title: High endemic levels of multidrug-resistant Acinetobacter baumannii among hospitals in southern Brazil.
abstract: BACKGROUND
  Most published data on multidrug-resistant Acinetobacter baumanii (MDR Ab) are derived from outbreaks. We report incidence trends on health care-acquired infections due to MDR Ab over a 12-month period in the city of Porto Alegre in southern Brazil.
  
  
  METHODS
  Clinical and epidemiologic data were obtained from the local health care information system of the municipal health department. Polymerase chain reaction was used to detect the presence of the genes bla(OXA-23-like), bla(OXA-24-like), bla(OXA-51), and bla(OXA-58), and repetitive sequence-based polymerase chain reaction and pulsed-field gel electrophoresis were performed for molecular typing.
  
  
  RESULTS
  The highest rate of infection (9.0/1,000 inpatient-days) was identified in a trauma hospital. The gene bla(OXA-23-like) was identified in 99.0% of MDR Ab isolates. Eight main clonal groups were identified by molecular typing, and 3 of these were found in all hospitals.
  
  
  CONCLUSIONS
  The presence of 3 clones in all hospitals demonstrates the ability of MDR Ab to spread among hospitals. Moreover, the occurrence of one particular clone (clone 4) throughout the study period suggests its increased ability to cause outbreaks and to remain in the environment. The monitoring of epidemic strains by molecular methods is of paramount importance to prevent or reduce the spread of MDR Ab.
authors.affiliation: Department of Surveillance Health, Porto Alegre, Brazil. amartins20@bol.com.br
authors.forename: Andreza F
authors.initials: AF
authors.lastname: Martins
authors.forename: Ricardo S
authors.initials: RS
authors.lastname: Kuchenbecker
authors.forename: Kátia O
authors.initials: KO
authors.lastname: Pilger
authors.forename: Mariana
authors.initials: M
authors.lastname: Pagano
authors.forename: Afonso L
authors.initials: AL
authors.lastname: Barth
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000235:genetics*; D015373:Bacterial Typing Techniques; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks / Q000517:prevention & control*; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005798:Genes, Bacterial; D006761:Hospitals; D006801:Humans; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D001618:beta-Lactamases / Q000235:genetics / Q000302:isolation & purification
chemical_list: D001618:beta-Lactamases