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Plasmid-borne extended-spectrum beta-lactamase in a clinical isolate of Acinetobacter baumannii.

Acinetobacter baumannii has emerged over the last decade as a significant opportunistic pathogen. Although it is generally associated with benign colonization of hospitalized patients, it is responsible for about 10% of nosocomial infection in intensive care unit (ICU) patients, causing a wide range of infections such as bacteraemia, nosocomial pneumonia, urinary tract infection, secondary meningitis and burn and wound infections (Bergogne-Berezin, 2001; Joshi, 1998; Levin et al., 2003; Poirel et al., 1999). In Acinetobacter-associated nosocomial infection, the major problem encountered by ICU clinicians relates to the readily transferable antimicrobial resistance expressed by this organism (BergogneBerezin, 2001; Joshi, 1998). In addition to intrinsic resistance, A. baumannii has the ability to acquire resistance to many major classes of antibiotics including newer lactams (Perilli et al., 1996). The presence of resistance plasmids (R-plasmids) is a significant feature of this organism, and plasmid profiling has been proposed as a method of epidemiological typing for Acinetobacter (Joshi, 1998; Perilli et al., 1996). Although A. baumannii colonizes hospitalized patients, approximately 30% of isolates are associated with frank infection in ICUpatients and, in this setting, tend to demonstrate variable susceptibility profiles (Dy et al., 1999). Nevertheless, despite the rising clinical importance of A. baumannii compared with other nosocomial pathogens in developing countries, this organism has been widely overlooked. In this study, five isolates of A. baumannii isolated in 1998 fromexudates of post-surgical wound sepsis from our teaching hospital were examined. The isolates were found to harbour transferable extended-spectrum -lactamase (ESBL)encoding resistance determinants on a 66·1 kb conjugative plasmid.