The newly identified ST164 strain of antibiotic-resistant CRAB bacteria is spreading in Asia and poses a global health risk due to high resistance and limited treatment options. Careful infection control and genomic monitoring are critical to containing its spread. A highly virulent, antibiotic-resistant strain of bacteria that causes serious disease may spread widely in Asia and pose serious challenges to global public health, a new study suggests.

While investigating the impact of integrated infection prevention and control (IPC) measures on the spread of CRAB, researchers identified the ST164 variant of carbapenem-resistant Acinetobacter baumannii (CRAB) in a Chinese intensive care unit (ICU).

Experts conducted a comprehensive genomic study in an intensive care unit in Hangzhou over three months in 2021 and found that 80.9% of A. baumannii bacteria found in patients were CRAB and ST164 accounted for 40.2% of the samples found it.

By publishing your findings Nature Communication, Researchers from the University of Birmingham and Zhejiang University show that other hospital wards and transferred patients may be the source of new CRAB strains entering intensive care units.

The study follows up on the team’s previous study in 2019 at the Hangzhou Intensive Care Unit, which found that about a third of patients were infected with CRAB.

Recent studies show that one type of strain (GC2) among CRAB isolates has decreased from 99.5% in 2019 to 50.8% in 2021. The remainder of the population consisted mainly of ST164 isolates that had evolved since mid-2020 and had double carbapenem resistance. Those with GC2 strains.

Increased resistance and need for careful monitoring

Co-author Professor Alan McNally, from the University of Birmingham, commented: “We believe that ST164 has become established in intensive care units and may spread widely in Asia. Although ST164 caused fewer infections than GC2 during the study period, antibiotic resistance has If it is high, it indicates that close monitoring is required.

CRAB poses a serious risk to hospitalized patients and can cause serious illnesses such as pneumonia, urinary tract infections, bacteremia, meningitis and soft tissue infections. “Current IPC measures are vital to control the spread of these bacteria in hospitals, and further research is needed to understand how these strains thrive in the hospital environment.”

The research was supported by funding from the Medical Research Council and the National Natural Science Foundation of China. The study involved high-resolution whole genome sequencing and comparative analysis of CRAB isolates. CRAB can persist on hospital surfaces and medical equipment for extended periods of time, colonizing patients within 48 hours of hospital admission, thanks to hospital staff, shared equipment, airflow, and plumbing. CRAB outbreaks may require intervention or change in infrastructure, creating clinical, logistical, and financial burdens.

A global threat to public health and an urgent need for new treatment methods

Antibiotic-resistant infections are a serious threat to global public health. CRAB infections occur worldwide with very limited treatment options, which has led the World Health Organization to identify CRAB as a priority organism for which new therapeutic agents are urgently needed.

Co-author Professor Willem van Schaik, from the University of Birmingham, added: “The health impacts of CRAB, particularly the ST164 clone, are profound and are affecting patient outcomes, healthcare systems and public health worldwide. In the absence of new therapeutic agents, morbidity and mortality caused by bacteria in hospitals “Effective CRAB IPC strategies are vital if we are to limit mortality. Moreover, our study demonstrates the power of genomic surveillance to map the emergence and spread of this drug-resistant clone.”