• Acinetobacter baumannii
• Antibiotic resistance
• Burn wound infection
• Clinical strains
• Efflux pumps

• Acinetobacter baumannii/drug effects
• Acinetobacter baumannii/genetics
• Acinetobacter baumannii/isolation & purification
• Acinetobacter baumannii/metabolism
• Acinetobacter Infections/microbiology
• Humans
• Anti-Bacterial Agents/pharmacology
• Burns/microbiology
• Burns/complications
• Microbial Sensitivity Tests
• Membrane Transport Proteins/genetics
• Membrane Transport Proteins/metabolism
• Bacterial Proteins/genetics
• Bacterial Proteins/metabolism
• Wound Infection/microbiology
• Drug Resistance, Multiple, Bacterial
• Mexico

• antibiotic resistance
• carbapenem-resistant Acinetobacter baumannii
• hospital-acquired infections
• infection control
• interrupted time series analysis

• Health and Medical Research Fund
• Theme Based Research Scheme
• RGC Postdoctoral Fellowship
• Collaborative Research Fund
• Guangdong Major Project of Basic and Applied Basic Research

• A. baumannii
• OprD
• Porins
• Single-channel Electrophysiology

• 117S114 Türkiye Bilimsel ve Teknolojik Araştirma Kurumu

• Acinetobacter baumannii
• carbapenem resistant
• liver transplantation

• Acinetobacter baumannii
• Multidrug resistance
• carbapenem resistance
• extensive-drug resistance
• risk factors

• Humans
• Acinetobacter baumannii
• Retrospective Studies
• Prospective Studies
• Amikacin/therapeutic use
• Amikacin/pharmacology
• Drug Resistance, Multiple, Bacterial
• Acinetobacter Infections/drug therapy
• Acinetobacter Infections/epidemiology
• Carbapenems/pharmacology
• Carbapenems/therapeutic use
• Cross Infection/drug therapy
• Cross Infection/epidemiology
• Risk Factors

Antimicrobial-resistant pathogenic bacteria are an increasing problem in public health, especially in the healthcare environment, where nosocomial infection microorganisms find their niche. Among these bacteria, the genus Acinetobacter which belongs to the ESKAPE pathogenic group harbors different multi-drug resistant (MDR) species that cause human nosocomial infections. Although A. baumannii has always attracted more interest, the close-related species A. pittii is the object of more study due to the increase in its isolation and MDR strains. In this work, we present the genomic analysis of five clinically isolated A. pittii strains from a Spanish hospital, with special attention to their genetic resistance determinants and plasmid structures. All the strains harbored different genes related to β-lactam resistance, as well as different MDR efflux pumps. We also found and described, for the first time in this species, point mutations that seem linked with colistin resistance, which highlights the relevance of this comparative analysis among the pathogenic species isolates.

• CRE
• ESKAPE pathogens
• Gram-negative bacteria
• Infection control
• MDR-GNB
• Nosocomial infections

• A. baumannii
• Colistin
• FIC index
• Imipenem
• MIC
• Pandrug-resistant
• Silver nanoparticles
• Synergy

Introduction  The outbreak of Acinetobacter calcoaceticus baumannii ( ACB ) is mainly reported to be a notorious pathogens at health-care settings. It is the major problem on the health-care system with high morbidity and mortality rates because of the broad range of antibiotic resistance and lack of understanding the mechanism of developing new antibiotic resistance rapidly. It emphasizes the importance of local surveillance in describing or understanding and predicting microbial resistance patterns so that there will be limited use of antibiotics by developing strategies to control the extensive use of antimicrobial chemotherapy in clinical environment, which is still considered as one of the factors in the emergence of multidrug resistance microorganisms.

Objectives  The study aims to detect the occurrence rate of ACB infections from various clinical samples, identify the resistance levels to different groups of antimicrobial agents, and the occurrence rate of multidrug resistant (MDR) ACB clinical isolates from a tertiary hospital in Durgapur, West Bengal, India.

Material and Methods  The study was performed in the Department of Microbiology of the IQ City Medical College and Hospital, Durgapur, West Bengal, India, for the 24 months duration, that is, from January 1, 2018 to December 31, 2019. Altogether 15,800 clinical samples consisting of endotracheal tube aspirates, sputum, pus, blood, catheter tips, urine, tissue, and other body fluids were studied. ACB from clinical samples were identified by its characteristic colonies (nonlactose fermenting, glistening, small mucoid colonies), Gram-staining pattern (Gram-negative coccobacillus), and standard biochemical reactions. It was further confirmed in the Department of Microbiology of the Healthworld Hospital, Durgapur, West Bengal, India, by Vitek2 compact system (bioMerieux, Inc., Durham, North Carolina, United States). Antibiotic susceptibility testing was performed using automated broth microdilutions by Vitek2 compact system (bioMerieux, Inc.) and Kirby-Bauer disk diffusion test on Mueller-Hinton Agar (HiMedia).

Results  Nonrepetitive 289 ACB were isolated from various clinical samples. A total of 277 (96%) isolates of ACB were MDR strains.

Conclusion   ACB was mostly isolated from the intensive care unit department and was found to be the most MDR type in the tertiary care hospital by this study.

• Acinetobacter baumannii
• coaX
• coenzyme A
• multidrug resistance
• pantothenate kinase.
• pathogen

• A. baumannii
• carbapenem
• efflux pump
• metallo β-lactamase
• oxacillinase
• porin
• treatment options

• Acinetobacter baumannii/drug effects
• Anti-Bacterial Agents/pharmacology
• Bacteriophages/metabolism
• Carbapenems/pharmacology
• Cephalosporins
• Colistin/pharmacology
• Drug Resistance, Multiple, Bacterial/genetics
• Drug Resistance, Multiple, Bacterial/physiology
• Humans
• Membrane Transport Proteins/genetics
• Microbial Sensitivity Tests
• Polymyxin B/pharmacology
• Tetracyclines/pharmacology
• beta-Lactamases/pharmacology
• beta-Lactams/pharmacology
• Cefiderocol

• Acinetobacter baumannii
• biofilms
• human medicine
• multi-drug resistance
• veterinary medicine

This study aimed to develop and validate a personalized prediction model of death risk in patients with Acinetobacter baumannii (A. baumannii) infection and thus guide clinical research and support clinical decision-making.

The development group is comprised of 350 patients with A. baumannii infection admitted between January 2013 and December 2015 in The First Affiliated Hospital of Anhui Medical University. Further, 272 patients in the validation group were admitted between January 2016 and December 2018. The univariate and multivariate logistic regression analyses were used to determine the independent risk factors for death with A. baumannii infection. The nomogram prediction model was established based on the regression coefficients. The discrimination of the proposed prediction model was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curves and decision curve analysis (DCA). The calibration diagram was used to evaluate the calibration degree of this model.

The infectious source, carbapenem-resistant A. baumannii (CRAB), hypoalbuminemia, Charlson comorbidity index (CCI), and mechanical ventilation (MV) were independent risk factors for death. The AUC of the ROC curve of the two groups was 0.768 and 0.792, respectively. The net income was higher when the probability was between 30% and 80%, showing a strong discrimination capacity of the proposed model. The calibration curve swung around the 45° oblique line, indicating a high degree of calibration.

The proposed model helped predict the risk of death from A. baumannii infection, improve the early identification of patients with a higher risk of death, and guide clinical treatment.

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• Acinetobacter baumannii
• carbapenem resistance
• prediction model
• risk factors

• Acinetobacter baumannii
• Essential dynamics
• HTVS
• MD Simulation
• MurB protein
• SBDD

The spread of carbapenem-resistant A. baumannii (CrAb) is gaining worldwide attention. The spread of this pathogen is largely due to its ability to acquire various resistance genes of intrinsic and extrinsic origins that confer unpredictable susceptibility to β-lactams. The aim of this study was to analyze β-lactamase genetic compositions of CrAb in Malaysia.

Whole-genome sequencing (WGS) was carried out on 13 CrAb isolates from clinical samples in Malaysia from 2011 to 2016.

Endotracheal aspirate was the dominant clinical sample source (n = 6), and only one isolate was obtained from wound swab. A total of 6 sequence types (STs) of the Oxford scheme were identified, including 4 reported STs and 2 novel STs. Eleven isolates were classified into clonal complex 92 (CC92/ICII), among which ST195 and ST208 were the most prevalent STs. All 13 CrAb isolates harbored multiple β-lactamase genes. bla_OXA-23 (n = 13) and bla_OXA-66 (n = 11) were the dominant carbapenemase gene families found in these isolates. All isolates harbor bla_ADC, bla_OXA-51-like, and bla_OXA-23-like genes. bla_TEM (n = 7), bla_NDM-1 (n = 3), bla_CARB-8 (n = 1), and bla_PER-3 (n = 1) are amongst other β-lactamase genes found in this study. ISAba1 was found upstream to bla_OXA-23 (n = 13), bla_OXA-66 (n = 1), and bla_ADC (n = 11). All bla_NDM-1 isolates had ISAba125 (mobile genetic element) upstream to the genes. All isolates were positive for Tn2006/2008 and Tn2009 but were negative for Tn2007.

Most of the isolates were grouped under the CC92 clonal complex which belongs to international clonal lineage 2. These findings predict that carriage of carbapenem-resistant genes possibly constitutes the underlying basis of high level of international clone II prevalence. Therefore, molecular surveillance and antimicrobial stewardship are essential in implementing policies to prevent and control the spread of CrAb in hospital settings.

• Acinetobacter Infections/immunology
• Acinetobacter Infections/pathology
• Acinetobacter baumannii/immunology
• Acinetobacter baumannii/pathogenicity
• Animals
• Chemokines/immunology
• Female
• Immunity, Innate/drug effects
• Kanamycin/pharmacology
• Lung/immunology
• Lung/pathology
• Mice
• Mice, Knockout
• Phagocytes/pathology
• Pneumonia, Bacterial/immunology
• Pneumonia, Bacterial/microbiology

• S10 OD023475 NIH HHS
• F32 AI122516 NIAID NIH HHS
• Howard Hughes Medical Institute
• U24 DK059637 NIDDK NIH HHS
• R01 AI101171 NIAID NIH HHS
• T32 GM152284 NIGMS NIH HHS
• T32 HL087738 NHLBI NIH HHS
• K99 HL143441 NHLBI NIH HHS
• T32 GM007347 NIGMS NIH HHS
• P30 CA068485 NCI NIH HHS
• U.S. Department of Veterans Affairs
• National Institutes of Health
• Cystic Fibrosis Foundation
• Gilead Sciences

ICU shows increasing incidence of infection associated with the use of invasive procedures for the diagnostic purpose as well as the indiscriminate use of antibiotics. Pseudomonas aeruginosa and Acinetobacter species are “very successful” pathogen and the emergence of the Metallo-β-Lactamases (MBL) is becoming a therapeutic challenge.

To isolate the Nonfermenting Gram negative bacilli from the ICU samples. To identify the metallo betalactamase producers and to detect the bla gene presence among the Pseudomonas aeruginosa and Acinetobacter baumannii.

The Nonfermenting Gram negative bacilli isolates from the ICU samples were taken over for 5 years (2009-2014) in a tertiary care hospital.

The isolates of Pseudomonas species and Acinetobacter species were confirmed by API analyser and processed according to standard procedures. Detection of the MBL producers were done by E strip method and subjected for bla gene detection by PCR method.

In our study a total of 195 isolates of NFGNB were obtained from various ICU. Of these MBL producers, 26 % were Pseudomonas aeruginosa and 25 % were Acinetobacter baumannii. The subtypes of bla_VIM MBL producing P.aeruginosa were 26%. The predominant gene coding for MBL activity in A.baumannii were found to be bla_OXA gene 11.9%. The gene accession numbers were KF975367, KF975372.

We have to control the development and dissemination of these superbugs among the ICU's.

• Acinetobacter baumanni
• ICU
• Metallo-β-lactamases
• Pseudomonas aeruginosa
• bla genes

Acinetobacter baumannii is an important cause of hospital-acquired, multidrug-resistant (MDR) infections occurring worldwide. Anti-microbial combination regimens may be the only feasible treatment option for affected patients. In the present study, the efficacy of the combined therapy of meropenem with colistin, ampicillin-sulbactam, tazobactam and vancomycin against clinical strains of MDR A. baumannii was determined. Anti-microbial susceptibility testing was performed and resistance genes were characterized by a multiplex polymerase chain reaction (PCR)-reverse line blot assay. The genetic background of New Delhi metallo-β-lactamase 1 (NDM-1) was analysed by primer walking. The presence of NDM-1 was detected using the modified Hodge test and the EDTA-combined disk test. To screen for synergistic drug effects, the fractional inhibitory concentration index was calculated using a checkerboard assay. The results of the PCR as well as the sequence analyses suggested that NDM-1 was located downstream of the ISAba125 element. In addition, a synergistic effect was determined for meropenem + vancomycin, meropenem + tazobactam and meropenem + ampicillin + sulbactam in two strains each, and in four strains for meropenem + colistin. A total of five A. baumannii strains with resistance to numerous antibiotics and carrying numerous resistance genes were identified. In the strains of A. baumannii, the NDM-1 gene was integrated in a transposon structure with a copy of the ISAba125 insertion sequence. However, the genetic background was not identical among the different species and strains. The genetic variability of NDM-1 may facilitate the rapid dissemination of this gene. In conclusion, meropenem may enhance the efficacy of antibiotics in A. baumannii strains with NDM-1-associated MDR.

• Acinetobacter baumannii
• New Delhi metallo-β-lactamase 1
• antimicrobial effect
• metallo-β-lactamase
• multidrug-resistant

• Acinetobacter baumannii
• Burn unit
• Nosocomial infection
• Outbreak
• Ultrasound gel

• Lung transplantation
• Mortality
• Multidrug resistance
• Risk factor

• ABC Transporter
• Acinetobacter baumannii
• glycerophospholipids
• infectious disease
• microbiology

• Acinetobacter baumannii/genetics
• Acinetobacter baumannii/metabolism
• Adenosine Triphosphate/chemistry
• Anti-Bacterial Agents/pharmacology
• Bacterial Outer Membrane Proteins/metabolism
• Biological Transport
• Cell Membrane/metabolism
• Computational Biology
• Cryoelectron Microscopy
• DNA Transposable Elements
• Escherichia coli/metabolism
• Escherichia coli Proteins/metabolism
• Genome, Bacterial
• Glycerophospholipids/metabolism
• Hydrolysis
• Lipopolysaccharides/metabolism
• Molecular Conformation
• Mutagenesis
• Mutation
• Phenotype

• R01GM118396 NIH HHS
• U19 AI107775 NIAID NIH HHS
• R01 GM118396 NIGMS NIH HHS
• T32 GM008268 NIGMS NIH HHS

The human pathogen Acinetobacter baumannii has emerged as a frequent cause of hospital-acquired infections, but infection of animals has rarely been observed. Here we analyzed an outbreak of epidemic pneumonia killing hundreds of sheep on a farm in Pakistan and identified A. baumannii as the infecting agent. A pure culture of strain AbPK1 isolated from lungs of sick animals was inoculated into healthy sheep, which subsequently developed similar disease symptoms. Bacteria re-isolated from the infected animals were shown to be identical to the inoculum, fulfilling Koch’s postulates. Comparison of the AbPK1 genome against 2283 A. baumannii genomes from the NCBI database revealed that AbPK1 carries genes for unusual surface structures, including a unique composition of iron acquisition genes, genes for O-antigen synthesis and sialic acid-specific acetylases of cell-surface carbohydrates that could enable immune evasion. Several of these unusual and otherwise rarely present genes were also identified in genomes of phylogenetically unrelated A. baumannii isolates from combat-wounded US military from Afghanistan indicating a common gene pool in this geographical region. Based on core genome MLST this virulent isolate represents a newly emerging lineage of Global Clone 2, suggesting a human source for this disease outbreak. The observed epidemic, direct transmission from sheep to sheep, which is highly unusual for A. baumannii, has important consequences for human and animal health. First, direct animal-to-animal transmission facilitates fast spread of pathogen and disease in the flock. Second, it may establish a stable ecological niche and subsequent spread in a new host. And third, it constitutes a serious risk of transmission of this hyper-virulent clone from sheep back to humans, which may result in emergence of contagious disease amongst humans.

• Acinetobacter baumannii
• Koch’s postulates
• cgMLST
• epidemic pneumonia in sheep
• genome comparison
• immune evasion
• iron acquisition

• Acinetobacter
• antimicrobial resistance
• hospital

• Acinetobacter/isolation & purification
• Acinetobacter Infections/microbiology
• Adult
• Anti-Bacterial Agents/pharmacology
• Cross Infection/microbiology
• Drug Resistance, Multiple, Bacterial/drug effects
• Drug Resistance, Multiple, Bacterial/genetics
• Female
• Humans
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Retrospective Studies

• Antibiotics
• ESKAPE
• infection
• intracellular
• nanoparticles

• disease-modifying antirheumatic drugs
• multidrug-resistance acinetobacter baumannii
• rheumatoid arthritis
• tumor necrosis factor inhibitor

• Acinetobacter baumannii/isolation & purification
• Aged
• Anti-Bacterial Agents/administration & dosage
• Anti-Bacterial Agents/therapeutic use
• Antirheumatic Agents/adverse effects
• Antirheumatic Agents/therapeutic use
• Arthritis, Rheumatoid/complications
• Arthritis, Rheumatoid/diagnosis
• Arthritis, Rheumatoid/drug therapy
• C-Reactive Protein/analysis
• Cefoperazone/administration & dosage
• Cefoperazone/therapeutic use
• Drug Resistance, Multiple
• Female
• Humans
• Pneumonia/diagnostic imaging
• Pneumonia/drug therapy
• Pneumonia/microbiology
• Radiography/methods
• Sulbactam/administration & dosage
• Sulbactam/therapeutic use
• Tomography, X-Ray Computed/methods
• Treatment Outcome
• Tumor Necrosis Factor-alpha/adverse effects
• Tumor Necrosis Factor-alpha/antagonists & inhibitors
• Tumor Necrosis Factor-alpha/therapeutic use

• antibiotic resistance
• drug efflux

Multidrug-resistant Acinetobacter baumannii is among the most common causes of infectious complications associated with combat-related trauma in military personnel serving overseas. However, little is currently known about its pathogenesis. While the gastrointestinal (GI) tract has been found to be a major reservoir for A. baumannii, as well as to potentially contribute to development of multidrug resistance, no studies have addressed the mechanisms involved in gut colonization. In this study, we address this critical gap in knowledge by first assessing the interaction between secretory IgA (SIgA), the principal humoral immune defense on mucosal surfaces, and the A. baumannii clinical isolate Ci79. Surprisingly, SIgA appeared to enhance A. baumannii GI tract colonization, in a process mediated by bacterial thioredoxin A (TrxA), as evidenced by reduction of bacterial attachment in the presence of TrxA inhibitors. Additionally, a trxA targeted deletion mutant (ΔtrxA) showed reduced bacterial burdens within the GI tract 24 h after oral challenge by in vivo live imaging, along with loss of thiol-reductase activity. Surprisingly, not only was GI tract colonization greatly reduced but the associated 50% lethal dose (LD₅₀) of the ΔtrxA mutant was increased nearly 100-fold in an intraperitoneal sepsis model. These data suggest that TrxA not only mediates A. baumannii GI tract colonization but also may contribute to pathogenesis in A. baumannii sepsis following escape from the GI tract under conditions when the intestinal barrier is compromised, as occurs with cases of severe shock and trauma.

Acinetobacter baumannii is an emerging bacterial pathogen recently classified as a serious threat to U.S. and global health by both the Centers for Disease Control and Prevention and the World Health Organization. It also is one of the leading causes of combat-related infections associated with injured military personnel serving overseas. Little is known regarding mechanisms of gastrointestinal tract colonization despite this site being shown to serve as a reservoir for multidrug-resistant (MDR) A. baumannii isolates. Here, we establish that secretory IgA, the major immunoglobulin of mucosal surfaces, promotes A. baumannii GI tract colonization via bacterial thioredoxin A as evidenced through significant reduction in colonization in IgA-deficient animals. Additionally, bacterial colonization and mortality were significantly reduced in animals challenged with a thioredoxin A-deficient A. baumannii mutant. Combined, these data suggest that thioredoxin A is a novel virulence factor, for which antithioredoxin therapies could be developed, for this important multidrug-resistant pathogen.

• Acinetobacter
• SIgA
• bacterial virulence
• gastrointestinal infection
• thioredoxin

• MDR-GNB
• healthcare-associated infection
• pediatric intensive care unit

• Acinetobacter baumannii
• Pseudomonas aeruginosa
• colistin
• imipenem
• meropenem
• piperacillin/tazobactam

• Acinetobacter
• Characteristics
• Epidemiology
• Multi-drug resistance
• Nosocomial infections

The study aims to determine the prevalence of multidrug-resistant A. baumannii in Aseer Region, Kingdom of Saudi Arabia.

This study evaluated the antibiotic susceptibility of ninety-four (n = 94) clinical isolates of A. baumannii. The isolates were collected from the south region of Saudi Arabia, and notably Aseer Region, during the period from 15 October 2014 to 15 January 2015. The isolates were tentatively identified as A. baumannii by routine bench tests and were confirmed by using VITEK® 2 Compact. The latest instrument was used to identify antibiotic susceptibility of these isolates.

Antibiotic susceptibility in this study showed that 69% of these isolates were multidrug-resistant strains. Moreover, they were highly resistant to carbapenem drugs. Several strains of these isolates were found to be extremely resistant to test antibiotics and were only sensitive to one or two of them.

High rate of multidrug-resistant A. baumannii bacteraemia has emerged in the south region of Saudi Arabia as an important health problem. Therefore, it is considered as a new threat in hospitals, which requires a tremendous effort to stop its escalation and spread.

• Acinetobacter
• Intensive care unit
• Lebanon
• Multi-drug resistance
• Ventilator-associated pneumonia

The purpose of the study was to determine the proportions of multidrug-resistant (MDR) Acinetobacter spp. isolates from the district of Nashik in Western India during the period from 2011–2014. Antibacterial susceptibility testing of isolates from inpatients and outpatients was performed using Kirby–Bauer disc diffusion method to determine inhibitory zone diameters. Proportions of non-susceptible isolates were calculated from the antibacterial susceptibility data. MDR was defined as an isolate being non-susceptible to at least one antibacterial agent in at least three antibacterial categories. The change in proportions of MDR isolates; extended-spectrum β-lactamase (ESBL)-producing isolates; and non-susceptible isolates to specific antibacterial categories over calendar time was investigated by logistic regression. The proportions of MDR and ESBL-producing isolates ranged from 89.4% to 95.9% and from 87.9% to 94.0%; respectively. The proportions of non-susceptible isolates to aminoglycosides; carbapenems; antipseudomonal penicillins/β-lactamase inhibitors; cephalosporins; folate pathway inhibitors; or penicillins/β-lactamase inhibitors exceeded 77.5%. Proportions of fluoroquinolone and tetracycline non-susceptible isolates ranged from 65.3% to 83.3% and from 71.3% to 75.9%; respectively. No changes in trends were observed over time; except for a decreasing trend in fluoroquinolone non-susceptible isolates (OR = 0.75 (95% CI, 0.62–0.91)). Significantly higher proportions of non-susceptible; MDR and ESBL-producing isolates were found among isolates from the respiratory system compared to isolates from all other specimen types (p < 0.05). High proportions of MDR Acinetobacter spp. isolates were observed in the period from 2011–2014. Antimicrobial stewardship programmes are needed to prevent the emergence and spread of antibiotic resistance.

• Acinetobacter
• India
• antibacterial susceptibility testing
• antibiotic resistance
• multidrug resistance

The American Centers for Disease Control and Prevention (CDC) recognizes Acinetobacter baumannii as a source of global outbreaks and epidemics especially due to its increasing resistance to commercially available antibiotics. In this study, 69 single patient multidrug resistant isolates collected from all over Palestine, except Gaza, were studied. All the isolates were resistant to all the β–lactam antibiotics including the carbapenems. Of the 69 isolates, 82.6% were positive for bla_OXA-23, 14.5% were positive for bla_OXA-24, and 3% were positive for bla_OXA-58. None were positive for bla_OXA-143 and bla_OXA-235. In addition, 5.8% and 0% were positive for bla_NDM and bla_KPC, respectively. Of the 69 isolates, none were positive for the aminoglycoside aphA6 gene while 93% were positive for the aphA1 gene. The acetyltransferases aacC1 and aacA4 genes tested positive in 22% and 13% of the isolates, respectively. The ompA biofilm-producing virulence gene was detected in all isolates. Finally, Multilocus Sequence Typing (MLST) of 13 isolates revealed that more than one strain of A. baumannii was circulating in Palestinian hospitals as results revealed that 7 isolates were of ST208, 2 isolates ST218, 1 isolate ST231, 1 isolate ST348, and 2 new Sequence Types. The detection of these drug resistant pathogens is a reminder of the importance of active surveillance for resistant bacteria in order to prevent their spread in hospital settings.

• Acinetobacter baumannii
• Carbapenemase gene
• MLST
• PFGE
• Pulsotype
• Sequence type

• Coronary heart disease
• functional foods
• hypercholesterolemia
• probiotics

• Gram-negative
• MDR
• MLST
• carbapenem
• nonfermenter
• nosocomial infections
• typing