Rectal Colonization and Nosocomial Transmission of Carbapenem-Resistant Acinetobacter baumannii in an Intensive Care Unit, Southwest Nigeria
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Background: Acinetobacter baumannii are of major human health importance because they cause life-threatening nosocomial infections and often are highly resistant to antimicrobials. Specific multidrug-resistant A. baumannii lineages are implicated in hospital outbreaks globally. We retrospectively investigated a suspected outbreak of carbapenem-resistant A. baumannii (CRAB) colonizing patients in an intensive care unit (ICU) of a tertiary hospital in Southwest Nigeria where genomic surveillance of Acinetobacter has hitherto not been conducted. Methods: A prospective observational study was conducted among all patients admitted to the ICU between August 2017 and June 2018. Acinetobacter species were isolated from rectal swabs and verified phenotypically with the Biomerieux Vitek 2 system. Whole genome sequencing (WGS) was performed on the Illumina platform to characterize isolates from a suspected outbreak during the study period. Phylogenetic analysis, multilocus sequence typing, and antimicrobial resistance gene prediction were carried out in silico. Results: Acinetobacter isolates belonging to the A. baumannii complex were recovered from 20 (18.5%) ICU patients. Single nucleotide polymorphism (SNP) analysis and epidemiological information revealed a putative outbreak clone comprising seven CRAB strains belonging to the globally disseminated international clone (IC) 2. These isolates had ≤2 SNP differences, identical antimicrobial resistance and virulence genes, and were all ST1114/1841. Conclusion: We report a carbapenem-resistant IC2 A. baumannii clone causing an outbreak in an ICU in Nigeria. The study findings underscore the need to strengthen the capacity to detect A. baumannii in human clinical samples in Nigeria and assess which interventions can effectively mitigate CRAB transmission in Nigerian hospital settings.
Originalsprog | Engelsk |
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Artikelnummer | 846051 |
Tidsskrift | Frontiers in Medicine |
Vol/bind | 9 |
ISSN | 2296-858X |
DOI | |
Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
This work was supported by Official Development Assistance (ODA) funding from the National Institute of Health Research (16/136/111: NIHR Global Health Research Unit on Genomic Surveillance of Antimicrobial Resistance). This research was commissioned by the National Institute of Health Research using Official Development Assistance (ODA) funding. This work was supported (in part) by a grant from the International Society for Infectious Diseases. INO is an African Research Leader supported by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement that is also part of the EDCTP2 program supported by the European Union.
Publisher Copyright:
Copyright © 2022 Odih, Irek, Obadare, Oaikhena, Afolayan, Underwood, Adenekan, Ogunleye, Argimon, Dalsgaard, Aanensen, Okeke and Aboderin.
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