Background
Methods
Study setting, specimen collection and patient characteristics
Bacterial isolation and identification
Antimicrobial susceptibility testing
Molecular characterization
Nucleotide accession numbers
Results and discussion
The patients’ characteristics of the three NDM-1-carrying strains
Patient | A | B | C |
---|---|---|---|
Patient type | Inpatient | Inpatient | Inpatient |
Department | ICU, surgical department | surgical department | ICU |
Underlying disease | Hypertension | None | Asthma bronchiale |
Clinical diagnosis | Hemopneumothorax | Inguinal abscess | Generalized peritonitis secondary to PUD and bronchial asthma, laparotomy |
Specimen type | Fluid from hemopneumothorax | Abscess fluid/drain | Peritoneal swab |
Antibiotics used during hospital stay |
cotrimoxazol, ceftriaxone, metronidazol, ciprofloxacin, flucloxacillin | ceftazidime, cloxacillin, chloramphenicol | ceftriaxone, metronidazol, cloxacillin |
Travel history | None | None | None |
Outcome | Improved | Improved | Died |
Antimicrobial compound | MIC breakpoint (μg/ml) | Isolate A | Isolate B | Isolate C | ||||
---|---|---|---|---|---|---|---|---|
μg/ml | mm | μg/ml | mm | μg/ml | mm | |||
S ≤ | R > |
A. baumannii
|
A. baumannii
|
A. baumannii
| ||||
Chloramphenicol | – | – | >256 | n.a. | >256 | n.a. | >256 | n.a. |
Fosfomycin | – | – | >256 | – | >256 | – | >256 | – |
Ciprofloxacin | 1 | 1 | >32 | n.a. | >32 | n.a. | >32 | n.a. |
Erythromycin | – | – | >256 | n.a. | >256 | n.a. | >256 | n.a. |
Amoxicillin | – | – | >256 | n.a. | >256 | n.a. | >256 | n.a. |
Amoxicillin/Clavulanic Acid | – | – | >256 | 12 | >256 | 13 | >256 | 14 |
Cefoxitin | – | – | >256 | n.a. | >256 | n.a. | >256 | n.a. |
Ceftazidime | – | – | >256 | n.a. | >256 | n.a. | >256 | n.a. |
Cefepime | – | – | >256 | n.a. | >256 | n.a. | >256 | n.a. |
Meropenem | 2 | 8 | >32 | n.a. | >32 | 8 [21/15]
| >32 | n.a. |
Aztreonam | – | – | >256 | – | >256 | – | >256 | – |
Amikacin | 8 | 16 |
3
|
22 [18/15]
|
3.5
|
23 [18/15]
|
3.5
|
23 [18/15]
|
Gentamicin | 4 | 4 | 32 | n.a. | 32 | n.a. | 32 | n.a. |
Trimethoprim/Sulfamethoxazole | 2 | 4 |
0,25
|
25 [16/13]
| 32 | n.a. | 32 | n.a. |
Polymyxin B | 2 | 2 |
1,5
|
13
|
1
|
17
|
1
|
17
|
Tetracycline | – | – | 12 | 18 | 12 | 20 | 12 | 21 |