{
  "abstract": "Background\n\nCarbapenem-resistant A. baumannii (CRAB) has been recognized as a critical priority pathogen responsible for a wide range of hospital-acquired infections.Methods\n\nWe included pediatric CRAB infection cases at a Maternal and Child Health Hospital in Guangxi, China, from January 2019 to December 2024. The bacterial isolates had previously undergone whole-genome sequencing (WGS). An NDM-1-producing CRAB strain isolated from a bloodstream infection was subjected to Nanopore sequencing to characterize the NDM-1-encoding plasmid. We then retrospectively analyzed the risk factors for NDM-1-producing CRAB infection in children. In addition, the NDM-1-producing and OXA-23-producing CRAB strains were subjected to antimicrobial susceptibility testing (AST) against sulbactam-durlobactam, cefiderocol, and eravacycline using the micro-broth dilution method, and their susceptibility profiles were compared. Associated resistance genes were analyzed.Results\n\nA total of 131 pediatric patients with CRAB infections were included in this study. Based on the WGS data, 33 CRAB strains harboring bla NDM-1 were classified into the NDM-1-producing group, while 98 CRAB strains harboring bla OXA-23 were classified into the OXA-23-producing group. On multivariable analysis, indwelling urethral catheters (OR = 0.293; P = 0.009) and white blood cell (WBC) count (OR = 0.896; P = 0.039) were negatively associated with NDM-1-producing CRAB infection, yet positively associated with OXA-23-producing infections (P < 0.05). WGS analysis revealed that 32 of the 33 (97.0%) NDM-1-producing CRAB isolates co-carried bla PER-1, which has been reported to be associated with cefiderocol resistance in A. baumannii. Plasmid mapping showed that the same plasmid co-harbored bla NDM-1 and bla PER-1, together with a type IV secretion system (T4SS). The resistance rate of NDM-1-producing CRAB isolates to sulbactam-durlobactam was 100%, and to cefiderocol was 66.7%-both rates being significantly higher than those observed in the OXA-23-producing group (1.0% and 0.0%, respectively; P < 0.001). However, all 131 isolates demonstrated susceptibility to eravacycline in vitro.Conclusion\n\nClinical characteristics and antibiotic susceptibility differed significantly between NDM-1-producing and OXA-23-producing CRAB infections. Carbapenemase surveillance is critical for the management of CRAB infections among pediatric patients in Guangxi, China, and AST is essential to guide treatment.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Laboratory Medicine, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Minxue Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Mengjun Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Chenglan Yan"
    },
    {
      "affs": [
        0
      ],
      "name": "Liying Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Huan Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4dsaw2kp3tdp1.bib",
  "cited_by": 0,
  "doi": "10.3389/fcimb.2026.1965770",
  "fulltext_url": "https://europepmc.org/articles/PMC13686866",
  "id": "4dsaw2kp3tdp1",
  "issns": [
    "2235-2988"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923101",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1313|Antibiotic Resistance in Bacteria"
    ]
  ],
  "openalex": "W7220981933",
  "pdf_url": "https://europepmc.org/articles/PMC13686866?pdf=render",
  "pmcid": "PMC13686866",
  "pmid": "42923101",
  "published": "2026-10-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4dsaw2kp3tdp1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42923101",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923101"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:1313|Antibiotic Resistance in Bacteria",
      "subfield": "general"
    }
  ],
  "title": "Clinical characteristics, molecular features and in vitro susceptibility to sulbactam-durlobactam, cefiderocol, and eravacycline in NDM-1-producing versus OXA-23-producing carbapenem-resistant Acinetobacter baumannii isolates from children in Guangxi, China.",
  "title_text": "Clinical characteristics, molecular features and in vitro susceptibility to sulbactam-durlobactam, cefiderocol, and eravacycline in NDM-1-producing versus OXA-23-producing carbapenem-resistant Acinetobacter baumannii isolates from children in Guangxi, China.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/4dsaw2kp3tdp1",
  "venue": "Frontiers in cellular and infection microbiology",
  "versions": []
}