The evolution of carbapenem resistance determinants and major epidemiological lineages among carbapenem-resistant Acinetobacter baumannii isolates in Germany, 2010-2019

The aim of this study was to investigate and compare the molecular epidemiology and carbapenem resis-tance determinants in clinical Acinetobacter baumannii isolates collected during four multicentre surveil-lance studies conducted by the Paul-Ehrlich-Society for Infection Therapy. Isolates were collected prospec-tively from hospital in-patients at 17 medical centres in Germany over four periods of three-to six -months starting in October of each of 2010, 2013, 2016 and 2019. Species identification was performed by MALDI-TOF, gyrB multiplex polymerase chain reaction (PCR), and detection of the intrinsic blaOXA-51-like gene. Minimum inhibitory concentrations were determined by broth microdilution. The prevalence of carbapenemase-encoding genes was investigated by OXA-multiplex PCR and whole-genome sequencing. Molecular epidemiology was examined by rep-PCR and core-genome multi-locus sequence typing. A to-tal of 302 A. baumannii isolates were collected. Resistance to imipenem and/or meropenem was detected in 58 isolates (19.2%) from 14 centres. The proportion of carbapenem-resistant isolates increased from 21.3% in 2010 to 33.3% in 2013, and then decreased to 13.8% in 2016 and 12.3% in 2019. Forty-six of these isolates were associated with the international clonal lineage IC2 and five with IC1. The most prevalent carbapenemase gene detected was blaOXA-23-like (n = 51). Further carbapenem-resistance determinants were blaOXA-40-like (n = 1), blaOXA-58-like (n = 3) and blaNDM-1 (n = 2). In one isolate, ISAba1 was detected upstream of blaOXA-51-like. In conclusion, IC2 was the most prevalent clonal lineage detected in this study. Interestingly, in Germany, carbapenem resistance seems to have decreased in A. baumannii between 2013 and 2019.(c) 2022 Published by Elsevier Ltd.

Automated summary

The aim of this study was to investigate and compare the molecular epidemiology and carbapenem resistance determinants in clinical Acinetobacter baumannii isolates. The study found that carbapenem resistance in A. baumannii in Germany has seemingly decreased from 2013 to 2019.