title: How carbapenem-resistant Acinetobacter spp. established in a newly constructed hospital.
abstract: Annually increasing rates of carbapenem-resistant Acinetobacter spp. were observed in a Taiwan hospital since its establishment in November 1998 to March 2005. Increasing consumption of carbapenems was also noticed. Carbapenem-resistant Acinetobacter spp. from 33 patients carried a class 1 integron. Twenty-eight isolates were Acinetobacter baumannii harbouring both ISAba1 and an OXA-51-like gene. Twenty-four of the 28 A. baumannii isolates had ISAba1 upstream of the OXA-51-like gene. Four A. baumannii isolates harboured the OXA-24-like gene and one isolate had the VIM-11 gene. Regarding the five non-baumannii Acinetobacter spp., three Acinetobacter genomic species 3 isolates and one Acinetobacter radioresistens isolate had both IMP-1 and OXA-58-like genes. One A. radioresistens isolate had an OXA-23-like gene. One major clone of A. baumannii (25/28; 89.3%) was identified by ribotyping. Three ribotypes were identified as being brought into the hospital by patient transfer from other hospitals. In conclusion, an insidious clonal dissemination with various resistance mechanisms contributed to the spread of carbapenem-resistant Acinetobacter spp. in a hospital setting, with increasing usage of carbapenems as the possible selection pressure. Notification of carbapenem-resistant Acinetobacter spp. infection when patients are transferred between hospitals is important to control the spread of carbapenem resistance.
authors: Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors: Po-Liang
authors: PL
authors: Lu
authors: Li-Yueh
authors: LY
authors: Huang
authors: Shen-Tsuen
authors: ST
authors: Lian
authors: Ko
authors: K
authors: Chang
authors: Chun-Lu
authors: CL
authors: Lin
authors: In-Jane
authors: IJ
authors: Hwang
authors: Wen-Gin
authors: WG
authors: Chiang
authors: Yen-Hsu
authors: YH
authors: Chen
authors: Sheng-Fung
authors: SF
authors: Lin
authors: L K
authors: LK
authors: Siu
mesh_terms: D000150:Acinetobacter / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D040981:Acinetobacter baumannii; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D004269:DNA, Bacterial / Q000235:genetics; D006761:Hospitals; D006801:Humans; D032023:Integrons; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D004269:DNA, Bacterial; D001618:beta-Lactamases