ABSTRACT
The rate of recovery of carbapenem-resistant
Acinetobacter baumannii
(CRAB) isolates has increased significantly in recent decades in Taiwan. This study investigated the molecular epidemiology of CRAB with a focus on the mechanisms of resistance and spread in isolates with
bla
OXA-23-like
or
bla
OXA-24-like
. All 555 CRAB isolates in our multicenter collection, which were recovered from 2002 to 2010, were tested for the presence of class A, B, and D carbapenemase genes. All isolates with
bla
OXA-23-like
or
bla
OXA-24-like
were subjected to pulsed-field gel electrophoresis, and 82 isolates (60 isolates with
bla
OXA-23-like
and 22 isolates with
bla
OXA-24-like
) were selected for multilocus sequence typing to determine the sequence type (ST) and clonal group (CG) and for detection of additional β-lactamase and aminoglycoside resistance genes. The flanking regions of carbapenem and aminoglycoside resistance genes were identified by PCR mapping and sequencing. The localization of
bla
OXA
was determined by S1 nuclease and I-CeuI assays. The numbers of CRAB isolates carrying
bla
OXA-23-like
or
bla
OXA-24-like
, especially those carrying
bla
OXA-23-like
, increased significantly from 2008 onward. The
bla
OXA-23-like
gene was carried by antibiotic resistance genomic island 1 (AbGRI1)-type structures located on plasmids and/or the chromosome in isolates of different STs (CG92 and novel CG786), whereas
bla
OXA-24-like
was carried on plasmids in CRAB isolates of limited STs (CG92). No class A or B carbapenemase genes were identified. Multiple aminoglycoside resistance genes coexisted in CRAB. Tn
6180
-borne
armA
was found in 74 (90.2%) CRAB isolates, and 58 (70.7%) isolates had Tn
6179
upstream, constituting AbGRI3.
bla
TEM
was present in 38 (46.3%) of the CRAB isolates tested, with 35 (92.1%) isolates containing
bla
TEM
in AbGRI2-type structures, and 61% of
ampC
genes had IS
Aba1
upstream. We conclude that the dissemination and spread of a few dominant lineages of CRAB containing various resistance island structures occurred in Taiwan.