title: Emergence and dissemination of blaOXA-23-carrying imipenem-resistant Acinetobacter sp in a regional hospital in Taiwan.
abstract: BACKGROUND
  The distribution and characterization of OXA-type carbapenemases in Acinetobacter sp in Taiwan has less been reported. The aim of the study was to investigate the molecular epidemiology and OXA-type carbapenemase genes in a regional hospital in Taiwan.
  
  
  METHODS
  Imipenem-resistant Acinetobacter sp were collected between 2005 and 2007 in a regional hospital. Genotyping was performed by pulsed-field gel electrophoresis. OXA-type carbapenemase genes were determined by multiplex polymerase chain reaction (PCR) and gene sequencing.
  
  
  RESULTS
  A total of 136 isolates were collected. Fifty-six pulsotypes were identified. None of the pulsotypes established predominance throughout the 3-year period. Multiplex PCR of blaOXA genes showed that 99% (135/136) of the Acinetobacter sp possessed blaOXA51-like genes. The coexistences of blaOXA51-like/blaOXA-23-like and blaOXA51-like/blaOXA-24-like were detected in 19% (26/136) and 1% (2/136) of the isolates, respectively. Among blaOXA-23-like gene-carrying isolates, two isolates (Pulsotypes 18 and 20) were found in 2006 and the remainder (n=24), including Pulsotypes 27 (n=18), 29 (n=1), 52 (n=3), and 53 (n=2), were found in 2007. Sequencing performed on the 26 representative isolates confirmed the presence of the blaOXA-23 carbapenemase gene. Analysis of the genetic content of blaOXA-23 showed that these genes were presumably chromosomal and associated with the upstream-located insertion sequence ISAba1.
  
  
  CONCLUSIONS
  The emergence and imminent widespread of blaOXA-23-carrying imipenem-resistant Acinetobacter sp appeared in Taiwan during the period from 2006 to 2007.
authors.affiliation: Department of Health, Chutung Hospital, Hsin-Chu County, Taiwan.
authors.forename: Ming-Feng
authors.initials: MF
authors.lastname: Lin
authors.affiliation: Department of Health, Hsin-Chu General Hospital, Hsin-Chu City, Taiwan.
authors.forename: Han-Yueh
authors.initials: HY
authors.lastname: Kuo
authors.affiliation: Department of Health, Hsin-Chu General Hospital, Hsin-Chu City, Taiwan.
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Yeh
authors.affiliation: Department of Health, Hsin-Chu General Hospital, Hsin-Chu City, Taiwan.
authors.forename: Chih-Man
authors.initials: CM
authors.lastname: Yang
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsin-Chu City, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Sung
authors.affiliation: Department of Health, Chutung Hospital, Hsin-Chu County, Taiwan; Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsin-Chu City, Taiwan.
authors.forename: Chi-Chao
authors.initials: CC
authors.lastname: Tu
authors.affiliation: Department of Health, Hsin-Chu General Hospital, Hsin-Chu City, Taiwan.
authors.forename: Mei-Luan
authors.initials: ML
authors.lastname: Huang
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsin-Chu City, Taiwan.
authors.forename: Ming-Li
authors.initials: ML
authors.lastname: Liou
mesh_terms: D000150:Acinetobacter / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006767:Hospitals, District; D006801:Humans; D015378:Imipenem / Q000494:pharmacology*; D058889:Molecular Typing; D060885:Multiplex Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D013624:Taiwan / Q000453:epidemiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D015378:Imipenem; C466679:beta-lactamase OXA-23; D001618:beta-Lactamases