1887

Microbial Genomics logo

Volume 9, Issue 4

Molecular characterization and comparative genomic analysis of isolated from the community and the hospital: an epidemiological study in Segamat, Malaysia Open Access

Abstract

is a common cause of multidrug-resistant (MDR) nosocomial infections around the world. However, little is known about the persistence and dynamics of in a healthy community. This study investigated the role of the community as a prospective reservoir for and explored possible links between hospital and community isolates. A total of 12 independent strains were isolated from human faecal samples from the community in Segamat, Malaysia, in 2018 and 2019. Another 15 were obtained in 2020 from patients at the co-located tertiary public hospital. The antimicrobial resistance profile and biofilm formation ability were analysed, and the relatedness of community and hospital isolates was determined using whole-genome sequencing (WGS). Antibiotic profile analysis revealed that 12 out of 15 hospital isolates were MDR, but none of the community isolates were MDR. However, phylogenetic analysis based on single-nucleotide polymorphisms (SNPs) and a pangenome analysis of core genes showed clustering between four community and two hospital strains. Such clustering of strains from two different settings based on their genomes suggests that these strains could persist in both. WGS revealed 41 potential resistance genes on average in the hospital strains, but fewer (=32) were detected in the community strains. In contrast, 68 virulence genes were commonly seen in strains from both sources. This study highlights the possible transmission threat to public health posed by virulent present in the gut of asymptomatic individuals in the community.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): Acinetobacter baumannii , antimicrobial resistance , community , comparative genomics , CRISPR–Cas , faecal , hospital , Malaysia and virulence
Funding
This study was supported by the:
  • Monash Malaysia Strategic Large Grant Scheme (Award LG-2017–01-SCI)
    • Principle Award Recipient: SadequrRahman
  • Fundamental Research Grant Scheme (FRGS) from the Ministry of Education (MOE) Malaysia (Award FRGS/1/2019/SKK01/MUSM/01/1)
    • Principle Award Recipient: SadequrRahman
© 2023 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
Loading

Article metrics loading...

/content/journal/mgen/10.1099/mgen.0.000977
2023-04-05
2024-05-04
Loading full text...

Full text loading...

/deliver/fulltext/mgen/9/4/mgen000977.html?itemId=/content/journal/mgen/10.1099/mgen.0.000977&mimeType=html&fmt=ahah

References

  1. Kyriakidis I, Vasileiou E, Pana ZD, Tragiannidis A. Acinetobacter baumannii antibiotic resistance mechanisms. Pathogens 2021; 10:1–31 [View Article]
     [Google Scholar]
  2. Furuya EY, Lowy FD. Antimicrobial-resistant bacteria in the community setting. Nat Rev Microbiol 2006; 4:36–45 [View Article] [PubMed]
     [Google Scholar]
  3. Cave R, Cole J, Mkrtchyan HV. Surveillance and prevalence of antimicrobial resistant bacteria from public settings within urban built environments: challenges and opportunities for hygiene and infection control. Environ Int 2021; 157:106836 [View Article]
     [Google Scholar]
  4. Aldeyab MA, Harbarth S, Vernaz N, Kearney MP, Scott MG et al. The impact of antibiotic use on the incidence and resistance pattern of extended-spectrum beta-lactamase-producing bacteria in primary and secondary healthcare settings. Br J Clin Pharmacol 2012; 74:171–179 [View Article] [PubMed]
     [Google Scholar]
  5. Zeana C, Larson E, Sahni J, Bayuga SJ, Wu F et al. The epidemiology of multidrug-resistant Acinetobacter baumannii: does the community represent a reservoir?. Infect Control Hosp Epidemiol 2003; 24:275–279 [View Article]
     [Google Scholar]
  6. Karanika S, Karantanos T, Arvanitis M, Grigoras C, Mylonakis E. Fecal colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae and risk factors among healthy individuals: a systematic review and metaanalysis. Clin Infect Dis 2016; 63:310–318 [View Article]
     [Google Scholar]
  7. Woerther PL, Burdet C, Chachaty E, Andremont A. Trends in human fecal carriage of extended-spectrum β-lactamases in the community: toward the globalization of CTX-M. Clin Microbiol Rev 2013; 26:744–758 [View Article] [PubMed]
     [Google Scholar]
  8. Asif M, Alvi IA, Rehman SU. Insight into Acinetobacter baumannii: pathogenesis, global resistance, mechanisms of resistance, treatment options, and alternative modalities. Infect Drug Resist 2018; 11:1249–1260 [View Article] [PubMed]
     [Google Scholar]
  9. Dekic S, Hrenovic J, Ivankovic T, van Wilpe E. Survival of ESKAPE pathogen Acinetobacter baumannii in water of different temperatures and pH. Water Sci Technol 2018; 78:1370–1376 [View Article]
     [Google Scholar]
  10. Tacconelli E, Carrara E, Savoldi A, Harbarth S, Mendelson M et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect Dis 2018; 18:318–327 [View Article] [PubMed]
     [Google Scholar]
  11. Diancourt L, Passet V, Nemec A, Dijkshoorn L, Brisse S. The population structure of Acinetobacter baumannii: expanding multiresistant clones from an ancestral susceptible genetic pool. PLoS One 2010; 5:e10034 [View Article]
     [Google Scholar]
  12. Nemec A, Dijkshoorn L, van der Reijden TJK. Long-term predominance of two pan-European clones among multi-resistant Acinetobacter baumannii strains in the Czech Republic. J Med Microbiol 2004; 53:147–153 [View Article]
     [Google Scholar]
  13. Hujer KM, Hujer AM, Hulten EA, Bajaksouzian S, Adams JM et al. Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed army medical center. Antimicrob Agents Chemother 2006; 50:4114–4123 [View Article]
     [Google Scholar]
  14. Wareth G, Linde J, Nguyen NH, Nguyen TNM, Sprague LD et al. WGS-based analysis of carbapenem-resistant Acinetobacter baumannii in Vietnam and molecular characterization of antimicrobial determinants and MLST in Southeast Asia. Antibiotics (Basel) 2021; 10:1–15 [View Article]
     [Google Scholar]
  15. Singh H, Thangaraj P, Chakrabarti A. Acinetobacter baumannii: a brief account of mechanisms of multidrug resistance and current and future therapeutic management. J Clin Diagn Res 2013; 7:2602–2605 [View Article]
     [Google Scholar]
  16. Howard A, O’Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii. Virulence 2012; 3:243–250 [View Article]
     [Google Scholar]
  17. Doughari HJ, Ndakidemi PA, Human IS, Benade S. The ecology, biology and pathogenesis of Acinetobacter spp.: an overview. Microbes Environ 2011; 26:101–112 [View Article]
     [Google Scholar]
  18. Rafei R, Hamze M, Pailhoriès H, Eveillard M, Marsollier L et al. Extrahuman epidemiology of Acinetobacter baumannii in Lebanon. Appl Environ Microbiol 2015; 81:2359–2367 [View Article]
     [Google Scholar]
  19. Antunes LCS, Visca P, Towner KJ. Acinetobacter baumannii: evolution of a global pathogen. Pathog Dis 2014; 71:292–301 [View Article]
     [Google Scholar]
  20. Hamouda A, Findlay J, Al Hassan L, Amyes SGB. Epidemiology of Acinetobacter baumannii of animal origin. Int J Antimicrob Agents 2011; 38:314–318 [View Article]
     [Google Scholar]
  21. Meumann EM, Anstey NM, Currie BJ, Piera KA, Kenyon JJ et al. Genomic epidemiology of severe community-onset Acinetobacter baumannii infection. Microb Genom 2019; 5:e000258 [View Article]
     [Google Scholar]
  22. Leung WS, Chu CM, Chan VL, Lam JY, Ho PL. Fulminant community acquired Acinetobacter baumannii pneumonia as a distinct clinical syndrome. Chest 2005; 128:149S [View Article]
     [Google Scholar]
  23. Wang JT, McDonald LC, Chang SC, Ho M. Community-acquired Acinetobacter baumannii bacteremia in adult patients in Taiwan. J Clin Microbiol 2002; 40:1526–1529 [View Article]
     [Google Scholar]
  24. Li G, Yang M, Zhou K, Zhang L, Tian L et al. Diversity of duodenal and rectal microbiota in biopsy tissues and luminal contents in healthy volunteers. J Microbiol Biotechnol 2015; 25:1136–1145 [View Article]
     [Google Scholar]
  25. Al Atrouni A, Joly-Guillou M-L, Hamze M, Kempf M. Reservoirs of non-baumannii Acinetobacter species. Front Microbiol 2016; 7:49 [View Article]
     [Google Scholar]
  26. Partap U, Young EH, Allotey P, Soyiri IN, Jahan N et al. HDSS profile: The South East Asia community observatory health and demographic surveillance system (SEACO HDSS). Int J Epidemiol 2017; 46:1370–1371G [View Article]
     [Google Scholar]
  27. Huët MAL, Wong LW, Goh CBS, Hussain MH, Muzahid NH et al. Investigation of culturable human gut mycobiota from the segamat community in Johor, Malaysia. World J Microbiol Biotechnol 2021; 37:1–15 [View Article]
     [Google Scholar]
  28. Alsan M, Klompas M. Acinetobacter baumannii: an emerging and important pathogen. J Clin Outcomes Manag 2010; 17:27–35
     [Google Scholar]
  29. Schuurman T, de Boer RF, Kooistra-Smid AMD, van Zwet AA. Prospective study of use of PCR amplification and sequencing of 16S ribosomal DNA from cerebrospinal fluid for diagnosis of bacterial meningitis in a clinical setting. J Clin Microbiol 2004; 42:734–740 [View Article] [PubMed]
     [Google Scholar]
  30. Dashti A, Jadaon M, Abdulsamad A, Dashti H. Heat treatment of bacteria: a simple method of DNA extraction for molecular techniques. Kuwait Med J 2009; 41:
     [Google Scholar]
  31. Vijayakumar S, Biswas I, Veeraraghavan B. Accurate identification of clinically important Acinetobacter spp.: an update. Future Sci OA 2019; 5:FSO395 [View Article] [PubMed]
     [Google Scholar]
  32. Higgins PG, Lehmann M, Wisplinghoff H, Seifert H. gyrB multiplex PCR to differentiate between Acinetobacter calcoaceticus and Acinetobacter genomic species 3. J Clin Microbiol 2010; 48:4592–4594 [View Article]
     [Google Scholar]
  33. CLSI CLSI supplement M100: Performance Standards for Antimicrobial Susceptibility Testing, 28th ed. Clinical and Laboratory Standards Institute; 2018
     [Google Scholar]
  34. Amin M, Navidifar T, Shooshtari FS, Rashno M, Savari M et al. Association between biofilm formation, structure, and the expression levels of genes related to biofilm formation and biofilm-specific resistance of Acinetobacter baumannii strains isolated from burn infection in Ahvaz, Iran. Infect Drug Resist 2019; 12:3867–3881 [View Article]
     [Google Scholar]
  35. Lin MF, Lin YY, Lan CY. Characterization of biofilm production in different strains of Acinetobacter baumannii and the effects of chemical compounds on biofilm formation. PeerJ 2020; 8:e9020 [View Article] [PubMed]
     [Google Scholar]
  36. Zhang D, Xia J, Xu Y, Gong M, Zhou Y et al. Biological features of biofilm-forming ability of Acinetobacter baumannii strains derived from 121 elderly patients with hospital-acquired pneumonia. Clin Exp Med 2016; 16:73–80 [View Article]
     [Google Scholar]
  37. Bolger AM, Lohse M, Usadel B. Trimmomatic: a flexible trimmer for Illumina sequence data. Bioinformatics 2014; 30:2114–2120 [View Article]
     [Google Scholar]
  38. Prjibelski A, Antipov D, Meleshko D, Lapidus A, Korobeynikov A. Using SPAdes De novo assembler. Curr Protoc Bioinformatics 2020; 70:e102 [View Article]
     [Google Scholar]
  39. Seemann T. Prokka: rapid prokaryotic genome annotation. Bioinformatics 2014; 30:2068–2069 [View Article] [PubMed]
     [Google Scholar]
  40. Bartual SG, Seifert H, Hippler C, Luzon MAD, Wisplinghoff H et al. Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii. J Clin Microbiol 2005; 43:4382–4390 [View Article]
     [Google Scholar]
  41. Jia B, Raphenya AR, Alcock B, Waglechner N, Guo P et al. CARD 2017: expansion and model-centric curation of the comprehensive antibiotic resistance database. Nucleic Acids Res 2017; 45:D566–D573 [View Article] [PubMed]
     [Google Scholar]
  42. Zankari E, Hasman H, Cosentino S, Vestergaard M, Rasmussen S et al. Identification of acquired antimicrobial resistance genes. J Antimicrob Chemother 2012; 67:2640–2644 [View Article]
     [Google Scholar]
  43. Chen L, Yang J, Yu J, Yao Z, Sun L et al. VFDB: a reference database for bacterial virulence factors. Nucleic Acids Res 2005; 33:325–328 [View Article]
     [Google Scholar]
  44. Sitto F, Battistuzzi FU. Estimating pangenomes with roary. Mol Biol Evol 2020; 37:933–939 [View Article]
     [Google Scholar]
  45. Couvin D, Bernheim A, Toffano-Nioche C, Touchon M, Michalik J et al. CRISPRCasFinder, an update of crisrfinder, includes a portable version, enhanced performance and integrates search for cas proteins. Nucleic Acids Res 2018; 46:W246–51 [View Article]
     [Google Scholar]
  46. Yoshimura D, Kajitani R, Gotoh Y, Katahira K, Okuno M et al. Evaluation of SNP calling methods for closely related bacterial isolates and a novel high-accuracy pipeline: BactSNP. Microb genomics 2019; 5:1–8 [View Article]
     [Google Scholar]
  47. Page AJ, Taylor B, Delaney AJ, Soares J, Seemann T et al. SNP-sites: rapid efficient extraction of SNPs from multi-FASTA alignments. Microb Genom 2016; 2:e000056 [View Article]
     [Google Scholar]
  48. Croucher NJ, Page AJ, Connor TR, Delaney AJ, Keane JA et al. Rapid phylogenetic analysis of large samples of recombinant bacterial whole genome sequences using Gubbins. Nucleic Acids Res 2015; 43:e15 [View Article] [PubMed]
     [Google Scholar]
  49. Price MN, Dehal PS, Arkin AP. FastTree: computing large minimum evolution trees with profiles instead of a distance matrix. Mol Biol Evol 2009; 26:1641–1650 [View Article] [PubMed]
     [Google Scholar]
  50. Balaban M, Moshiri N, Mai U, Jia X, Mirarab S. TreeCluster: clustering biological sequences using phylogenetic trees. PLoS One 2019; 14:e0221068 [View Article]
     [Google Scholar]
  51. Letunic I, Bork P. Interactive Tree Of Life (iTOL) v5: an online tool for phylogenetic tree display and annotation. Nucleic Acids Res 2021; 49:W293–W296 [View Article] [PubMed]
     [Google Scholar]
  52. Bian X, Liu X, Zhang X, Li X, Zhang J et al. Correction to: epidemiological and genomic characteristics of A. baumannii from different infection sites using comparative genomics (BMC Genomics, (2021), 22, 1, (530), 10.1186/s12864-021-07842-5). BMC Genomics 2021; 22:649 [View Article]
     [Google Scholar]
  53. Turton JF, Woodford N, Glover J, Yarde S, Kaufmann ME et al. Identification of Acinetobacter baumannii by detection of the blaOXA-51-like carbapenemase gene intrinsic to this species. J Clin Microbiol 2006; 44:2974–2976 [View Article]
     [Google Scholar]
  54. Evans BA, Amyes SGB. OXA β-lactamases. Clin Microbiol Rev 2014; 27:241–263 [View Article] [PubMed]
     [Google Scholar]
  55. Tahbaz SV, Azimi L, Lari AR. Characterization of aminoglycoside resistance mechanisms in Acinetobacter baumannii isolates from burn wound colonization. Ann Burns Fire Disasters 2019; 32:115–121
     [Google Scholar]
  56. Hasani A, Sheikhalizadeh V, Ahangarzadeh Rezaee M, Rahmati-Yamchi M, Hasani A et al. Frequency of aminoglycoside-modifying enzymes and ArmA among different sequence groups of Acinetobacter baumannii in Iran. Microb Drug Resist 2016; 22:347–353 [View Article]
     [Google Scholar]
  57. Lin MF, Lin YY, Tu CC, Lan CY. Distribution of different efflux pump genes in clinical isolates of multidrug-resistant Acinetobacter baumannii and their correlation with antimicrobial resistance. J Microbiol Immunol Infect 2017; 50:224–231 [View Article]
     [Google Scholar]
  58. Abdi SN, Ghotaslou R, Ganbarov K, Mobed A, Tanomand A et al. Acinetobacter baumannii efflux pumps and antibiotic resistance. Infect Drug Resist 2020; 13:423–434 [View Article]
     [Google Scholar]
  59. Pérez-Varela M, Corral J, Aranda J, Barbé J. Functional characterization of AbaQ, a novel efflux pump mediating quinolone resistance in Acinetobacter baumannii. Antimicrob Agents Chemother 2018; 62:1–4 [View Article]
     [Google Scholar]
  60. Rajamohan G, Srinivasan VB, Gebreyes WA. Molecular and functional characterization of a novel efflux pump, AmvA, mediating antimicrobial and disinfectant resistance in Acinetobacter baumannii. J Antimicrob Chemother 2010; 65:1919–1925 [View Article]
     [Google Scholar]
  61. Wang J, Zhou Z, He F, Ruan Z, Jiang Y et al. The role of the type VI secretion system vgrG gene in the virulence and antimicrobial resistance of Acinetobacter baumannii ATCC 19606. PLoS One 2018; 13:e0192288 [View Article]
     [Google Scholar]
  62. Brossard KA, Campagnari AA. The Acinetobacter baumannii biofilm-associated protein plays a role in adherence to human epithelial cells. Infect Immun 2012; 80:228–233 [View Article]
     [Google Scholar]
  63. Longo F, Vuotto C, Donelli G. Biofilm formation in Acinetobacter baumannii. New Microbiol 2014; 37:119–127
     [Google Scholar]
  64. Leal NC, Campos TL, Rezende AM, Docena C, Mendes-Marques CL et al. Comparative genomics of Acinetobacter baumannii clinical strains from Brazil reveals polyclonal dissemination and selective exchange of mobile genetic elements associated with resistance genes. Front Microbiol 2020; 11:1176 [View Article]
     [Google Scholar]
  65. Sheldon JR, Skaar EP. Acinetobacter baumannii can use multiple siderophores for iron acquisition, but only acinetobactin is required for virulence. PLoS Pathog 2020; 16:e1008995 [View Article]
     [Google Scholar]
  66. Tomaras AP, Dorsey CW, Edelmann RE, Actis LA. Attachment to and biofilm formation on abiotic surfaces by Acinetobacter baumannii: involvement of a novel chaperone-usher pili assembly system. Microbiology 2003; 149:3473–3484 [View Article]
     [Google Scholar]
  67. Nie D, Hu Y, Chen Z, Li M, Hou Z et al. Outer membrane protein A (OmpA) as a potential therapeutic target for Acinetobacter baumannii infection. J Biomed Sci 2020; 27:26 [View Article]
     [Google Scholar]
  68. Wang Z, Li H, Zhang J, Wang H. Co-Occurrence of bla(OXA-23) in the chromosome and plasmid: increased fitness in carbapenem-resistant Acinetobacter baumannii. Antibiotics (Basel, Switzerland) 2021; 10:1196 [View Article]
     [Google Scholar]
  69. Hassan A, Naz A, Obaid A, Paracha RZ, Naz K et al. Pangenome and immuno-proteomics analysis of Acinetobacter baumannii strains revealed the core peptide vaccine targets. BMC Genomics 2016; 17:732 [View Article]
     [Google Scholar]
  70. Gaba S, Kumari A, Medema M, Kaushik R. Pan-genome analysis and ancestral state reconstruction of class halobacteria: probability of a new super-order. Sci Rep 2020; 10:21205 [View Article] [PubMed]
     [Google Scholar]
  71. Park SC, Lee K, Kim YO, Won S, Chun J. Large-scale genomics reveals the genetic characteristics of seven species and importance of phylogenetic distance for estimating pan-genome size. Front Microbiol 2019; 10:834 [View Article]
     [Google Scholar]
  72. Guo L, Wei D, Zhang X, Wu Y, Li Q et al. Clinical features predicting mortality risk in patients with viral pneumonia: the MuLBSTA score. Front Microbiol 2019; 10:2752 [View Article]
     [Google Scholar]
  73. Zeana C, Larson E, Sahni J, Bayuga SJ, Wu F et al. The epidemiology of multidrug-resistant Acinetobacter baumannii: does the community represent a reservoir?. Infect Control Hosp Epidemiol 2003; 24:275–279 [View Article]
     [Google Scholar]
  74. Dijkshoorn L, van Aken E, Shunburne L, van der Reijden TJK, Bernards AT et al. Prevalence of Acinetobacter baumannii and other Acinetobacter spp. in faecal samples from non-hospitalised individuals. Clin Microbiol Infect 2005; 11:329–332 [View Article]
     [Google Scholar]
  75. Kempf M, Rolain J-M, Diatta G, Azza S, Samb B et al. Carbapenem resistance and Acinetobacter baumannii in Senegal: the paradigm of a common phenomenon in natural reservoirs. PLoS One 2012; 7:e39495 [View Article]
     [Google Scholar]
  76. Berlau J, Aucken H, Malnick H, Pitt T. Distribution of Acinetobacter species on skin of healthy humans. Eur J Clin Microbiol Infect Dis 1999; 18:179–183 [View Article]
     [Google Scholar]
  77. Seifert H, Dijkshoorn L, Gerner-Smidt P, Pelzer N, Tjernberg I et al. Distribution of Acinetobacter species on human skin: comparison of phenotypic and genotypic identification methods. J Clin Microbiol 1997; 35:2819–2825 [View Article]
     [Google Scholar]
  78. Dortet L, Potron A, Bonnin RA, Plesiat P, Naas T et al. Rapid detection of colistin resistance in Acinetobacter baumannii using MALDI-TOF-based lipidomics on intact bacteria. Sci Rep 2018; 8:16910 [View Article]
     [Google Scholar]
  79. Ahmad N, Hashim R, Amran F, Zamri H, Ling L et al. National antimicrobial surveillance report. Inst Med Res Kuala Lumpur Malaysia; 2017
  80. Kong BH, Hanifah YA, Yusof MYM, Thong KL. Antimicrobial susceptibility profiling and genomic diversity of multidrug-resistant Acinetobacter baumannii isolates from a teaching hospital in Malaysia. Jpn J Infect Dis 2011; 64:337–340
     [Google Scholar]
  81. Weber BS, Miyata ST, Iwashkiw JA, Mortensen BL, Skaar EP et al. Genomic and functional analysis of the type VI secretion system in Acinetobacter. PLoS One 2013; 8:e55142 [View Article]
     [Google Scholar]
  82. Liu L-L, Ji S-J, Ruan Z, Fu Y, Fu Y-Q et al. Dissemination of blaOXA-23 in Acinetobacter spp. in China: main roles of conjugative plasmid pAZJ221 and transposon Tn2009. Antimicrob Agents Chemother 2015; 59:1998–2005 [View Article]
     [Google Scholar]
  83. Grissa I, Vergnaud G, Pourcel C. The CRISPRdb database and tools to display CRISPRs and to generate dictionaries of spacers and repeats. BMC Bioinformatics 2007; 8:1–10 [View Article] [PubMed]
     [Google Scholar]
  84. Tyumentseva M, Mikhaylova Y, Prelovskaya A, Tyumentsev A, Petrova L et al. Genomic and phenotypic analysis of multidrug-resistant Acinetobacter baumannii clinical isolates carrying different types of CRISPR/Cas systems. Pathogens 2021; 10:205 [View Article]
     [Google Scholar]
  85. Westra ER, Buckling A, Fineran PC. CRISPR-Cas systems: beyond adaptive immunity. Nat Rev Microbiol 2014; 12:317–326 [View Article] [PubMed]
     [Google Scholar]
  86. Uwingabiye J, Lemnouer A, Roca I, Alouane T, Frikh M et al. Clonal diversity and detection of carbapenem resistance encoding genes among multidrug-resistant Acinetobacter baumannii isolates recovered from patients and environment in two intensive care units in a Moroccan hospital. Antimicrob Resist Infect Control 2017; 6:1–9 [View Article]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/mgen/10.1099/mgen.0.000977
Loading
Molecular characterization and comparative genomic analysis of Acinetobacter baumannii isolated from the community and the hospital: an epidemiological study in Segamat, Malaysia
M Gen 9, 000977 (2023); https://doi.org/10.1099/mgen.0.000977
/content/journal/mgen/10.1099/mgen.0.000977
/content/journal/mgen/10.1099/mgen.0.000977
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF

Supplementary material 2

EXCEL

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error