title: [Antimicrobial resistance and genotyping of Acinetobacter baumannii in ICU].
abstract: OBJECTIVE
  To investigate the outbreak of acinetobacter baumannii in the ICU, and to explore the antimicrobial resistance characteristics of pathogens, and therefore to determine the optimal prevention strategies.
  
  
  METHODS
  From May to June 2007, most of the cases of infection by acinetobacter baumannii in our ICU were collected. PFGE (pulsed field gel electrophoresis) and standard disk diffusion susceptibility tests were performed on the strains isolated from the patients' body fluids including sputum, blood, urine, secretion and from the ICU environment involving the patients' bed sheet, skin surface and medical staff's hands, humidification water of ventilator tubes.
  
  
  RESULTS
  Twelve strains were resistant to imipenem and meropenem. Colistin sulphate and tigecycline showed a high rate of antimicrobial activity against the strains, the rate of susceptibility being 100% and 91.7% respectively. These strains belonged to 3 clones (clone A, B, C) and there were 2 sub-clones (A1, A2) belonging to clone A. The sub-clone A1 was isolated from the surface of unwashed medical staff's hands and patients' body fluids. From intermediate to resistance, the antimicrobial characteristics of clone A and clone B to minocycline changed over a month, and there was one strain that was resistant to tigecycline.
  
  
  CONCLUSIONS
  The outbreak of acinetobacter baumannii in the ICU was caused by carbapenem resistant acinetobacter baumannii (CRAb). The delicate changes of disk diffusion susceptibility in clones A and B occurred in one month. Unwashed hands of medical staff were probably responsible for the outbreak.
authors.affiliation: Department of Respiratory Disease of Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Guo-xin
authors.initials: GX
authors.lastname: Mo
authors.forename: Dan-yang
authors.initials: DY
authors.lastname: She
authors.forename: Xi-zhou
authors.initials: XZ
authors.lastname: Guan
authors.forename: Jun-chang
authors.initials: JC
authors.lastname: Cui
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.forename: Liang-an
authors.initials: LA
authors.lastname: Chen
mesh_terms: D000150:Acinetobacter / Q000145:classification* / Q000187:drug effects* / Q000235:genetics; D000151:Acinetobacter Infections / Q000382:microbiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005838:Genotype; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017385:Sequence Homology