{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T11:24:58Z","timestamp":1791717898641,"version":"4.3.4"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      We aimed to provide an analysis of\n                      <jats:italic>A<\/jats:italic>\n                      .\n                      <jats:italic>baumannii<\/jats:italic>\n                      complex (ABC) isolated from blood cultures in South Africa.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>ABC surveillance was conducted from 1 April 2017 to 30 September 2019 at 19 hospital sites from blood cultures of any age and sex. Organism identification was performed using the MALDI-TOF MS and antimicrobial susceptibility testing (AST), MicroScan Walkaway System. We confirmed colistin resistance with Sensititre, FRCOL panel, and selected for whole-genome sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the study period, we identified 4822 cases of ABC, of which 2152 cases were from 19 enhanced surveillance sites were reported during the enhanced surveillance period (1 August 2018 to 30 September 2019). Males accounted for 54% (2611\/4822). Of the cases with known age, 41% (1968\/4822) were infants (&lt; 1-year-old). Seventy-eight percent (1688\/2152) of cases had a known hospital outcome, of which 36% (602\/1688) died. HIV status was known for 69% (1168\/1688) of cases, and 14% (238\/1688) were positive. Eighty-two percent (1389\/1688) received antimicrobial treatment in admission. Three percent (35\/1389) of cases received single colistin. Four percent (75\/2033) were resistant to colistin. At least 75% of the isolates (1530\/2033) can be classified as extensively drug-resistant (XDR), with resistance to most antibiotics except for colistin. The majority, 83% (20\/24), of the colistin-resistant isolates were of the sequence type (ST) 1. Resistance genes, both plasmid- and chromosomal- mediated were not observed. Although all isolates had, nine efflux pump genes related to antimicrobial resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our surveillance data contributed to a better understanding of the natural course of\n                      <jats:italic>A<\/jats:italic>\n                      .\n                      <jats:italic>baumannii<\/jats:italic>\n                      disease, the patient characteristics among infants, and the level of resistance. At least two-thirds of the isolates were extensively drug-resistant, and four percent of isolates were resistant to colistin.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0271355","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T13:54:39Z","timestamp":1659621279000},"page":"e0271355","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["Acinetobacter baumannii complex, national laboratory-based surveillance in South Africa, 2017 to 2019"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5580-4629","authenticated-orcid":true,"given":"Olga","family":"Perovic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Duse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vindana","family":"Chibabhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Black","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2610-0440","authenticated-orcid":true,"given":"Mohamed","family":"Said","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Prentice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Wadula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yesholata","family":"Mahabeer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Swe Swe","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Mogokotleng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilhelmina","family":"Strasheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabelle","family":"Jallow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husna","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for GERMS-SA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"pone.0271355.ref001","doi-asserted-by":"crossref","first-page":"4739","DOI":"10.2147\/IDR.S324707","article-title":"The First Saudi Study Investigating the Plasmid-borne Aminoglycoside and Sulfonamide Resistance among Acinetobacter baumannii Clinical Isolates Genotyped by RAPD-PCR: the Declaration of a Novel Allelic Variant Called aac(6\u2019)-SL and Three Novel Mutations in the sul1 Gene in the Acinetobacter Plasmid (s","volume":"14","author":"MF El-Badawy","year":"2021","journal-title":"Infect Drug Resist"},{"issue":"10","key":"pone.0271355.ref002","doi-asserted-by":"crossref","first-page":"e802","DOI":"10.1016\/j.ijid.2013.03.021","article-title":"Reservoirs of Acinetobacter baumannii outside the hospital and potential involvement in emerging human community-acquired infections","volume":"17","author":"M Eveillard","year":"2013","journal-title":"Int J Infect Dis"},{"key":"pone.0271355.ref003","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s13756-019-0537-z","article-title":"Control of Acinetobacter baumannii outbreak in the neonatal intensive care unit in Latvia: whole-genome sequencing powered investigation and closure of the ward","volume":"8","author":"A Gramatniece","year":"2019","journal-title":"Antimicrob Resist Infect Control"},{"key":"pone.0271355.ref004","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ijid.2014.10.014","article-title":"An update on the arsenal for multidrug-resistant Acinetobacter infections: polymyxin antibiotics","volume":"30","author":"Z Kassamali","year":"2015","journal-title":"Int J Infect Dis"},{"issue":"3","key":"pone.0271355.ref005","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"AP Magiorakos","year":"2012","journal-title":"Clin Microbiol Infect"},{"issue":"6","key":"pone.0271355.ref006","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms8060935","article-title":"Antibiotic Resistance Profiles, Molecular Mechanisms and Innovative Treatment Strategies of Acinetobacter baumannii","volume":"8","author":"CO Vrancianu","year":"2020","journal-title":"Microorganisms"},{"key":"pone.0271355.ref007","unstructured":"WHO. 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