Local Genomic Epidemiology of Acinetobacter baumannii Circulating in Hospital and Non-hospital Environments in Kano, Northwest Nigeria

尼日利亚西北部卡诺市医院和非医院环境中鲍曼不动杆菌的局部基因组流行病学研究

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Abstract

Acinetobacter baumannii is a pathogenic bacterium of public health significance, capable of rapidly spreading within and between environments. The local epidemiology and transmission pattern of A. baumannii strains circulating in hospitals and non-hospital environments is rarely studied, and hence this is investigated in Kano, Nigeria. A cross-sectional study design was used to collect 172 samples from clinical, hospital, and non-hospital samples. Acinetobacter baumannii isolates were identified and confirmed using microbiological and molecular techniques. Variants of bla(OXA-51) were determined through amplicon sequencing, while whole genome sequencing was performed on 22 isolates to determine their allelic variants/sequence types (ST), resistance/virulence genes, insertion sequences, plasmids, single-nucleotide polymorphism (SNPs) and investigate phylogenetic relationships between the isolates. Twenty-seven A. baumannii were isolated from door handle and toilet floors of student hostels (14), soil and sullage samples (3 each), bed, chair, and drawer of hospital environments (9), and 1 from the urine of a patient. All these isolates belong to only 2 variants of bla(OXA51)-like genes, 16 (48.8%) are bla(OXA-66) and 11 (33.3%) are bla(OXA-180). About 70% of the isolates were susceptible to many antibiotics, and 8 resistance genes encoding aminoglycoside, tetracycline, and sulphonamide resistance were acquired by only strains harbouring bla(OXA-66), and between 37 and 39 virulence genes were harboured by all the variants. Intrinsic bla(ADC-25) encoding resistance to β-lactams was found in all A. baumannii strains. The 2 variants had Pasteur scheme MLST allelic profiles ST2 and 267, which are not commonly reported in Nigeria. Few isolates from hospital and non-hospital sources form a cluster with SNPs number distances within the two clusters in the range of 85-100, suggesting a close relationship. The 2 variants circulate in both environments, suggesting transmission in both directions. Detection of ST267 (bla(OXA-180) variant) in a clinical sample indicates an environment-to-human transmission.

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