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Investigating an Outbreak of Extensively Drug-Resistant Acinetobacter baumannii in a Tertiary Healthcare Center in Lebanon Using Next-Generation Sequencing

2024; Elsevier BV; Linguagem: Inglês

10.1016/j.ijantimicag.2024.107353

1872-7913

Fatima I Darwiche, Hadi Hussein, Souad Bou Harb, Sarah Nahhal, Abdallah Kurdi, Ahmad Sleiman, Lama Hamadeh, Sara Barada, Jose-Rita Gerges, George F. Araj, Nada Kara Zahreddine, Ibrahim Ahmad, Zeina A. Kanafani, Rami Mahfouz, Souha S. Kanj, Ghassan M. Matar, Antoine Abou Fayad,

Antibiotic Resistance in Bacteria

The frequent occurrence of Acinetobacter baumannii in hospital settings and the elevated rate of antimicrobial resistance in this pathogen represent a serious clinical and public health threat worldwide and particularly in Lebanon where outbreak surveillance and control are still insufficient. Whole-genome sequencing (WGS) is currently a fast and reliable tool to study outbreaks at the molecular level and obtain actionable knowledge leading to better control measures. We collected 59 A. baumannii isolates from intensive care unit (ICU) patients and from the hospital environment between August 2022 and May 2023, performed AST and subjected their gDNA to WGS. Analysis was performed to reveal the sequence types (ST), the relatedness to strains that caused other outbreaks and the arsenal of resistance genes harbored by these bacteria. Out of 59 isolates, 81.4% were categorized as extensively drug-resistant (XDR), 13.6% as multi-drug-resistant (MDR) and 1.7% as pan-drug-resistant. All isolates belonged to international clone (IC)2, of which the majority were of ST2 (91.5%). Our isolates clustered well with those of a previous outbreak in the same hospital. In addition, isolates from Lebanese hospitals clustered well together and some clustered with those originating from different countries. The observed genetic relatedness between our current isolates with those from the previous outbreaks underscores the importance of strict surveillance to limit the threat of outbreaks. Moreover, the clustering of Lebanese isolates with others from distant countries proves the necessity of further investigations addressing the international spread of drug-resistant pathogens and resulting in the implementation of control strategies.