Nosocomial spread of carbapenem-resistant Acinetobacter baumannii (types ST75 and ST137) carrying blaOXA-23-like gene with an upstream ISAba1 in a Chinese hospital.

The most widespread type of carbapenemases among carbapenem-resistant Acinetobacter baumannii (CRAB) belongs to the oxacillinase (OXA) group. A total of 57 CRAB isolates and 20 non-CRAB isolates (i.e., A. baumannii susceptible to carbapenems) were studied to investigate the molecular epidemiology of CRAB isolates and to identify the OXAs responsible for resistance to imipenem. The ISAba1-blaOXA-23-like gene was detected in all 57 CRAB isolates but was detected in none of the non-CRAB isolates. Pulsed-field gel electrophoresis (PFGE) revealed that clones A and B were the dominant genotypes, and all blaOXA-23-like gene positive strains were classified as either clone A or B strains. ST75 and ST137 were the most prominent sequence types (STs). Finally, the A. baumannii isolates of clone A, C and F were all demonstrated to be genetically similar to the previously identified European clone II. In conclusion, ST75- and ST137-type CRAB isolates that produced the blaOXA-23-like gene with an upstream ISAba1 contributed to the nosocomial outbreaks studied in this work.