Dissemination of A Clone of Unusual Phenotype of Pandrug-Resistant Acinetobacter baumannii at a Univer sity Hospital in Taiwan
From December 2002 to February 2003, 15 isolates of pandrug-resistant
unidentified Acinetobacter species were recovered from seven patients with
nosocomial infections or colonizations treated at different wards or intensive
care units at the National Taiwan Univer sity Hospital. These isolates, which were
glucose- and lactose-non-acidifier s, failed to recognize to the species level using
three commercial identification systems: the Vitek GNI, API 20NE system
(bioMerieux, Marcy L’Etoile, France) and the Phoenix System
(Becton-Dickinson, Sparks, Md.), and 16S rRNA gene sequence analysis.
However , 16S-23S rRNA intergenic spacer PCR-restr iction fragment length
polymorphism profiles and the sequence analysis of these isolates both identified
as A. baumannii. All these isolates were uniformly resistant to
ampicillin-sulbactam (MICs, 128->128 mg/ml), ceftazidime (MICs, 64->128
mg/ml), piperacillin-tazobactam (MICs, 128->128 mg/ml), cefepime (MICs, 16-32
mg/ml), aztreonam (MICs, 64-128 mg/ml), ciprofloxacin (MICs, 64-128 mg/ml),
trovafloxacin (MICs, 8-16 mg/ml), moxifloxacin (MICs, 4 mg/ml), garenoxacin
(MICs, 16-32 mg/ml), amikacin (MICs, >128 mg/ml), imipenem (MICs, 8-16
mg/ml), and meropenem (MICs, 128->128 mg/ml). The identity of the pulsed-field
gel electrophoresis patterns and antibiotypes among these isolates from the same
patients with an interval of 4-8 weeks and different patients indicated that this
pandrug-resistant A.baumannii with unusual phenotype could have long-term
per sistence in humans and has widely disseminated at the hospital.
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