genus-species">Acinetobacter baumannii</named-content> Hospital Outbreak

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