AI Article Synopsis

  • The study aimed to analyze the characteristics of tigecycline-resistant Acinetobacter baumannii (TRAB) isolates from a Chinese hospital over five years, assessing their clonal dynamics and resistance mechanisms.
  • Researchers screened 64 TRAB isolates using whole-genome sequencing (WGS) and various analyses, finding that 95% were multidrug-resistant (MDR) and classified into three major genetic clusters, with the KL7 cluster emerging as dominant in 2019.
  • Key mechanisms of resistance included genetic mutations affecting efflux pump gene expression, with novel mutations identified that increase tigecycline resistance, emphasizing the need for ongoing monitoring of these strains in clinical environments.*

Article Abstract

Objectives: To investigate the characteristics and clonal dynamics of tigecycline-resistant Acinetobacter baumannii (TRAB) isolates from a Chinese hospital from 2016 to 2021.

Methods: A total of 64 TRAB isolates were screened and WGS was performed. Phylogenetic analysis and non-polymorphic mutation analysis were used to analyse their clonal dynamics and tigecycline resistance-related mutations. RT-PCR was used to analyse the expression of the resistance-nodulation cell-division (RND) efflux pump genes adeB and adeJ. Gene cloning was used to explore the effect of tet(39) variants on tigecycline resistance.

Results: Most TRAB isolates were found to be MDR, with 95% (61/64) of the isolates showing resistance to carbapenems. These TRAB isolates were classified into three primary genetic clusters based on core-genome SNPs. The KL2 cluster persisted throughout the study period, whereas the KL7 cluster emerged in 2019 and became the dominant clone. The KL7 cluster carried more antimicrobial resistance genes than the other two clusters. The predominant tigecycline resistance mechanism of the KL2 cluster and KL7 cluster was IS insertion in adeN (82.1%, 23/28) and genetic alterations in adeS (76.2%, 16/21), respectively. Eleven novel AdeS mutations were identified associated with elevated AdeB expression and tigecycline resistance. Moreover, we characterized a plasmid-borne tet(39) variant with an Ala-36-Thr substitution that synergizes with the RND efflux pump to confer high-level tigecycline resistance.

Conclusions: This work provides important insights into the diverse mechanisms associated with tigecycline resistance in A. baumannii, highlighting a pressing need for further monitoring of ST2-KL7 A. baumannii in clinical settings.

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http://dx.doi.org/10.1093/jac/dkae314DOI Listing

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Article Synopsis
  • The study aimed to analyze the characteristics of tigecycline-resistant Acinetobacter baumannii (TRAB) isolates from a Chinese hospital over five years, assessing their clonal dynamics and resistance mechanisms.
  • Researchers screened 64 TRAB isolates using whole-genome sequencing (WGS) and various analyses, finding that 95% were multidrug-resistant (MDR) and classified into three major genetic clusters, with the KL7 cluster emerging as dominant in 2019.
  • Key mechanisms of resistance included genetic mutations affecting efflux pump gene expression, with novel mutations identified that increase tigecycline resistance, emphasizing the need for ongoing monitoring of these strains in clinical environments.*
View Article and Find Full Text PDF

Tigecycline-resistant Acinetobacter baumannii (TRAB) is increasing in Thailand, complicating antibiotic treatment due to limited antibiotic options. The specific resistance mechanism behind tigecycline resistance is still unclear, necessitating further investigation. We investigated the presence of OXA-type carbapenemases, the antimicrobial susceptibility profile, the inhibitory effect of carbonyl cyanide m-chlorophenylhydrazone (CCCP) on tigecycline susceptibility, the expression levels of RND-type efflux pumps and amino acid substitutions within a two-component regulatory system on 30 Thai clinical isolates.

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