Bacterial Community and Genomic Analysis of Carbapenem-Resistant Acinetobacter baumannii Isolates from the Environment of a Health Care Facility in the Western Region of Saudi Arabia

Abstract

The escalating transmission of hospital-acquired infections, especially those due to antimicrobial-resistant bacteria, is a major health challenge worldwide. In this study, a culturomic analysis of bacterial community in a tertiary care hospital in the western region of Saudi Arabia is performed using environmental samples. The genome sequencing of four Acinetobacter baumannii was performed on isolates recovered from an intensive care unit (ICU) environment and clinical samples. A total of 361 bacterial isolates from surface and air samples were identified by MALDI-TOF technique or 16S rRNA gene sequencing. The isolates were classified into 70 distinct species, including ESKAPE pathogens. Resistance in Gram-positive isolates was mainly found to be against benzylpenicillin, azithromycin, ampicillin, and trimethoprim/sulfamethoxazole. Carbapenem- and multidrug-resistant isolates of A. baumannii and Klebsiella pneumonia were found on the ICU surfaces. Genome sequencing revealed that the carbapenem-resistant A. baumannii isolate from ICU environment was linked with those of clinical origin. The isolate Ab133-HEnv was classified as a novel sequence type (ST2528) based on a new allele of Oxf_gdhB-286. Three beta-lactam-antibiotic-resistance genes, blaADC-25, blaOXA-23, and blaOXA-66, were found in most of the analyzed genomes. Collectively, the results of this study highlight the spread of antimicrobial-resistant nosocomial pathogens in a health care facility in Saudi Arabia.

Acinetobacter baumannii

“…A few researchers obtained 361 isolates from environmental surfaces and patients at King Abdulaziz University Hospital in Jeddah in 2015 and conducted a genomic analysis to determine the distribution of resistance genes across bacterial strains. 57 The analysis found similarities between A. baumannii strains obtained from the environment and those from clinical settings. Most of the isolated strains expressed the resistance genes blaOXA-66, blaADC-25, as well as blaOXA-23.…”

“…Most of the isolated strains expressed the resistance genes blaOXA-66, blaADC-25, as well as blaOXA-23. 57 The findings highlighted the significance of the environmental spread of multidrug-resistant strains of A. baumannii in the hospital setting. In a 2018 study, 6840 samples collected from patients in a tertiary facility in Al Madinah Al Munawwarah were screened for Acinetobacter to determine antimicrobial resistance patterns.…”