OBJECTIVETo characterize the genetic background of multidrug-resistant Acinetobacter baumannii (A. baumannii) from China, and the population structure of this pathogen.

METHODSA previously reported MLST scheme was applied to a collection of 33 multidrug-resistant strains of A. baumannii from China, and the data of all the strains in the A. baumannii MLST database were downloaded for the population structure analysis. The sequence types and clonal complexes were identified, the presence or absence of recombination was analyzed for each MLST locus, and the values of I(A)(S), and recombination/mutation ratio were calculated for the whole strain collection. A phylogenetic tree was constructed using all the allelic profiles in the database.

RESULTSA total of six sequence types were identified from the 33 Chinese strains tested, and 29 of these strains belonged to the CC92 clonal complex. Three (gdhB, gpi, and rpoD) of the seven MLST loci (gltA, gyrB, recA, cpn60, gdhB, gpi, rpoD) had undergone recombination with statistical evidence. For all allele profiles in the MLST database, the I(A)(S) value was 0.155 and the recombination/mutation ratio was 6.083. Sequence types from each clonal complex were grouped closely in the phylogenetic tree, which gave an overview of the microevolution of this pathogen.

CONCLUSIONThe spread of multidrug-resistant A. baumannii in China was closely related to the CC92 clonal complex. A. baumannii had an 'epidemic' population structure, i.e., a superficially clonal structure with high levels of recombination, in which successful epidemic clones arise especially including worldwide dissemination of the CC92 clonal complex to cause a widespread occurrence of multidrug-resistant infections.