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Peer-reviewedCC BY-NC-ND 4.0BMC Microbiology

Risk factors and molecular epidemiology of ST2-type carbapenem-resistant Acinetobacter baumannii carrying blaOXA−23−like and blaOXA−51−like genes

  • Yong Xia1
  • Xu Chen1
  • Xue Wei Sun1
  • Zi Juan Wang1
  • Chuang Meng2
  • Tingting Guo3
  • Jia Xin Shi1
  • Jun Zhou1
  1. 1Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225001 China
  2. 2Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou, 225001 China
  3. 3Department of Microbiology, Medical College, Yangzhou University, Yangzhou, 225001 China
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Abstract

Objective: The emergence and spread of carbapenem-resistant Acinetobacter baumannii (CRAB, A. baumannii) has raised significant concerns and challenges globally. This study analyzes the risk factors, distribution of antibiotic resistance genes, and virulence genes associated with CRAB infections, and explores the molecular epidemiological characteristics of CRAB. The findings provide scientific evidence for the development of prevention and treatment strategies for CRAB.

Methods: A total of 100 patients diagnosed with A. baumannii(AB) infection through culture and antimicrobial susceptibility testing were included in the study. These patients were classified into the CRAB group and the carbapenem-sensitive A. baumannii (CSAB) group based on their susceptibility to carbapenem antibiotics. Univariate analysis was used to screen for factors associated with CRAB infection, and significant variables were included in a multivariate logistic regression analysis. Additionally, five CRAB strains carrying both blaOXA−51−like and blaOXA−23−like genes were randomly selected for multilocus sequence typing (MLST) and whole-genome sequencing. The analysis included the identification of antimicrobial resistance genes (ARGs), virulence factor genes, pathogen-host interaction annotations from the Pathogen Host Interactions Database, and functional annotations through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG).

Results: Significant differences were observed between the CRAB group and the CSAB group in terms of length of hospital stay (P = 0.022, OR = 1.068), ICU admission rate (P = 0.019, OR = 8.032), prior carbapenem use (P = 0.028, OR = 4.445), and mechanical ventilation use (P = 0.044, OR = 7.226). In vitro antimicrobial susceptibility testing showed that all CRAB strains were resistant to ceftriaxone, ceftazidime, and ciprofloxacin, with some strains showing resistance to levofloxacin (87.5%) and doxycycline (93.8%), but remaining sensitive to tigecycline and polymyxin B. Through multiplex PCR analysis, we tested 48CRAB strains (carbapenem-resistant A. baumannii). The results revealed that 41 of these strains carried both the blaOXA−51−like and blaOXA−23−like genes. The presence rate of OXA-type β-lactamase genes and efflux pump genes in randomly selected positive strains is 100%. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotation results indicated that the genes of these randomly selected positive strains were primarily involved in cellular processes, metabolic pathways, and environmental information processing, and exhibited strong enzymatic activity and binding functions.

Conclusion: Length of hospital stay, ICU admission, prior carbapenem use, and mechanical ventilation are susceptibility factors for carbapenem resistance in A. baumannii infections at this hospital. MLST typing and multiplex PCR analysis indicate the spread of ST2-type blaOXA−51−like and blaOXA−23−like positive CRAB infections in the hospital, with ST2-type CRAB potentially being the dominant clone in circulation. Whole-genome sequencing revealed the resistance and virulence characteristics of CRAB strains isolated from clinical samples at this hospital, and showed that these CRAB strains from the hospital are distinct from those found in different provinces and cities in China.

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Cite

BibTeXRIS
BibTeX
@article{xia2026risk,
  title = {{Risk factors and molecular epidemiology of ST2-type carbapenem-resistant Acinetobacter baumannii carrying blaOXA−23−like and blaOXA−51−like genes}},
  author = {Yong Xia and Xu Chen and Xue Wei Sun and Zi Juan Wang and Chuang Meng and Tingting Guo and Jia Xin Shi and Jun Zhou},
  journal = {BMC Microbiology},
  year = {2026},
  month = aug,
  doi = {10.1186/s12866-026-05493-8},
  url = {https://doi.org/10.1186/s12866-026-05493-8},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Risk factors and molecular epidemiology of ST2-type carbapenem-resistant Acinetobacter baumannii carrying blaOXA−23−like and blaOXA−51−like genes
AU  - Yong Xia
AU  - Xu Chen
AU  - Xue Wei Sun
AU  - Zi Juan Wang
AU  - Chuang Meng
AU  - Tingting Guo
AU  - Jia Xin Shi
AU  - Jun Zhou
PY  - 2026
DA  - 2026/08/11
JO  - BMC Microbiology
DO  - 10.1186/s12866-026-05493-8
UR  - https://doi.org/10.1186/s12866-026-05493-8
AB  - Objective: The emergence and spread of carbapenem-resistant Acinetobacter baumannii (CRAB, A. baumannii) has raised significant concerns and challenges globally. This study analyzes the risk factors, distribution of antibiotic resistance genes, and virulence genes associated with CRAB infections, and explores the molecular epidemiological characteristics of CRAB. The findings provide scientific evidence for the development of prevention and treatment strategies for CRAB.  Methods: A total of 100 patients diagnosed with A. baumannii(AB) infection through culture and antimicrobial susceptibility testing were included in the study. These patients were classified into the CRAB group and the carbapenem-sensitive A. baumannii (CSAB) group based on their susceptibility to carbapenem antibiotics. Univariate analysis was used to screen for factors associated with CRAB infection, and significant variables were included in a multivariate logistic regression analysis. Additionally, five CRAB strains carrying both blaOXA−51−like and blaOXA−23−like genes were randomly selected for multilocus sequence typing (MLST) and whole-genome sequencing. The analysis included the identification of antimicrobial resistance genes (ARGs), virulence factor genes, pathogen-host interaction annotations from the Pathogen Host Interactions Database, and functional annotations through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG).  Results: Significant differences were observed between the CRAB group and the CSAB group in terms of length of hospital stay (P = 0.022, OR = 1.068), ICU admission rate (P = 0.019, OR = 8.032), prior carbapenem use (P = 0.028, OR = 4.445), and mechanical ventilation use (P = 0.044, OR = 7.226). In vitro antimicrobial susceptibility testing showed that all CRAB strains were resistant to ceftriaxone, ceftazidime, and ciprofloxacin, with some strains showing resistance to levofloxacin (87.5%) and doxycycline (93.8%), but remaining sensitive to tigecycline and polymyxin B. Through multiplex PCR analysis, we tested 48CRAB strains (carbapenem-resistant A. baumannii). The results revealed that 41 of these strains carried both the blaOXA−51−like and blaOXA−23−like genes. The presence rate of OXA-type β-lactamase genes and efflux pump genes in randomly selected positive strains is 100%. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotation results indicated that the genes of these randomly selected positive strains were primarily involved in cellular processes, metabolic pathways, and environmental information processing, and exhibited strong enzymatic activity and binding functions.  Conclusion: Length of hospital stay, ICU admission, prior carbapenem use, and mechanical ventilation are susceptibility factors for carbapenem resistance in A. baumannii infections at this hospital. MLST typing and multiplex PCR analysis indicate the spread of ST2-type blaOXA−51−like and blaOXA−23−like positive CRAB infections in the hospital, with ST2-type CRAB potentially being the dominant clone in circulation. Whole-genome sequencing revealed the resistance and virulence characteristics of CRAB strains isolated from clinical samples at this hospital, and showed that these CRAB strains from the hospital are distinct from those found in different provinces and cities in China.
SN  - 1471-2180
ER  -