Abstract:
Background: Although members of the Acinetobacter genus are not commonly part of the human flora, their relatively high
prevalence in hospital environment frequently results in colonization of the skin and respiratory tract.
Objectives: The present investigation was carried out to elucidate epidemiologic characteristics of nosocomial Acinetobacter
baumannii infections in a teaching hospital.
Methods: Epidemiologic, clinical, and demographic features of the 66 patients with A baumannii infection during a 14-month
period were recorded. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method, and
the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis (PFGE).
Results: The incidence of A baumannii infection was especially high in January, April, May, and June 2006. The isolates were most
frequently obtained from blood and tracheal aspirates sent from the intensive care unit and neurosurgery ward. Although the most
frequently identified predisposing factors were cerebrovascular disease and surgical operation, the main risk factors identified in
these patients were catheterization and mechanical ventilation. Genotype analysis of the 66 A baumannii strains by PFGE revealed
the circulation of 36 different PFGE types, of which type A (12) and K (17) accounted for 44% of the isolates. We found high clonal
relationship (80.3%) among the typed strains. Thirteen antibiotypes were observed. Most of the isolates were multidrug resistant.
Resistance to imipenem, meropenem, gentamicin, amikacin, tobramycin, netilmicin, ampicillin-sulbactam, trimethoprimsulfamethoxazole,
piperacillin-tazobactam, cefoperazone-sulbactam, ciprofloxacin, and levofloxacin were found in 44%, 47%,
47%, 84.8%, 21.2%, 3%, 62.1%, 57.6%, 94%, 62.1%, 95.5%, and 95.5% of the isolates, respectively.
Conclusion: The epidemiologic data obtained suggested that the increase in the number of A baumannii infections in our hospital
was caused by the interhospital spread of especially 2 epidemic clones. We determined that clonally related strains can survive for
a long time in our hospital and cause nosocomial infections in the predisposed patients.
