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May 28, 2026Open Access

Genomic and phenotypic characterization of carbapenem-resistant Acinetobacter baumannii isolates from patients and trolleys and their potential connections in an intensive care unit

PMPengpeng MinHangzhou Medical College HXHaotian XuZhejiang Chinese Medical University HPHongjia PanHangzhou Medical College

Key Points

This research aims to explore the genomic and phenotypic characteristics of carbapenem-resistant Acinetobacter baumannii isolates from both patients and environmental surfaces in an intensive care unit.
Comparative genomic analysis of isolates from patients and trolleys to assess relatedness.
Evaluation of biofilm formation using Live/Dead staining and scanning electron microscopy.
Analysis of disinfectant susceptibility across all isolates.
Three clonal clusters of isolates were identified with SNP differences < 19.
Predominant capsular polysaccharide type was KL7 and lipopolysaccharide type was OCL1.
Demonstrated coexistence of closely related CRAB on patients and trolley surfaces within the ICU.

Abstract

BACKGROUND: Carbapenem-resistant Acinetobacter baumannii (CRAB) poses significant challenges in intensive care units (ICU) due to its multidrug resistance and environmental persistence. To date, most studies have focused on clinical isolates or patient-environment transmission. However, high-touch mobile surfaces have been less extensively characterized. RESULTS: . The capsular polysaccharide (K locus) and lipopolysaccharide (OC locus) types were predominantly KL7 and OCL1, respectively. Comparative genomic analysis revealed a high degree of genomic relatedness between patient and trolley associated isolates, including three clonal clusters (SNP differences < 19). To further characterize environmental persistence, we assessed biofilm formation using Live/Dead staining and scanning electron microscopy (SEM), and evaluated disinfectant susceptibility across all isolates. CONCLUSIONS: These findings demonstrate the coexistence of closely related CRAB on patients and trolley surfaces within the same ICU and highlight the importance of considering high-touch mobile surfaces in infection prevention and control (IPC) strategies. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04310722. Registered on 18 March 2020. Retrospectively registered.

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