Your new experience awaits. Try the new design now and help us make it even better

ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.

Sec. Molecular Bacterial Pathogenesis

Molecular, biofilm and motility characterization of Acinetobacter baumannii isolated from a neonatal intensive care unit at a children's hospital in South China

Provisionally accepted
Ze-Lin  YUZe-Lin YUXiaobing  HongXiaobing Hong*Hong-Bo  FUHong-Bo FUYanqiong  ZhouYanqiong ZhouXiajiong  LuoXiajiong LuoYue-Bin  WUYue-Bin WUDan-Wei  CAIDan-Wei CAIZe-Jian  KUANGZe-Jian KUANG
  • The Second Affiliated Hospital of Shantou University Medical College, Shantou, China

The final, formatted version of the article will be published soon.

Background: Multidrug-resistant Acinetobacter baumannii (MDR-AB) poses a critical threat in neonatal intensive care units (NICUs), however few studies have reported the molecular characterization of A. baumannii isolates from the NICU in China. This study aims to describe the molecular, biofilm and motility characteristics related to carbapenem resistance genes in A. baumannii isolates from the NICU. Methods: Following an outbreak in March–April 2024, 21 A. baumannii isolates from neonatal and environmental sources were collected. These isolates underwent antimicrobial susceptibility testing, whole-genome sequencing (WGS) for resistance gene profiling and multi-locus sequence typing (MLST). Biofilm formation and twitching motility were measured in representative strains exposed to subinhibitory concentrations of gentamicin, levofloxacin, and meropenem. Results: All 21 A. baumannii isolates were carbapenem-resistant Acinetobacter baumannii (CRAB), showing resistance to cephalosporins, aminoglycosides, and quinolones. WGS identified 25 resistance genes, including the universalblaOXA-23, blaOXA-66, blaADC-25and blaTEM-1D, aminoglycoside resistance genes (armA, aph genes), macrolide resistance genes (mphE, msrE), and tetracycline (tetB) resistance genes. Efflux pumps (adeABC, adeFGH, adeIJK) were ubiquitous. Two sequence types emerged: ST195 (20 isolates) and ST1959 (1 isolate), with high genetic similarity suggesting nosocomial transmission. ST1959 exhibited stronger biofilm formation than ST195. Biofilm formation of ST1959 was significantly enhanced by gentamicin but inhibited by levofloxacin. Meropenem suppressed only the ST195 biofilms. Twitching motility was markedly reduced in ST1959 and also decreased after levofloxacin exposure. Conclusion: This NICU outbreak was driven by CRAB ST195 harboring a conserved resistome. Strain-specific differences in biofilm formation and motility under antibiotic stress highlight the interplay between genetic lineage and phenotypic adaptability. Levofloxacin demonstrates dual anti-biofilm and anti-motility effects, which could guide targeted infection control strategies against high-risk A. baumannii clones.

Keywords: Acinetobacter baumannii, Biofilm, motility, multidrug resistance, Children

Received: 14 Sep 2025; Accepted: 05 Nov 2025.

Copyright: © 2025 YU, Hong, FU, Zhou, Luo, WU, CAI and KUANG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xiaobing Hong, xiaobinghong@126.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.