Nosocomial transmission of tet(x3), blaNDM-1 and blaOXA-97-carrying Acinetobacter baumannii conferring resistance to eravacycline and omadacycline, the Netherlands, March to August 2021

Ditmer T. Talsma*, Rodrigo Monteiro, Rosario del Carmen Flores-Vallejo, Maarten Heuvelmans, Thuy Nga Le, Antoni P.A. Hendrickx, Sigrid Rosema, Ianthe Maat, Jan Maarten van Dijl, Erik Bathoorn

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Carbapenem-resistant Acinetobacter baumannii (CRAb) is an important pathogen causing serious nosocomial infections. We describe an outbreak of CRAb in an intensive care unit in the Netherlands in 2021. During an outbreak of non-resistant A. baumannii, while infection control measures were in place, CRAb isolates carrying highly similar blaNDM-1- and tet(x3)-encoding plasmids were isolated from three patients over a period of several months. The chromosomal and plasmid sequences of the CRAb and non-carbapenemase-carrying A. baumannii isolates cultured from patient materials were analysed using hybrid assemblies of short-read and long-read sequences. The CRAb isolates revealed that the CRAb outbreak consisted of two different strains, carrying similar plasmids. The plasmids contained multiple antibiotic resistance genes including the tetracycline resistance gene tet(x3), and the blaNDM-1 and blaOXA-97 carbapenemase genes. We determined minimal inhibitory concentrations (MICs) for 13 antibiotics, including the newly registered tetracycline antibiotics eravacycline and omadacycline. The CRAb isolates showed high MICs for tetracycline antibiotics including eravacycline and omadacycline, except for minocycline which had a low MIC. In this study we show the value of sequencing multidrug-resistant A. baumannii for outbreak tracking and guiding outbreak mitigation measures.

Original languageEnglish
Article numbere2400019
Number of pages10
JournalEurosurveillance
Volume29
Issue number28
DOIs
Publication statusPublished - 1-Jul-2024

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