{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:23:20Z","timestamp":1787725400001,"version":"build-2784847793"},"reference-count":60,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2301101"],"award-info":[{"award-number":["2021YFC2301101"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100118"],"award-info":[{"award-number":["82100118"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Science and Technology Projects in Guangzhou","award":["2023A03J0333"],"award-info":[{"award-number":["2023A03J0333"]}]},{"name":"Guangdong Special Support Program Project 2024"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      is a critical opportunistic pathogen increasingly linked to hospital-acquired infections due to its ability to acquire multidrug resistance (MDR). Its persistence in clinical environments and resistance to nearly all major antibiotic classes make it a formidable challenge for infection control and treatment. This study investigated the molecular epidemiology and therapeutic strategies for\n                      <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                      across three hospital campuses. A total of 148 clinical MDR\n                      <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                      isolates were collected, mostly recovered from respiratory tract specimens in ICU settings. All isolates underwent whole-genome sequencing (WGS), antibiotic susceptibility testing against 16 antibiotics, and\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      evaluation of 14 antibiotic combinations. WGS confirmed 140 clinical isolates as\n                      <jats:italic toggle=\"yes\">A. baumannii,<\/jats:italic>\n                      and 42.3% were classified as extensively drug-resistant (XDR). High resistance rates were observed for carbapenems (98.6%), fluoroquinolones (100%), and aminoglycosides (91.4%), while susceptibility to polymyxin B (PMB) and tigecycline (TGC) remained largely preserved. Four antibiotic combinations, TGC + cefoperazone\/sulbactam (CSL), TGC + PMB, PMB + CSL, and minocycline (MNO) + CSL, demonstrated strong synergistic effects (&gt;90%). The efficacy and safety of the MNO + CSL combination were preliminarily assessed in the mouse model. Genome sequence typing revealed ST2 as the dominant clone (92.9%), while a novel XDR clone, ST697, was identified. Genomic and virulence profiling suggests that ST697 evolved from ST2, representing a high-risk lineage with potential for early, rapid dissemination. A notably high mortality rate (71.4%) was observed among patients infected with ST697. Long-read sequencing assembled complete ST697 genomes revealed that ST697 isolates carry multiple copies of the\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>OXA-23<\/jats:sub>\n                      gene, and the\n                      <jats:italic toggle=\"yes\">Galleria mellonella<\/jats:italic>\n                      infection model revealed that ST697 isolates exhibit virulence comparable to the highly virulent ST2\n                      <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      This study reveals the emergence of ST697, a novel, highly drug-resistant, and virulent clone of\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      , closely related to ST2. It also identifies potent antibiotic combinations that may serve as effective alternatives to last-line monotherapy. These findings highlight the urgent need for surveillance, infection control, and targeted therapy, especially in ICU and respiratory settings, to curb the spread of this emerging clone.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02293-25","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T13:00:44Z","timestamp":1776344444000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Emergence of a high-risk multidrug-resistant\n                    <i>Acinetobacter baumannii<\/i>\n                    clone ST697 in nosocomial settings"],"prefix":"10.1128","volume":"14","author":[{"given":"Jing","family":"Guan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"State Key Laboratory of Respiratory Disease, Department of respiratory, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University","place":["Guangzhou, People's Republic of China"]},{"id":[{"id":"https:\/\/ror.org\/00z0j0d77","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9317-4488","authenticated-orcid":false,"given":"Huiqi","family":"Qu","sequence":"additional","affiliation":[{"name":"Center for Applied Genomics, Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Yu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00zat6v61","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, KingMed School of Laboratory Medicine, Guangzhou Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weilong","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"State Key Laboratory of Respiratory Disease, Department of respiratory, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University","place":["Guangzhou, People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garnet","family":"Eister","sequence":"additional","affiliation":[{"name":"Center for Applied Genomics, Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2814-7461","authenticated-orcid":false,"given":"Hakon","family":"Hakonarson","sequence":"additional","affiliation":[{"name":"Center for Applied Genomics, Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]},{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"Division of Human Genetics, Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]},{"name":"Division of Pulmonary Medicine, Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]},{"id":[{"id":"https:\/\/ror.org\/01db6h964","id-type":"ROR","asserted-by":"publisher"}],"name":"Faculty of Medicine, University of Iceland","place":["Reykjav\u00edk, Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9663-5358","authenticated-orcid":true,"given":"Shaoqiang","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"State Key Laboratory of Respiratory Disease, Department of respiratory, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University","place":["Guangzhou, People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/2049-632X.12125"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2019.09.012"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1301.060716"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002318"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro.2017.148"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2022.2093134"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11071171"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-021-06690-6"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02207-23"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-022-00536-0"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens10030373"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.159497"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2019.11.021"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10101239"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2020.104263"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1086\/595977"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-007-0330-4"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2008.11.002"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10070880"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-018-0141-x"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(18)65573-5"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ078"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(22)00181-1"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2022.106689"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.715568"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2020.07.011"},{"key":"e_1_3_5_29_2","first-page":"119","article-title":"Biofilm formation in Acinetobacter baumannii","volume":"37","author":"Longo F","year":"2014","unstructured":"Longo F, Vuotto C, Donelli G. 2014. Biofilm formation in Acinetobacter baumannii. New Microbiol 37:119\u2013127.","journal-title":"New Microbiol"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.16718\/j.1009-7708.2023.01.013"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9061295"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/bty560"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1005595"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msab199"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13059-019-1891-0"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btu153"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2015.06.007"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkz935"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkab1107"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-2836(05)80360-2"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13059-014-0524-x"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btv421"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btz305"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkab301"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2012.0076"},{"key":"e_1_3_5_47_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-023-04583-z"},{"key":"e_1_3_5_48_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.1017488"},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1118122"},{"key":"e_1_3_5_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67060-2"},{"key":"e_1_3_5_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14649"},{"key":"e_1_3_5_52_2","doi-asserted-by":"publisher","DOI":"10.1155\/2000\/382415"},{"key":"e_1_3_5_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2021.119882"},{"key":"e_1_3_5_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2022.120915"},{"key":"e_1_3_5_55_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01805-22"},{"key":"e_1_3_5_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2016.09.033"},{"key":"e_1_3_5_57_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01732-10"},{"key":"e_1_3_5_58_2","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.02852-24"},{"key":"e_1_3_5_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(22)00064-7"},{"key":"e_1_3_5_60_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2012-7"},{"key":"e_1_3_5_61_2","doi-asserted-by":"publisher","DOI":"10.1099\/mgen.0.000306"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.02293-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.02293-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T13:13:51Z","timestamp":1781702031000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.02293-25"}},"subtitle":[],"editor":[{"given":"Gillian A. M.","family":"Tarr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":60,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,2]]}},"alternative-id":["10.1128\/spectrum.02293-25"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.02293-25","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]},"assertion":[{"value":"2025-08-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e02293-25"}}