Epidemiological markers of Acinetobacter baumannii clinical isolates from a spinal cord injury unit.

During a period of 28 months, 114 isolates of Acinetobacter baumannii obtained from urine samples of 57 patients, were recovered in a Spinal Cord Unit; an unusual increase in the number of A. baumannii isolates was observed between February 1991 and January 1992. Six different typing methods [biotyping, antimicrobial susceptibility, whole cell and cell-envelope protein analysis, plasmid analysis and chromosomal DNA analysis by pulsed-field gel electrophoresis (PFGE)] were used to study the isolates to establish any potential relationships among them. Chromosomal DNA analysis by digestion with ApaI and separation of the fragments by PFGE was the most powerful tool to determine the relatedness of isolates. The results suggest that the isolates from 1991 and 1992 may have originated from strains present in 1990 that subsequently acquired resistance to amikacin and tobramycin during the epidemic.