title: An investigation of drug-resistant Acinetobacter baumannii infections in a comprehensive hospital of East China.
abstract: BACKGROUND
  To investigate the drug resistant gene profiles and molecular typing of Acinetobacter baumannii isolates collected from clinical specimens in a comprehensive hospital, Jiangsu province.
  
  
  METHODS
  This study included 120 patients in a comprehensive hospital with drug-resistant A. baumannii infections on clinical specimens from October 2011 to December 2013. Antibiotic susceptibility test was determined by Vitek 2 Compact system. OXA-51, OXA-23, OXA-24, OXA-58, VIM, IMP, SHV, GES, TEM, AmpC, qacEΔ1-sul1, intI l, CarO, aac(6')-Ib, and aac(6')-II were analyzed by PCR. The analysis of molecular typing for 50 multidrug resistant A. baumannii isolates was performed by PFGE.
  
  
  RESULTS
  A total of 64(53%) isolates were multidrug-resistant A.baumannii. The antibiotic susceptibility tests showed that the resistant rates to common antibiotics of mutidrug-resistant A. baumannii were extremely high, most of which over 60%. One hundred and ten isolates harbored OXA-51 (91.7%), 100 for OXA-23(83.3%), 103 for VIM-1(85.8%), 90 for AmpC(75.00%), 50 for aac(6')-Ib(41.7%), 77 for the loss of CarO (64.2%), 85 for intl1(70.8%), and 64 for qacEΔ1-sul1(53.33%), while OXA-24 was undetected. Fifty multidrug-resistant A. baumannii isolates belong to 14 clones according to the PFGE DNA patterns. Main clone A includes 24 isolates, while clone B and clone C includes 6 and 9 isolates, respectively and others with no common source identified.
  
  
  CONCLUSIONS
  There is high morbidity of A. baumannii infections in the hospital, especially in ICU and sputum is the most common sample type.The mainly drug-resistant genes of A. baumannii are OXA-51, OXA-23, and VIM-1 in the hospital. Clonal dissemination provides evidence for the prevalence of multidrug-resistant A. baumannii among clinical isolates. It is suggested that there is an urgent need for effective control and prevention measures.
authors: Department of Laboratory Medicine, Jiangsu provincial hospital of Traditional Chinese Medicine, Nanjing, China. suzan795@163.com.
authors: Su-ying
authors: SY
authors: Zhao
authors: The State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China. 384972830@qq.com.
authors: Dong-yang
authors: DY
authors: Jiang
authors: The State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China. lyronlu@163.com.
authors: Peng-cheng
authors: PC
authors: Xu
authors: The State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China. 386980303@qq.com.
authors: Yi-kai
authors: YK
authors: Zhang
authors: Department of Laboratory Medicine, Jiangsu provincial hospital of Traditional Chinese Medicine, Nanjing, China. 43315349@qq.com.
authors: Heng-fang
authors: HF
authors: Shi
authors: Department of Laboratory Medicine, Jiangsu provincial hospital of Traditional Chinese Medicine, Nanjing, China. lmh-@gmail.com.
authors: Hui-ling
authors: HL
authors: Cao
authors: The State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China. wuqian@njmu.edu.cn.|Department of Hygienic Analysis and Detection, School of Public Health, Nanjing Medical University, Nanjing, 211166, China. wuqian@njmu.edu.cn.|Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA. wuqian@njmu.edu.cn.
authors: Qian
authors: Q
authors: Wu
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins
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