Abstract
The rapid emergence (from 0% before 1998 to 6.5% in 2000) of pandrug-resistant Acinetobacter baumannii (PDRAB) was noted in a university hospital in Taiwan. To understand the epidemiology of these isolates, we studied 203 PDRAB isolates, taken from January 1999 to April 2000: 199 from 73 hospitalized patients treated at different clinical settings in the hospital and 4 from environmental sites in an intensive-care unit. Pulsed-field gel electrophoresis analysis and random amplified polymorphic DNA (RAPD) generated by arbitrarily primed polymerase chain reaction of these 203 isolates showed 10 closely related genotypes (10 clones). One (clone 5), belonging to pulsotype E and RAPD pattern 5, predominated (64 isolates, mostly from patients in intensive care). Increasing use of carbapenems and ciprofloxacin (selective pressure) as well as clonal dissemination might have contributed to the wide spread of PDRAB in this hospital.
Highlights
The rapid emergence of pandrug-resistant Acinetobacter baumannii (PDRAB) was noted in a university hospital in Taiwan
Initial concern about carbapenem-resistant A. baumannii (CRAB) began when the first nosocomial outbreak occurred in the United States in 1991 [6]
Since April 1999, clusters of PDRAB isolates were found in patients infected or colonized by these organisms throughout the hospital, in patients hospitalized in several intensive-care units (ICUs)
Summary
The rapid emergence (from 0% before 1998 to 6.5% in 2000) of pandrug-resistant Acinetobacter baumannii (PDRAB) was noted in a university hospital in Taiwan. The emergence and rapid spread of multidrug-resistant isolates causing nosocomial infections are of great concern worldwide [1,2,3,4,5]. Nosocomial infections caused by multidrug-resistant A. baumannii have been reported [3,4,6,7,11,12,13]. Initial concern about carbapenem-resistant A. baumannii (CRAB) began when the first nosocomial outbreak occurred in the United States in 1991 [6]. Since April 1999, clusters of PDRAB isolates were found in patients infected or colonized by these organisms throughout the hospital, in patients hospitalized in several intensive-care units (ICUs). The aim of our study was to document the emergence of PDRAB in a university hospital and to char-
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