The Distribution of Carbapenem-Resistant Acinetobacter Species and High Prevalence of CC92 OXA-23-Producing Acinetobacter Baumannii in Community Hospitals in South Korea

Figures & data

Figure 1 Map showing the prevalence and characteristics of Acinetobacter clinical isolates in 16 regions in South Korea. The shade of Orange indicates the percentage each of carbapenem-resistant Acinetobacter species in this study. The gray and dark gray colors in the circle indicate the number of non-baumannii Acinetobacter and A. baumannii isolates, respectively. The white numbers in each colored pentagon arrow indicate the carbapenem resistance determinants.

Figure 2 Antimicrobial susceptibility of Acinetobacter clinical isolates in this study. (A) A. baumannii isolates (n=659); (B) Non-baumannii Acinetobacter species (n=158).

Abbreviations: S, susceptible; I, intermediate; R, resistant; SAM, Ampicillin/sulbactam; PIP, piperacillin; TZP, Piperacillin/tazobactam; CTX, cefotaxime; CAZ, ceftazidime; FEP, cefepime; ATM, aztreonam; IPM, imipenem; MEM, meropenem; AMK, amikacin; GEN, gentamicin; CIP, ciprofloxacin; MIN, minocycline; TGC, tigecycline; TIM, Ticarcillin/Clavulanic Acid.

Table 1 The Profiles of 14 Carbapenemase-Producing Non-Baumannii Acinetobacter Isolates

Isolate	Specimen	Identification	Region	Carbapenemase	MIC (µg/mL)		Co-resistant to:
					IPM	MEM
Eone73	Urine	A. pittii	Gyeonggi	OXA-23	16	16	PIP, TZP, CTX, CAZ, FEP, ATM, GEN, CIP, TIM
Eone203	Sputum	A. pittii	Daegu	OXA-23	16	16	PIP, TZP, CTX, CAZ, FEP, ATM, GEN, CIP, TIM
SCAB205	Urine	A. bereziniae	Busan	VIM-2	16	8	PIP, TZP, CTX, CAZ, ATM, AMK, GEN, CIP, TMP/SMX, TIM
SCAB220	Urine	A. bereziniae	Gyenoggi	OXA-23	16	16	PIP, TZP, CAZ, FEP, ATM, CIP, TMP/SMX, TIM
SCAB226	Sputum	A. seifertii	Jeonnam	OXA-23	32	16	SAM, PIP, TZP, CTX, CAZ, FEP, ATM, CIP, TMP/SMX, TIM
SCAB228	Sputum	A. pittii	Chungbuk	OXA-23	32	32	PIP, TZP, CTX, CAZ, FEP, ATM, GEN, CIP, TIM
SCAB251	Urine	A. nosocomialis	Gyenoggi	NDM-1	128	64	SAM, PIP, TZP, CTX, CAZ, FEP, ATM, CIP, TMP/SMX, TIM
SCAB253	Urine	A. bereziniae	Busan	NDM-1	128	64	SAM, PIP, TZP, CTX, CAZ, FEP, ATM, AMK, GEN, CIP, TGC, TIM
SCAB366	Sputum	A. nosocomialis	Chungbuk	OXA-23	16	32	PIP, TZP, CTX, CAZ, FEP, ATM, GEN, CIP, TIM
SCAB392	Sputum	A. nosocomialis	Chungbuk	OXA-23	32	32	PIP, TZP, CTX, CAZ, FEP, ATM, GEN, CIP, TIM
SCAB419	Sputum	A. nosocomialis	Chungbuk	OXA-23	32	32	PIP, TZP, CTX, CAZ, FEP, ATM, GEN, CIP, TIM
SCAB444	Other	A. bereziniae	Jeonbuk	VIM-2	16	8	PIP, TZP, CTX, CAZ, ATM, AMK, GEN, CIP, TMP/SMX, TIM
SCAB445	Sputum	A. seifertii	Jeonnam	OXA-23	32	16	SAM, PIP, TZP, CTX, CAZ, FEP, ATM, CIP, TMP/SMX, TIM
SCAB472	Urine	A. bereziniae	Gyeongbuk	NDM-1	64	32	SAM, PIP, TZP, CTX, CAZ, FEP, ATM, GEN, CIP, TMP/SMX, TIM

Abbreviations: SAM, Ampicillin/sulbactam; PIP, piperacillin; TZP, Piperacillin/tazobactam; CTX, cefotaxime; CAZ, ceftazidime; FEP, cefepime; ATM, aztreonam; IPM, imipenem; MEM, meropenem; AMK, amikacin; GEN, gentamicin; CIP, ciprofloxacin; MIN, minocycline; TGC, tigecycline; TIM, Ticarcillin/Clavulanic Acid.

Table 2 The Characteristics of A. Baumannii Related to Sequence Types (STs) and Clonal Complexes (CCs) Identified in This Study

GC (no. of isolates)	Species (Carbapenemase)	CC	ST	Allele							No. of Isolates
				gltA	gyrB	gdhB	recA	cpn60	gpi	rpoD
GC2 (519)	A. baumannii (OXA-23)	92	NE	1	NE	3	2	2	NE	3	519
GC1 (1)		108	397	10	53	4	6	4	50	5	1
Non-GC (56)		110	229	1	15	2	28	1	107	32	47
		20	620	1	1	13	12	4	16	2	1
		Singleton	373	1	12	12	11	4	13	3	7
			447	1	15	13	12	4	16	2	1

Abbreviations: GC, global clone; CC, clonal complex; ST, sequence type; NE, not estimable.