The modular chromosomal genomic plasticity mediating high level antibiotic resistance in eight clinical carbapenem-resistant <i>Acinetobacter baumannii</i> strains

Objective: (CRAB) strains, and to study the mechanisms and genomic context of antimicrobial resistance for this critical pathogen. Methods: strain to identify genomic context patterns of antibiotic resistance. Results: . Plasmid presence of these modules in other bacterial strains suggests they could have originated from plasmids. Conclusions: We find that modular chromosomal plasticity is the primary driver of carbapenem-resistance in our collection of CRAB isolates, which is a unique evolutionary strategy different from other ESKAPE pathogens. This study provides critical insights into CRAB genomic adaptability, and informs future strategies to combat their spread.