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Background  Carbapenem-resistant  Acinetobacter baumannii  poses a significant threat to hospitalized patients, as few therapeutic options remain. Thus, we investigated the molecular epidemiology and mechanism of resistance of carbapenem-resistant  A.baumannii  isolates in Beijing, China.    Methods  Carbapenem-resistant  A.baumannii  isolates ( n  = 101) obtained between June 2009 and November 2014 were used. Multilocus sequence typing (MLST) and PCR assays for class C and D β-lactamase were performed on all isolates. S1 nuclease pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to identify the resistance gene location.    Results  All 101  A.baumannii  isolates were highly resistant to frequently used antimicrobials, and were considered multidrug resistant. A total of 12 sequence types (STs) were identified, including 10 reported STs and 2 novel STs. Eighty-seven isolates were classified to clonal complex 92 (CC92), among which ST191 and ST195 were the most common STs. The  bla    OXA-23   gene was positive in most ( n  = 95) of the  A.baumannii  isolates. Using S1-nuclease digestion PFGE and Southern blot hybridization, 3 patterns of plasmids carrying  bla    OXA-23   were confirmed. ST191 and ST195 (both harboring  bla    OXA-23  ) caused outbreaks during the study period, and this is the first report of outbreaks caused by ST191 and ST195 in north China.    Conclusion    bla    OXA-23  -producing  A.baumannii  ST191 and ST 195 isolates can disseminate in a hospital and are potential nosocomial outbreak strains. Surveillance of imipenem-resistant  A.baumannii  and antimicrobial stewardship should be strengthened.

bmc infectious diseases

Molecular epidemiology of bla OXA-23 -producing carbapenem-resistant Acinetobacter baumannii in a single institution over a 65-month period in north China