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Antimicrobial Agents and Chemotherapy, September 2006, p. 2941-2945, Vol. 50, No. 9
0066-4804/06/$08.00+0     doi:10.1128/AAC.00116-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Multicity Outbreak of Carbapenem-Resistant Acinetobacter baumannii Isolates Producing the Carbapenemase OXA-40

Karen Lolans,1 Thomas W. Rice,1 L. Silvia Munoz-Price,2 and John P. Quinn1,3*

John Stroger Hospital, Chicago, Illinois,1 Munster Community Hospital, Munster, Indiana,2 Rush University Medical Center, Chicago, Illinois3

Received 27 January 2006/ Returned for modification 17 April 2006/ Accepted 18 June 2006

During 2005 we detected a multicity outbreak of infections or colonization due to high-level imipenem-resistant Acinetobacter baumannii (MIC, 64 µg/ml). One hundred isolates from diverse sources were obtained from seven acute-care hospitals and two extended-care facilities; 97% of the isolates belonged to one clone. Susceptibility testing of the first 42 isolates (January to April 2005) revealed broad resistance profiles. Half of the isolates were susceptible to ceftazidime, with many isolates susceptible only to colistin. The level of AmpC ß-lactamase expression was stronger in isolates resistant to ceftazidime. PCR and subsequent nucleotide sequencing analysis identified blaOXA-40. The presence of an OXA-40 ß-lactamase in these isolates correlated with the carbapenem resistance. By Southern blot analysis, a blaOXA-40-specific probe revealed that the gene was both plasmid and chromosomally located. This is the first time in the United States that such carbapenem resistance in A. baumannii has been attributable to a carbapenemase.

* Corresponding author. Mailing address: John Stroger Hospital, 1900 W. Polk, Rm. 1258, Chicago, IL 60612. Phone: (312) 864-4874. Fax: (312) 864-9522. E-mail: ESBLman{at}yahoo.com.

Antimicrobial Agents and Chemotherapy, September 2006, p. 2941-2945, Vol. 50, No. 9
0066-4804/06/$08.00+0     doi:10.1128/AAC.00116-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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