Multidrug Resistance Related to Biofilm Formation in Acinetobacter baumannii and Klebsiella pneumoniae Clinical Strains from Different Pulsotypes
The present study reports the dissemination of multidrug-resistant (MDR) OXA-23-producing Acinetobacter baumannii clones throughout hospitals in Rio de Janeiro, Brazil. A total of 110 imipenem-resistant A. baumannii isolates were obtained from January 2006 to September 2007 in eight hospitals. The modified Hodge test was performed to screen for carbapenemase production. Polymerase chain reaction (PCR) and DNA sequencing were performed for the detection of bla(IMP), bla(VIM), bla(OXA-23-like), bla(OXA-24-like), bla(OXA-58) and the class 1 integron. Isolates were typed by pulsed-field gel electrophoresis (PFGE) following digestion with ApaI. All the isolates were MDR and 96 (87.3%) produced the carbapenemase OXA-23. No isolates produced OXA-24, OXA-58 or the metallo-beta-lactamases IMP and VIM. The class 1 integron was absent in all isolates. The A. baumannii isolates were separated into five genotypes, with the highest prevalence of genotype A (71.8%) followed by genotype B (22.7%). Genotype A was present in seven hospitals, whilst genotype B had spread in five hospitals. The OXA-23-producing isolates belonged to all genotypes. The presence of MDR OXA-23-producing A. baumannii in different hospitals in Rio de Janeiro emphasises the need to control the use of carbapenems and to prevent the spread of these organisms in Rio de Janeiro.