Molecular Epidemiology of Carbapenem-Resistant Acinetobacter baumannii Strains Isolated at the German Military Field Laboratory in Mazar-e Sharif, Afghanistan

Abstract

The study was performed to provide an overview of the molecular epidemiology of carbapenem-resistant Acinetobacter baumannii in Afghanistan isolated by the German military medical service during the Afghanistan conflict. A total of 18 isolates were collected between 2012 and 2018 at the microbiological laboratory of the field hospital in Camp Marmal near Mazar-e Sharif, Afghanistan, from Afghan patients. The isolates were subjected to phenotypic and genotypic differentiation and antimicrobial susceptibility testing as well as to a core genome multi-locus sequence typing (cgMLST) approach based on whole-genome next-generation sequence (wgNGS) data. Next to several sporadic isolates, four transmission clusters comprising strains from the international clonal lineages IC1, IC2, and IC9 were identified. Acquired carbapenem resistance was due to blaOXA-23 in 17/18 isolates, while genes mediating resistance against sulfonamides, macrolides, tetracyclines, and aminoglycosides were frequently identified as well. In conclusion, the assessment confirmed both the frequent occurrence of A. baumannii associated with outbreak events and a variety of different clones in Afghanistan. The fact that acquired carbapenem resistance was almost exclusively associated with blaOXA-23 may facilitate molecular resistance screening based on rapid molecular assays targeting this resistance determinant.

High Genetic Diversity of Carbapenem-Resistant Acinetobacter baumannii Isolates Recovered in Nigerian Hospitals in 2016 to 2020

“…Even more notable is the associated increased prevalence of the previously rare bla NDM-1 carbapenem resistance gene. STs belonging to IC9, mostly oxf ST1089, and most of which also carry the bla NDM-1 gene or other variants such as bla NDM-6 , have been reported more frequently predominantly in Africa and the Middle East ( 27 – 33 ), but also in many other parts of the world ( 17 , 34 – 36 ).…”

International Clones of High Risk of Acinetobacter Baumannii—Definitions, History, Properties and Perspectives

“…IC8 A. baumannii clones were documented as single (sporadic) isolates in India [ 106 ], Afghanistan [ 108 ], Germany [ 109 ], Bangladesh [ 81 ], China [ 110 ], and the Philippines [ 111 ]. Multidrug resistance in A. baumannii from the investigated Bulgarian hospitals was also associated with intrahospital dissemination of IC8, along with IC1 and IC2 [ 14 ].…”

“…In total, 482 distinct STs were found in 17,546 complete or partial genomes of A. baumannii isolates, of which ST2 was detected in 63.3% (11,108) of the cases. In contrast, the second-largest ST1 was found only for 3.6% of the isolates.…”

High genetic diversity andblaNDM-1prevalence amongAcinetobacter baumanniiin Nigerian hospitals

“…gene or other variants such as NDM-6, have been reported more frequently predominantly in Africa and the Middle East [45][46][47][48][49][50][51] , but also in many other parts of the world 17,[52][53][54] .…”

“…Even more notable is the associated increased prevalence of the previously rare bla NDM-1 carbapenem resistance gene. STs belonging to IC9, mostly ST1089 (Pasteur ST85), and most of which also carry the bla NDM-1 gene or other variants such as NDM-6 , have been reported more frequently predominantly in Africa and the Middle East 45–51 , but also in many other parts of the world 17,52–54 .…”