Genomic and epidemiologic analyses reveal how multidrug‑resistant Acinetobacter baumannii spreads within intensive care units, mapping transmission networks and identifying environmental and procedural reservoirs that sustain outbreaks. The study highlights genetic determinants of resistance and transmission clusters tied to invasive devices and staffing patterns. Authors call for reinforced infection‑control measures, targeted environmental decontamination, and stewardship to curb spread. Findings underscore the pathogen’s ability to persist in clinical environments and the need for genomic surveillance to detect and interrupt transmission early. The work informs hospital infection prevention teams and developers of diagnostics and therapeutics by pinpointing transmission drivers and resistance mechanisms that complicate treatment in critical care settings.