Outbreaks of multidrug-resistant Acinetobacter baumannii strains in a Kenyan teaching hospital

Acinetobacter baumannii is a serious nosocomial pathogen with a high propensity to cause outbreaks. Whilst outbreaks of A. baumannii have been reported in many regions worldwide, few data are available from East Africa. In this study, 25 A. baumannii isolates derived from a single institution located in Nairobi, Kenya, between September 2010 and September 2011 were examined. Antimicrobial susceptibility testing was performed by the disc diffusion method and the relatedness among the isolates was examined by pulsed-field gel electrophoresis, repetitive sequence-based PCR (rep-PCR) and multilocus sequence typing. The examined isolates clustered into three distinct groups. The most prevalent sequence type (ST) was ST110 (17 isolates), followed by ST92 (5 isolates) and ST109 (3 isolates). All isolates exhibited resistance to cefepime, ceftazidime, ticarcillin/clavulanic acid, cefotaxime/clavulanic acid, piperacillin/tazobactam, cefoxitin, ciprofloxacin, gentamicin, nitrofurantoin, fosfomycin trometamol, trimethoprim/sulfamethoxazole, amikacin, meropenem and imipenem, with the exception of four isolates. Two isolates belonging to ST92 and two isolates belonging to ST109 were susceptible to amikacin; one of these amikacin-susceptible ST109 isolates was also susceptible to meropenem and imipenem. All isolates were positive for OXA 51-like and all carbapenem-resistant isolates were OXA-23 positive.