{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:02:01Z","timestamp":1784721721234,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Carbapenem-resistant\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      is a critical-priority pathogen in pediatric hospitals, but the relative roles of clonal transmission and environmental reservoirs remain unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed 42 non-duplicate\n                      <jats:italic>A. baumannii<\/jats:italic>\n                      isolates collected between 2020 and 2023 from clinical specimens (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f28), medical waste (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f8), and hospital-setting samples (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f6) at Wuhan Children\u2019s Hospital. Antimicrobial susceptibility testing, PCR-based resistance gene detection, pulsed-field gel electrophoresis, and crystal-violet biofilm assays were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Clinical isolates showed high multidrug resistance (75.0%, 21\/28), with 75.0% resistant to piperacillin\u2013tazobactam, ceftazidime, imipenem, meropenem, and ciprofloxacin. All isolates remained susceptible to tigecycline.\n                      <jats:italic>OXA-23<\/jats:italic>\n                      was detected in all carbapenem-resistant clinical isolates, and\n                      <jats:italic>aac(6\u2032)-Ib-cr<\/jats:italic>\n                      was present in all fluoroquinolone-resistant isolates. One dominant clinical clone, T11, accounted for 57.1% of clinical isolates and included one\n                      <jats:italic>OXA-23<\/jats:italic>\n                      \/\n                      <jats:italic>NDM<\/jats:italic>\n                      co-producing isolate. PFGE revealed no clonal overlap between clinical and non-clinical isolates; all medical-waste and hospital-setting isolates were fully susceptible. Biofilm formation was detected in 97.6% of isolates; among clinical isolates, biofilm intensity was inversely associated with multidrug resistance, with susceptible isolates forming stronger biofilm (Fisher\u2019s exact\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Pediatric multidrug-resistant\n                      <jats:italic>A. baumannii<\/jats:italic>\n                      infections in this hospital were most consistent with patient-to-patient dissemination of a dominant resistant clone rather than with contamination from the hospital-setting or medical-waste reservoirs sampled here, although the small environmental sample cannot definitively exclude such reservoirs. Phenotype\u2013genotype\u2013PFGE surveillance provides actionable guidance for infection control in resource-limited pediatric settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1911587","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:10:25Z","timestamp":1784718625000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clonal patient-to-patient spread is associated with multidrug-resistant Acinetobacter baumannii infections in a Chinese pediatric hospital: an integrated phenotype\u2013genotype\u2013PFGE surveillance study"],"prefix":"10.3389","volume":"13","author":[{"given":"Wanjun","family":"Luo","sequence":"first","affiliation":[{"name":"Hospital-Acquired Infection Control Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuyang","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Hubei University of Traditional Chinese Medicine","place":["Wuhan, China"]},{"name":"Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijing","family":"Liu","sequence":"additional","affiliation":[{"name":"Children\u2019s Medical Ward I, Wuhan Children\u2019s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongj Medical College, Huazhong University of Science & Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyong","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changzhen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuduan","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Wangjing Hospital of China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1111\/2049-632X.12125","article-title":"Acinetobacter baumannii: evolution of a global pathogen","volume":"71","author":"Antunes","year":"2014","journal-title":"Pathog Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant 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