Clonal relatedness of Acinetobacter baumannii isolated from the Middle East: a systematic review

Determination of clonal relatedness among Acinetobacter baumannii strains at region level is an important epidemiological issue. In this systematic review, we analyzed 33 MLST-based studies (both Oxford and Pasteur MLST schemes) conducted in the Middle East. This study showed that multidrug-resistant ST2(Pas) (belonging to CC2), ST195(Ox), and ST208(Ox) (both belonging to CC92) have been repeatedly reported from numerous Middle Eastern countries. In the Pasteur scheme, bla(VIM) and bla(IMP) as carbapenmase genes have been mainly detected from Saudi Arabia. Moreover, bla(OXA-58) encoding sequence types were from Turkey (ST2, ST109, and ST84) and Saudi Arabia (ST19, ST20, ST196, ST194). On the other hand, an analysis of the Oxford scheme revealed that there were five major clonal complexes, including CC218, CC109, CC99, CC236, and CC1151. Egyptian sequence types were the main producers of bla(NDM), bla(VIM), and bla(KPC). This study indicates that highly visited countries in this region have an important role in the distribution of major carbapenemase genes. These countries effectively involved in the expansion and circulation of multidrug-resistant sequence types through- out the Middle East. Copyright (C) 2021 Wolters Kluwer Health, Inc. All rights reserved.

Automated summary

This systematic review analyzed 33 MLST-based studies conducted in the Middle East and found repeated reports of multidrug-resistant sequence types such as ST2(Pas), ST195(Ox), and ST208(Ox) in multiple Middle Eastern countries. The Pasteur scheme mainly detected carbapenemase genes bla(VIM) and bla(IMP) from Saudi Arabia, while the Oxford scheme revealed five major clonal complexes. Egyptian sequence types were the main producers of bla(NDM), bla(VIM), and bla(KPC). This study indicates the important role of highly visited countries in the distribution and spread of major carbapenemase genes and multidrug-resistant sequence types throughout the Middle East.