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JAC Advance Access published online on April 5, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl129
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received October 7, 2005
Revised March 16, 2006
Accepted March 20, 2006

Brief report

Evolution of multidrug-resistant Acinetobacter baumannii isolates obtained from elderly patients with respiratory tract infections

Miren J. Canduela 1, Lucía Gallego 1 *, Elena Sevillano 1, Cristina Valderrey 1, Felícitas Calvo 2, and Julia Pérez 2

1 Dpto. Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, Universidad del País Vasco, Bilbao, Spain
2 Servicio de Microbiología y Medicina, Hospital de Santa Marina, Bizkaia, Spain

* To whom correspondence should be addressed.
Lucía Gallego, E-mail: lucia.gallego{at}ehu.es


  Abstract

Objectives: To study the evolution between 1999 and 2002 and mechanisms of antibiotic resistance in a multidrug-resistant Acinetobacter baumannii clone predominant in isolates from elderly patients with respiratory tract infections.

Methods: Susceptibility to antimicrobials was determined using an agar dilution method. Bacterial clones were identified by PCR-fingerprinting and PFGE with ApaI. Carbapenemases were detected by phenotypic tests; by PCR with primers specific for blaOXA-40, blaIMP, blaVIM-1 and blaVIM-2; and by hybridization with DNA probes. Class 1 integrons were detected using PCR.

Results: In 1999 isolates were grouped into two main genotypes: clone I (33%) and clone II (55%). These were also detected in 2002 with a different distribution: clone I (69%), clone II (22%). Resistance to amikacin, meropenem and imipenem increased significantly in clone I over this time, whereas clone II was not affected. In 2002, the incidence of blaOXA-40 rose to 91% in clone I isolates with some also harbouring blaVIM-2 and blaIMP genes. Different class 1 integrons were detected ranging in size from 550 to 1200 bp. No relationship was found between carbapenemases and class 1 integrons.

Conclusions: In elderly patients, a single clone became predominant among A. baumannii isolates, coinciding with an increase in antibiotic resistance rates. The majority of isolates harboured the blaOXA-40 carbapenemase gene and some of them also harboured blaVIM-2 and blaIMP genes. The presence of class 1 integrons also increased over time.

Keywords: A. baumannii; carbapenemases; OXA-40; resistance; integrons.
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