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

Abstract

Supplemental Digital Content is available in the text 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 ST2Pas (belonging to CC2), ST195Ox, and ST208Ox (both belonging to CC92) have been repeatedly reported from numerous Middle Eastern countries. In the Pasteur scheme, blaVIM and blaIMP as carbapenmase genes have been mainly detected from Saudi Arabia. Moreover, blaOXA-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 blaNDM, blaVIM, and blaKPC. 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 throughout the Middle East.