Carbapenem-non-susceptible Acinetobacter baumannii of sequence type 92 or its single-locus variants with a G428T substitution in zone 2 of the rpoB gene

Objectives: To investigate the epidemiological traits of carbapenem-non-susceptible Acinetobacter baumannii (CNSAB) and the usefulness of phylogenetic grouping based on partial rpoB gene sequencing in defining the epidemiological traits of CNSAB. Methods: A total of 547 non-duplicate clinical isolates of Acinetobacter spp. were collected from 19 hospitals in Korea in 2008. Detection of genes encoding OXA carbapenemases and metallo-β-lactamases was performed by PCR. The epidemiological relationships of the isolates were investigated by multilocus sequence typing and repetitive-sequence-based PCR. The 450 bp sequence (zone 2) of the rpoB gene was amplified and sequenced. Results: Molecular characterization of the 272 CNSAB isolates identified five sequence types (STs): ST92, ST75, ST137, ST138 and ST69. The first four of these STs were clustered into clonal complex (CC) 92, sharing alleles at six of seven housekeeping gene loci; ST69 shared alleles at five of seven loci. CNSAB of CC92 carried the bla_OXA-23 gene (n=169), the bla_OXA-51-like gene preceded by ISAba1 (n=89) or both (n=14). Notably, all CNSAB isolates carried a G428T substitution in zone 2 of the rpoB gene. Conclusions: CNSAB isolates of CC92 with the G428T substitution in zone 2 of the rpoB gene are disseminated nationwide in Korea. A. baumannii with the single nucleotide substitution may be more likely to acquire carbapenem resistance than are other isolates.