Clonal spread of ArmA- and OXA-23-coproducing Acinetobacter baumannii International Clone 2 in Brazil during the first wave of the COVID-19 pandemic

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Camargo, Carlos Henrique ; Yamada, Amanda Yaeko ; Nagamori, Filipe Onishi ; de Souza, Andreia Rodrigues ; Tiba-Casas, Monique Ribeiro ; de Moraes Franca, Flavia Aparecida ; Trigueiro Nobrega Porto, Maria Helena ; de Lima Garzon, Magda Lourdes ; Higgins, Paul ; Madalosso, Geraldine ; de Assis, Denise Brandao

• Document type: Journal article
• Source: Journal of Medical Microbiology; v. 71, n. 4, p. 6-pg., 2022-01-01.

Abstract

Introduction. Carbapenem-resistant Acinetobacter baumannii (CRAB) is the primary pathogen causing hospital-acquired infections. The spread of CRAB is mainly driven by the dissemination of resistant clones, and in Latin America, International Clones IC -1 (also known as clonal complex CC1), IC -4 (CC15) and IC -5 (CC79) are the most prevalent. Gap Statement. There are no documented outbreaks of CRAB International Clone 2 (IC -2) reported in Brazil. Aim. To describe a large outbreak of CRAB caused by the uncommon IC -2 in a Brazilian COVID- 19 hospital. Methodology. From May 2020 to May 2021, 224 patients infected or colonized with CRAB were identified in a single hospital; 92 % of them were also infected with SARS-CoV- 2. From these patients, 137 isolates were recovered and subjected to antimicrobial susceptibility testing, PCR analysis and molecular typing. Whole-genome sequencing and downstream analysis were carried out on a representative isolate (the first available isolate). Results. In 76 % of the patients, a single OXA- 23-producing CRAB IC -2 was identified. All the isolates were susceptible to polymyxin B, but highly resistant (>95 %) to aminoglycosides, fluoroquinolones and beta-lactams. Genomic analysis revealed that the representative isolate also carried the 16S rRNA Methylase ArmA, which was detected for the first time in this species in Brazil. Conclusion. We report the rapid spread of an emerging CRAB clone responsible for causing a large outbreak in a hospital in Brazil, a country with predominance of other CRAB clones. Continuous and prospective surveillance is warranted to evaluate the impact of this clone in Brazilian hospital settings. (AU)

• FAPESP's process: 17/16988-6 - Genomic analysis of high-risk clones of Acinetobacter baumannii from different hospitals in Brazil
• Grantee: Carlos Henrique Camargo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 20/06157-2 - Genomic Epidemiology of NDM-producing enterobacteria from Brazil
• Grantee: Carlos Henrique Camargo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/50333-7 - Institutional research development plan of the Instituto Adolfo Lutz (PDIp)
• Grantee: Carlos Henrique Camargo
• Support Opportunities: Research Grants - State Research Institutes Modernization Program
• FAPESP's process: 18/21192-9 - Multi-User Equipment approved in grant 2017/50333-7: MALDI-TOF
• Grantee: Carlos Henrique Camargo
• Support Opportunities: Multi-user Equipment Program
• FAPESP's process: 18/21193-5 - Multi-user equipment approved in grant 2017/50333-7: genetic analyzer
• Grantee: Carlos Henrique Camargo
• Support Opportunities: Multi-user Equipment Program