Dissemination of Acinetobacter baumannii OXA-23 in old and new intensive care units without transfer of colonized patients

To the Editor—The contamination of the environment and the hands of health professionals, transfer of patients, and movements of health professionals between hospitals are all possible routes for the dissemination of Acinetobacter baumannii.1–3 In our region during 2004–2008, an endemic carbapenem-resistant A. baumannii (CRAb) was detected.4 Later, it was verified (2011–2014), with a change in the dissemination mode of this microorganism (ie, the endemic situation to polyclonal dissemination).5 However, the routes of spread of A. baumannii have not yet been established. The identification and antimicrobial susceptibility of bacterial isolates were assessed using a BD Phoenix system (Becton, Dickinson and Company, Franklin Lakes, NJ, USA). The minimum inhibitory concentrations of imipenem, meropenem, and polymyxin B were confirmed using the agar-dilution method.6 A multiplex PCR assay was performed to detect the presence of MBL genes (blaIMP, blaVIM, blaGIM, blaSPM, and blaSIM) and oxacillinase genes (blaOXA23, blaOXA24, blaOXA51, and blaOXA58).7,8 Molecular typing was performed with enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) assays.