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We evaluated the spread of Acinetobacter baumannii strains among three hospitals located in São Paulo, Brazil. A total of 46 isolates, which were typed by chromosomal DNA analysis with use of pulsed field gel electrophoresis (PFGE), were tested for susceptibility to the fluoroquinolones, carbapenems, aminoglycosides (amikacin), cephalosporins, polymyxin B, and ampicillin/sulbactam by means of the broth microdilution method, disk diffusion, and the E-test. Isolates with an identical PFGE pattern (pattern B) that were susceptible only to carbapenems, polymyxin B, and ampicillin/sulbactam were recovered in all three hospitals. In addition, isolates with PFGE pattern A that were susceptible only to polymyxin Band ampicillin/sulbactam were recovered in hospitals 1 and 2. The results of our study strongly suggest the interhospital transmission of multiresistant epidemic strains of A. baumannii in São Paulo. Once in the hospital, these strains can disseminate and cause outbreaks with devastating consequences. [ABSTRACT FROM PUBLISHER]

A 6-year-old boy with non-Hodgkin's lymphoma presented because of recurrent episodes (on 13 September 1993 and 12 January 1994) of possibly catheter-related bacteremia. The strains isolated during both episodes and seven epidemiologically unrelated control strains were typed by pulsed-field gel electrophoresis (PFGE) of chromosomal DNA. The similarity of the PFGE patterns of the two isolates suggests that both episodes of bacteremia were caused by the same strain. The antimicrobial susceptibility of the nine strains was tested against 32 antimicrobial agents. The antimicrobial susceptibility patterns of the two isolates from the referred case were identical and differed from those of other clinical isolates. The best in vitro activity (associated with 100% susceptibility) was demonstrated by ofloxacin, clinafloxacin, minocycline, and rifampin. [ABSTRACT FROM PUBLISHER]