Emergence of oligoclonal Acinetobacter baumannii nosocomial infection in a Hospital in Nepal

The molecular epidemiology of fifteen clinical strains of Acinetobacter baumannii recovered from various clinical specimens from different wards during January to June, 2010 from a hospital in Nepal was evaluated. Kirby-Bauer disk diffusion test was used for determining in-vitro activities of antibiotics. Molecular epidemiology was investigated by polymerase chain reaction-randomly amplified polymorphic DNA (PCR-RAPD) and plasmid profiling. A. baumannii recovered were multidrug resistant. Isolates represented three antibiotypes (a, b and c). Isolates in antibiotype c (n = 12) were resistant to all antibiotics tested while isolates in antibiotype a (n = 2) was susceptible to netilmicin and b (n = 1) was susceptible to aminoglycosides and fluoroquinolones tested. Four plasmid profiles (i) 1 isolate; (ii) 1 isolate; (iii) 1 isolate; and (iv) 12 isolates and four PCR-RAPD types (I) 1isolate; (II) 8 isolates; (III) 1 isolate; (IV) 5 isolates revealed oligoclonal population of A. baumannii. Antibiotypes, plasmid profiles and PCR-RAPD types showed no empirical association. A. baumannii isolates were oligoclonal and multi-drug resistant. The emergence of multi-drug resistant oligoclonal population of this pathogen in a hospital warrants for development of appropriate antibiotic policies and immediate implementation of infection prevention and control measures.