ABSTRACT.Acinetobacter baumannii is an aerobic non-motile Gramnegative coccobacillus, and it is one of the most important nosocomial pathogens worldwide. The aim of this study was to determine the molecular epidemiology of the outbreak strains. Between March 2011 and March 2014, a total of 205 strains of A. baumannii were isolated from patients at the Nanyang City Center Hospital. The blaOXA-23, blaOXA-24, blaOXA-51, and blaOXA-58 genes were amplified by multiplex polymerase chain reaction. We found that 68 (33.17%) strains were positive for the blaOXA-23 gene, and 88.24% of these 68 showed resistance to carbapenems, while 11.76% were sensitive to carbapenems. The blaOXA-51 gene was found in 132 (64.39%) strains, and 17.42% of these were resistant to carbapenems while 82.58% were sensitive to carbapenems. Moreover, 5 (2.44%) strains were positive for blaOXA-58, of which 80% were resistant to carbapenems and 20% were sensitive to carbapenems. We found that A. baumannii showed 100% drug resistance to ampicillin, cefotetan, cefazolin, and cefoperazone. Our findings suggest that the blaOXA-23 and blaOXA-51 genes are most frequently identified in A. baumannii, while blaOXA-23 is the most important gene for resistance to carbapenems.
Tigecycline is a broad-spectrum antibiotic agent used to treat severe or multidrug-resistant (MDR) bacterial infections. Bacterial infection is a common and severe complication or co-morbidity associated with end-stage renal disease (ESRD). However, few cases have been reported regarding the adverse drug reaction of tigecycline in patients with ESRD. Here, we detail the case of a 19-year-old female with ESRD, who received tigecycline to treat sepsis due to a MDR Staphylococcus aureus. Following seven days of tigecycline, the patient developed coagulopathy with hypofibrinogenaemia, although there was no subsequent haemorrhage. The hypofibrinogenaemia resolved within 14 days after discontinuation of tigecycline. Therefore, we recommend that clinicians strictly monitor coagulation parameters in patients with ESRD during tigecycline treatment.
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