Emergence and spread of carbapenem-resistant Acinetobacter baumannii sequence type 191 in a Korean hospital

- We identified newly emerged CRAB ST191 clone in Korea.
- We found the nosocomial spread of CRAB ST191 in the study hospital.
- This is the first report of emergence and epidemicity of A. baumannii ST191 in Korea.
- The CRAB ST191 strains carry multiple resistance genes.
- A. baumannii evolves its own way of antimicrobial resistance against antibiotic selective pressure.

Emergence and spread of specific carbapenem-resistant Acinetobacter baumannii (CRAB) clones cause a serious therapeutic problem. This study was aimed to investigate the clonal diversity and genetic basis of antimicrobial resistance among the 69 CRAB isolates from 2009 to 2010 in a Korean hospital. All CRAB isolates were found to be sequence type (ST) 2 using the Institute Pasteur's multilocus sequence typing (MLST) scheme, but classified into two sequence groups and nine pulsotypes. Fifty-six CRAB isolates belonging to two main pulsotypes were found to be ST191 using the Bartual's MLST scheme. All CRAB isolates showed an extensively drug-resistant phenotype. The blaOXA-51/blaOXA-23, blaAmpC/blaPER-1 and armA genes were largely responsible for resistance to carbapenems, extended-spectrum β-lactams and aminoglycosides, respectively. The first CRAB strains identified in 2005 in this hospital were found to be ST2 using the Institute Pasteur's MLST scheme, but showed ST353 using the Bartual's MLST scheme and different pulsotypes from the CRAB isolates from 2009 to 2010. In conclusion, this is the first report of emergence and spread of A. baumannii ST191 in Korea, as well of the genetic basis of its antimicrobial resistance.