Rao, JayasimhaSusanti, DwiChildress, Johnathon CMitkos, Michael CBrima, Joshua KBaffoe-Bonnie, Anthony WPearce, Samuel NGrgurich, DaleFernandez-Cotarelo, Maria-JoseKerkering, Thomas MMukhopadhyay, Biswarup2024-01-292024-01-292018-03Rao J, Susanti D, Childress JC, Mitkos MC, Brima JK, Baffoe-Bonnie AW, Pearce SN, Grgurich D, Fernandez-Cotarelo MJ, Kerkering TM, Mukhopadhyay B. Tn2008-driven carbapenem resistance in Acinetobacter baumannii isolates from a period of increased incidence of infections in a Southwest Virginia hospital (USA). J Glob Antimicrob Resist. 2018 Mar;12:79-87. doi: 10.1016/j.jgar.2017.08.017. Epub 2017 Sep 9. PMID: 28899807.2213-7173https://hdl.handle.net/10115/29125Objectives: The objectives of this study were (i) to determine the genetic basis for carbapenem resistance in multidrug-resistant (MDR) Acinetobacter baumannii strains isolated from patients affected by a sudden increase in the incidence of infections by such organisms in a tertiary care hospital in Virginia, USA, in 2009– 2010 and (ii) to examine whether such strains are commonly encountered in the hospital setting. Methods: The whole genomes of one outbreak strain as well as one carbapenem-resistant and one carbapenem-sensitive strain from sporadic infections in 2010–2012 were sequenced and analysed. Then, 5 outbreak isolates and 57 sporadic isolates (of which 39 were carbapenem-resistant) were screened by PCR for relevant DNA elements identified in the genomics investigation. Results: All three strains for which whole-genome sequences were obtained carried resistance genes linked to MDR phenotypes and a ca. 111-kbp plasmid (pCMCVTAb1) without drug resistance genes. Of these, the two carbapenem-resistant strains possessed a ca. 74-kbp plasmid (pCMCVTAb2) carrying a Tn2008 transposon that provides high-level carbapenem resistance. PCR analysis showed that all of the outbreak isolates carried both plasmids and Tn2008, and of the sporadic isolates 88% carried pCMCVTAb1, 25% contained pCMCVTAb2 and 50% of the latter group carried Tn2008. Conclusions: Carbapenem resistance in outbreak strains and 12% of sporadic isolates was due to the pCMCVTAb2-borne Tn2008. This is the first report of a Tn2008-driven outbreak of carbapenem-resistant A. baumannii infections in the Commonwealth of Virginia, which followed similar cases in Pennsylvania and Ohio.engAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Acinetobacter baumanniiCarbapenem-resistantHospital-acquired infectionMulti-drug resistanceSouthwest VirginiaWhole-genome sequencinginfo:eu-repo/semantics/article10.1016/j.jgar.2017.08.017info:eu-repo/semantics/restrictedAccess