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Volume 13
Issue 5
10.3390/microorganisms13051149
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Article

Emergence of NDM-1- and OXA-23-Co-Producing Acinetobacter baumannii ST1 Isolates from a Burn Unit in Spain

by
Elena Hidalgo
1,†,
Jared Sotelo
2,3,†,
María Pérez-Vázquez
2,3,
Ángela Iniesta
1,
Javier E. Cañada-García
2,3,
Olga Valiente
2,
Belén Aracil
2,3,
David M. Arana
1,* and
Jesús Oteo-Iglesias
2,3,*
1
Servicio de Microbiología, Hospital Universitario de Getafe, 28905 Madrid, Spain
2
Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28222 Madrid, Spain
3
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Microorganisms 2025, 13(5), 1149; https://doi.org/10.3390/microorganisms13051149 (registering DOI)
Submission received: 16 April 2025 / Revised: 8 May 2025 / Accepted: 15 May 2025 / Published: 16 May 2025
(This article belongs to the Special Issue Prevention and Treatment of Healthcare-Associated Infections)
Review Reports Versions Notes

Abstract

The global emergence of carbapenem-resistant Acinetobacter baumanii (CRAB) represents a significant public health threat. In the summer of 2022, a polyclonal CRAB outbreak occurred in our hospital, marking the first detection of an NDM-1 plus OXA-23 co-producing A. baumannii strain in Spain. The aim of this study was to phenotypically and genotypically characterize the clonal spread of NDM-1 and OXA-23 co-producing A. baumannii isolates and to describe the infection control measures implemented to contain the outbreak. Patients with multidrug-resistant A. baumannii isolates (July 2022–May 2023) were included in the study. Isolates were identified via MALDI-TOF, and antimicrobial susceptibility was tested using a broth microdilution method (DKMGN SensititreTM panels). Whole-genome sequencing was performed on 24 representative isolates. Phylogenetic analysis was performed using Ridom SeqSphere+ (cgMLST), while sequence typing was performed using ARIBA (Pasteur and Oxford schemes). A. baumannii isolates from the affected patients belonged to five different sequence types. The two main STs were ST1Pas/ST231Oxf (NDM-1- and OXA-23-co-producing), which accounted for 58%, and ST136Pas/ST406Oxf (OXA-23-producing), which accounted for 21%. All isolates were resistant to fluoroquinolones, trimethoprim/sulfamethoxazole, aminoglycosides, and carbapenems. In addition, 8% were resistant to colistin and 17% to cefiderocol. Finally, the affected patients were cohorted, and a thorough cleaning of the affected units was carried out. This study documents the clonal spread of an NDM-1- and OXA-23-co-producing A. baumannii strain in Spain, linked to a Libyan patient, highlighting the risk of cross-border spread. Although infection control measures successfully contained the outbreak, surveillance is essential as the incidence of CRAB infections is expected to increase.
Keywords: Acinetobacter baumannii; antimicrobial resistance (AMR); NDM-1; OXA-23; ICU infections; whole-genome sequencing (WGS) Acinetobacter baumannii; antimicrobial resistance (AMR); NDM-1; OXA-23; ICU infections; whole-genome sequencing (WGS)

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MDPI and ACS Style

Hidalgo, E.; Sotelo, J.; Pérez-Vázquez, M.; Iniesta, Á.; Cañada-García, J.E.; Valiente, O.; Aracil, B.; Arana, D.M.; Oteo-Iglesias, J. Emergence of NDM-1- and OXA-23-Co-Producing Acinetobacter baumannii ST1 Isolates from a Burn Unit in Spain. Microorganisms 2025, 13, 1149. https://doi.org/10.3390/microorganisms13051149

AMA Style

Hidalgo E, Sotelo J, Pérez-Vázquez M, Iniesta Á, Cañada-García JE, Valiente O, Aracil B, Arana DM, Oteo-Iglesias J. Emergence of NDM-1- and OXA-23-Co-Producing Acinetobacter baumannii ST1 Isolates from a Burn Unit in Spain. Microorganisms. 2025; 13(5):1149. https://doi.org/10.3390/microorganisms13051149

Chicago/Turabian Style

Hidalgo, Elena, Jared Sotelo, María Pérez-Vázquez, Ángela Iniesta, Javier E. Cañada-García, Olga Valiente, Belén Aracil, David M. Arana, and Jesús Oteo-Iglesias. 2025. "Emergence of NDM-1- and OXA-23-Co-Producing Acinetobacter baumannii ST1 Isolates from a Burn Unit in Spain" Microorganisms 13, no. 5: 1149. https://doi.org/10.3390/microorganisms13051149

APA Style

Hidalgo, E., Sotelo, J., Pérez-Vázquez, M., Iniesta, Á., Cañada-García, J. E., Valiente, O., Aracil, B., Arana, D. M., & Oteo-Iglesias, J. (2025). Emergence of NDM-1- and OXA-23-Co-Producing Acinetobacter baumannii ST1 Isolates from a Burn Unit in Spain. Microorganisms, 13(5), 1149. https://doi.org/10.3390/microorganisms13051149

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