# The Road Less Traveled: Exploring the Genomic Characteristics and Antimicrobial Resistance Potential of Acinetobacter baumannii From the Indigenous Orang Asli Community in Peninsular Malaysia

## TL;DR

This study explores antibiotic-resistant Acinetobacter baumannii bacteria from healthy people in a remote Malaysian community, finding they share traits with hospital strains, suggesting public health importance.

## Contribution

The study identifies novel genomic features and resistance genes in A. baumannii from an understudied indigenous community, revealing their potential clinical relevance.

## Key findings

- Nine A. baumannii isolates from Orang Asli individuals showed genetic diversity, including new sequence types.
- Isolates carried resistance genes like bla_OXA-51 and bla_ADC but remained susceptible to certain antibiotics.
- Some isolates harbored mobile resistance gene modules on plasmids, indicating potential for spread.

## Abstract

Acinetobacter baumannii is widely recognized as a multidrug‐resistant pathogen, although most public genome datasets are biased toward hospital‐derived isolates. Little is known about A. baumannii isolates from healthy individuals in the community. This study analyzed genome sequences from nine A. baumannii isolates obtained from the upper respiratory tract of the indigenous Orang Asli in their rural community in Peninsular Malaysia. Genomic analysis revealed genetic diversity, including three new Pasteur sequence types (STs) and six novel Oxford STs. One isolate, A. baumannii 19064, belonged to Global Clone 8 (GC8), a lineage linked to clinical infections. Core genome phylogeny showed these community isolates interspersed with clinical isolates from a nearby hospital, indicating potential pathogenicity under suitable conditions. All isolates carried intrinsic bla
OXA‐51‐like carbapenemase and bla
ADC cephalosporinase genes but remained susceptible to meropenem. Two isolates, A. baumannii 19053 and 19062, were tetracycline resistant but minocycline susceptible, and harbored the tet(39)–tetR gene pair within a mobile pdif module on distinct Rep_3‐type plasmids. Only one isolate, A. baumannii 19055, is plasmid‐free; the rest mainly harbored cryptic plasmids, often containing identifiable pdif modules. These findings highlight the clinical relevance of A. baumannii strains residing in healthy individuals, particularly in isolated communities that are seldom accessible to public health. Despite their remote origins, these isolates possess virulence factors and resistance genes similar to those in hospital settings. This underscores the importance of genomic surveillance of commensal pathogens, as exploring these less‐studied isolates can yield insights into broader epidemiological trends and guide future public health strategies.

Analysis of Acinetobacter baumannii from healthy individuals in a rural Malaysian community revealed significant genetic diversity, including novel sequence types. These isolates carry resistance genes and resemble clinical strains, highlighting their potential to cause disease despite their commensal origin. This underscores the need for genomic surveillance of community pathogens.