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<p>Carbapenemase-producing <i>Acinetobacter baumannii</i> (CP-Ab) is a critical priority pathogen. Between October 2019 and September 2020, a multicentre study was conducted at four Ethiopian hospitals: Tikur Anbessa and Yekatit (central), Hawassa (southern), and Dessie (northern). A total of 1416 sepsis patients were enrolled, and blood cultures were performed. <i>Acinetobacter</i> isolates were confirmed using MALDI-TOF and tested for carbapenem susceptibility. All <i>Acinetobacter</i> isolates were subjected to whole-genome sequencing. Selected isolates underwent nanopore sequencing through Plasmidsaurus. Forty-five <i>Acinetobacter</i> isolates were identified, mostly <i>A. baumannii</i> (<i>n</i> = 38), with a few other species (<i>n</i> = 7). Among the 38 <i>A. baumannii</i> isolates, 18 carried <i>bla</i><sub>NDM−1</sub> and either <i>bla</i><sub>OXA−23</sub> or <i>bla</i><sub>OXA−58</sub> carbapenemase genes concurrently. <i>bla</i><sub>OXA−58</sub> and <i>bla</i><sub>NDM−1</sub> were co-located on plasmids of sizes 80&#xa0;kb to 113 kb. <i>bla</i><sub>OXA−66</sub> (<i>n</i> = 13) and <i>bla</i><sub>OXA−69</sub> (<i>n</i> = 12) were frequently identified chromosomally encoded carbapenemase genes. Several STs of <i>A. baumannii</i> were identified, with ST2 (<i>n</i> = 14) and ST1 (<i>n</i> = 13) being frequent. One <i>A. nosocomialis</i> carried <i>bla</i><sub>NDM−1</sub> and <i>bla</i><sub>OXA−58</sub> simultaneously. Several other genes were identified that confer resistance to aminoglycosides (<i>n</i> = 37), phenicol (<i>n</i> = 19), trimethoprim (<i>n</i> = 16), macrolides (<i>n</i> = 25), quinolones (<i>n</i> = 10), tetracyclines (<i>n</i> = 22), sulphonamides (<i>n</i> = 36), and disinfectants (<i>n</i> = 23). The high prevalence of carbapenemase-producing <i>A. baumannii</i> and other <i>Acinetobacter</i> species underscores the need for nationwide antibiotic stewardship.</p>

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High magnitude of carbapenemase-producing Acinetobacter baumannii in sepsis patients at Ethiopian referral hospitals: a whole genome analysis

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  • 发表日期：

    2026年3月18日

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  • Melese Hailu Legese,
  • Daniel Asrat,
  • Adane Mihret,
  • Badrul Hasan,
  • Abraham Aseffa,
  • Göte Swedberg

摘要

Carbapenemase-producing Acinetobacter baumannii (CP-Ab) is a critical priority pathogen. Between October 2019 and September 2020, a multicentre study was conducted at four Ethiopian hospitals: Tikur Anbessa and Yekatit (central), Hawassa (southern), and Dessie (northern). A total of 1416 sepsis patients were enrolled, and blood cultures were performed. Acinetobacter isolates were confirmed using MALDI-TOF and tested for carbapenem susceptibility. All Acinetobacter isolates were subjected to whole-genome sequencing. Selected isolates underwent nanopore sequencing through Plasmidsaurus. Forty-five Acinetobacter isolates were identified, mostly A. baumannii (n = 38), with a few other species (n = 7). Among the 38 A. baumannii isolates, 18 carried blaNDM−1 and either blaOXA−23 or blaOXA−58 carbapenemase genes concurrently. blaOXA−58 and blaNDM−1 were co-located on plasmids of sizes 80 kb to 113 kb. blaOXA−66 (n = 13) and blaOXA−69 (n = 12) were frequently identified chromosomally encoded carbapenemase genes. Several STs of A. baumannii were identified, with ST2 (n = 14) and ST1 (n = 13) being frequent. One A. nosocomialis carried blaNDM−1 and blaOXA−58 simultaneously. Several other genes were identified that confer resistance to aminoglycosides (n = 37), phenicol (n = 19), trimethoprim (n = 16), macrolides (n = 25), quinolones (n = 10), tetracyclines (n = 22), sulphonamides (n = 36), and disinfectants (n = 23). The high prevalence of carbapenemase-producing A. baumannii and other Acinetobacter species underscores the need for nationwide antibiotic stewardship.