title: Multicity outbreak of carbapenem-resistant Acinetobacter baumannii isolates producing the carbapenemase OXA-40.
abstract: During 2005 we detected a multicity outbreak of infections or colonization due to high-level imipenem-resistant Acinetobacter baumannii (MIC, 64 microg/ml). One hundred isolates from diverse sources were obtained from seven acute-care hospitals and two extended-care facilities; 97% of the isolates belonged to one clone. Susceptibility testing of the first 42 isolates (January to April 2005) revealed broad resistance profiles. Half of the isolates were susceptible to ceftazidime, with many isolates susceptible only to colistin. The level of AmpC beta-lactamase expression was stronger in isolates resistant to ceftazidime. PCR and subsequent nucleotide sequencing analysis identified bla(OXA-40). The presence of an OXA-40 beta-lactamase in these isolates correlated with the carbapenem resistance. By Southern blot analysis, a bla(OXA-40)-specific probe revealed that the gene was both plasmid and chromosomally located. This is the first time in the United States that such carbapenem resistance in A. baumannii has been attributable to a carbapenemase.
authors.affiliation: John Stroger Hospital, Chicago, IL 60612, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Lolans
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Rice
authors.forename: L Silvia
authors.initials: LS
authors.lastname: Munoz-Price
authors.forename: John P
authors.initials: JP
authors.lastname: Quinn
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology*; D002442:Ceftazidime / Q000494:pharmacology; D002641:Chicago / Q000453:epidemiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D007525:Isoelectric Focusing / Q000379:methods; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction / Q000379:methods; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002442:Ceftazidime; D001618:beta-Lactamases; C488541:beta-lactamase OXA-40, Acinetobacter baumannii