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Background  The systemic surveillance of imipenem-resistant  Acinetobacter baumannii  (IRAB) from multicenters in Taiwan revealed the emergence of isolates with  bla  OXA-72 . This study described their genetic makeup, mechanism of spread, and contribution to carbapenem resistance.    Methods  Two hundred and ninety-one non-repetitive isolates of  A. baumannii  were collected from 10 teaching hospitals from different geographical regions in Taiwan from June 2007 to September 2007. Minimal inhibitory concentrations (MICs) were determined by agar dilution. Clonality was determined by pulsed-field gel electrophoresis. Plasmid was extracted and digested by restriction enzymes, and subsequently analyzed by electrophoresis and Southern blot for  bla  OXA-72 . The flanking regions of  bla  OXA-72  were determined by inverse PCR. The contribution of  bla  OXA-72  to imipenem MIC was determined by transforming plasmids carrying  bla  OXA-72  into imipenem-susceptible  A. baumannii.Results  Among 142 IRAB in Taiwan, 27 harbored  bla  OXA-72 ; 22 originated from Southern Taiwan, 5 from Central Taiwan, and none from Northern Taiwan. There were two major clones. The  bla  OXA-72  was identified in the plasmids of all isolates. Two genetic structures flanking plasmid-borne  bla  OXA-72  were identified and shared identical sequences in certain regions; the one described in previous literature was present in only one isolate, and the new one was present in the remaining isolates. Introduction of  bla  OXA-72  resulted in an increase of imipenem MIC in the transformants. The overexpression of  bla  OXA-72  mRNA in response to imipenem further supported the contribution of  bla  OXA-72.Conclusions  In conclusion, isolates with new plasmid-borne  bla  OXA-72  were found to be disseminated successfully in Southern Taiwan. The spread of the resistance gene depended on clonal spread and dissemination of a new plasmid.  Bla  OXA-72  in these isolates directly led to their imipenem-resistance.

Dissemination of imipenem-resistant Acinetobacter baumannii with new plasmid-borne bla OXA-72 in Taiwan