{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:04:26Z","timestamp":1790262266163,"version":"4.1.0"},"reference-count":55,"publisher":"Akademiai Kiado Zrt.","content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMICR"],"published-print":{"date-parts":[[2026,9,24]]},"abstract":"Abstract<\/jats:title>\n \n Carbapenem resistance driven by carbapenemase production in Gram-negative bacteria is a global threat. Carbapenem-resistant\n Acinetobacter baumannii<\/jats:italic>\n (CRAb) is a critical priority pathogen listed by the World Health Organization (WHO). While\n bla<\/jats:italic>\n OXA-23<\/jats:sub>\n and\n bla<\/jats:italic>\n OXA-24\/40-like<\/jats:sub>\n are most frequently reported in CRAb, an increasing prevalence of\n bla<\/jats:italic>\n NDM<\/jats:sub>\n has been noted in recent years. This study aimed to investigate the distribution of carbapenemase genes among CRAb isolates obtained from three tertiary care centres in T\u00fcrkiye.\n <\/jats:p>\n \n A total of 336 CRAb isolates recovered from various clinical specimens (blood, respiratory samples, wound\/tissue swabs, urine, and catheter tip samples) between January 2023 and October\u00a02024 were included (Centre-1:198; Centre-2:86; Centre-3:52). Antimicrobial susceptibility testing was performed using the VITEK2 or BD Phoenix system, with additional tests carried out\u00a0using the disc diffusion or broth microdilution methods. The results were interpreted in\u00a0accordance with EUCAST criteria. The\u00a0presence of\n bla<\/jats:italic>\n OXA-51<\/jats:sub>\n ,\n bla<\/jats:italic>\n OXA-23<\/jats:sub>\n ,\n bla<\/jats:italic>\n OXA-24\/40-like<\/jats:sub>\n ,\n bla<\/jats:italic>\n OXA-58<\/jats:sub>\n ,\n bla<\/jats:italic>\n VIM<\/jats:sub>\n ,\n bla<\/jats:italic>\n IMP<\/jats:sub>\n ,\n bla<\/jats:italic>\n NDM<\/jats:sub>\n and\n bla<\/jats:italic>\n KPC<\/jats:sub>\n was tested by qPCR. The clonal relationship among\u00a0the isolates producing metallo-\u03b2-lactamase (MBL) was assessed using AP-PCR and PFGE methods.\n <\/jats:p>\n \n Our study detected\n bla<\/jats:italic>\n OXA-23<\/jats:sub>\n in 305 isolates (90.8%),\n bla<\/jats:italic>\n OXA-24\/40-like<\/jats:sub>\n in 88 (26.2%),\n bla<\/jats:italic>\n NDM<\/jats:sub>\n in 21\u00a0(6.3%), and\n bla<\/jats:italic>\n VIM<\/jats:sub>\n in one isolate. However,\n bla<\/jats:italic>\n OXA-58<\/jats:sub>\n ,\n bla<\/jats:italic>\n IMP<\/jats:sub>\n and\n bla<\/jats:italic>\n KPC<\/jats:sub>\n were not detected. Dual gene combinations were observed in 73 isolates, while triple combinations were identified in three isolates (two\n bla<\/jats:italic>\n NDM<\/jats:sub>\n \/\n bla<\/jats:italic>\n OXA-23<\/jats:sub>\n \/\n bla<\/jats:italic>\n OXA-24\/40-like<\/jats:sub>\n , one\n bla<\/jats:italic>\n VIM<\/jats:sub>\n \/bla<\/jats:italic>\n OXA-23<\/jats:sub>\n \/\n bla<\/jats:italic>\n OXA-24\/40-like<\/jats:sub>\n ). AP-PCR\/PFGE demonstrated a clonal relationship among 18 isolates, all originating from a single intensive care unit at Centre-1. Because carbapenem resistance is endemic in this unit, the cluster was indistinguishable from the background resistant population and was detected only retrospectively by molecular typing; we therefore describe it as a silent outbreak.\n <\/jats:p>\n \n In this study\n bla<\/jats:italic>\n OXA-23<\/jats:sub>\n and\n bla<\/jats:italic>\n OXA-24\/40-like<\/jats:sub>\n were the predominant carbapenemase genes in CRAb, with\n bla<\/jats:italic>\n NDM<\/jats:sub>\n detected at a notable frequency. The detection of combined gene profiles and inter-centre differences highlight the potential impact of local antibiotic use and infection control practices on the dissemination of resistance, and the clonal cluster identified here shows that such dissemination can go unrecognised in endemic settings.\n <\/jats:p>","DOI":"10.1556\/030.2026.03083","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:22:53Z","timestamp":1790259773000},"update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["Investigation of carbapenemase gene distribution in Acinetobacter baumannii in\u00a0a\u00a0region with high carbapenem resistance and\u00a0detection of a silent NDM outbreak"],"prefix":"10.1556","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0563-6185","authenticated-orcid":true,"given":"Hanife","family":"Tutan","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6046-4775","authenticated-orcid":true,"given":"Bilge","family":"Mazlumo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9168-1362","authenticated-orcid":true,"given":"Leyla","family":"Gen\u00e7","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0449-0356","authenticated-orcid":true,"given":"Elif Seren","family":"Tanr\u0131verdi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Inonu University Faculty of Medicine, Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1097-9465","authenticated-orcid":true,"given":"Zeynep","family":"\u00c7izmeci","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2097-3224","authenticated-orcid":true,"given":"Mehmet Emin","family":"Bulut","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3087-5425","authenticated-orcid":true,"given":"Elif","family":"Akta\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"BMC Infect Dis","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12879-021-07024-4","article-title":"Burden of illness in carbapenem-resistant Acinetobacter baumannii infections in US hospitals between 2014 and 2019","volume":"22","author":"Pogue JM","year":"2022","unstructured":"Pogue JM, Zhou Y, Kanakamedala H, Cai B. 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