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Geographic Stratification and Pangenome Plasticity Drive the Global Success of Carbapenem-Resistant Acinetobacter Baumannii ST2

Author

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  • Rong Xiang

    (Precision Medicine Center & Gut Microbiome Diagnosis and Treatment Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China & Chongqing Municipality Clinical Research Center for Geriatrics and Gerontology, Chongqing, China)

  • Senhong Ying

    (Precision Medicine Center & Gut Microbiome Diagnosis and Treatment Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China & Chongqing Municipality Clinical Research Center for Geriatrics and Gerontology, Chongqing, China)

  • Zhirong Zhang

    (Precision Medicine Center & Gut Microbiome Diagnosis and Treatment Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China & Chongqing Municipality Clinical Research Center for Geriatrics and Gerontology, Chongqing, China)

  • Rongzhong Huang

    (Precision Medicine Center & Gut Microbiome Diagnosis and Treatment Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China & Chongqing Municipality Clinical Research Center for Geriatrics and Gerontology, Chongqing, China)

  • Peng Hu

    (Institute for Viral Hepatitis, Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China)

Abstract

The global success of carbapenem-resistant Acinetobacter baumannii sequence type 2 (ST2) has been linked to extensive genomic plasticity, yet the mechanisms stabilizing resistance remain poorly defined. This study integrated bronchoalveolar lavage fluid metagenomics, whole-genome sequencing (WGS), and global phylogenomics to resolve the evolutionary architecture of carbapenem-resistant Acinetobacter baumannii. Local ST2 populations were polyclonal and uniformly exhibited chromosomal integration of the gene blaOXA-23 via the Tn2006 composite transposon. Metagenomic analyses revealed dense in situ cooccurrence networks comprising 34 resistance genes. At the global scale, Chinese isolates carried significantly higher resistance gene burdens than international counterparts. Structural analyses identified the replication-termination T1 and T2 plasmids as horizontal “shuttles” facilitating accessory gene dissemination, whereas chromosomal insertion sequences functioned as vertical “anchors” stabilizing core resistance loci. These findings supported a shuttle-and-anchor evolutionary model underlying ST2 persistence and regional endemic adaptation.

Suggested Citation

  • Rong Xiang & Senhong Ying & Zhirong Zhang & Rongzhong Huang & Peng Hu, 2026. "Geographic Stratification and Pangenome Plasticity Drive the Global Success of Carbapenem-Resistant Acinetobacter Baumannii ST2," International Journal of E-Health and Medical Communications (IJEHMC), IGI Global Scientific Publishing, vol. 17(1), pages 1-25, January.
    • Handle: RePEc:igg:jehmc0:v:17:y:2026:i:1:p:1-25
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