Multidrug-resistant Acinetobacter baumannii Harboring OXA-24 carbapenemase, Spain

Abstract

In February 2006, a patient colonized with a multidrug-resistant sequence type 56 Acinetobacter baumannii strain was admitted to a hospital in Madrid, Spain. This strain spread rapidly and caused a large outbreak in the hospital. Clinicians should be alert for this strain because its spread would have serious health consequences.

Figure 1

Temporal distribution of patients with Acinetobacter baumannii infections, Spain. A) Patients colonized/infected with A. baumannii classified by antibiotype. Arrows indicate times of intensification of infection control measures. The medical–surgical intensive care unit at Octubre University Hospital, Madrid, Spain, was refurbished in July 2007. B) Annual incidence of A. baumannii bacteremia. ABCA, A. baumannii clone A or AbH12O-A2; ABNCA: A. baumannii nonclone A.

Figure 2

Nucleotide sequence of the region between the septicolysin and Ton-B dependent receptor genes of Acinetobacter baumannii in plasmids pMMA2 and pMMCU3 from clone AbH12O-A2 (upper panel) and AbH12O-CU3 (lower panel), respectively. Integrated insertion sequence 4 (IS4) (red letters) provided a new promoter sequence for septicolysin in plasmid pMMA2 from clone AbH12O-A2. Upper case letters indicate amino acids. IRL, inverted repeated left sequence; IRR, inverted repeated right sequence from IS4; Stop, stop (termination) codon.