Discrimination of epidemic and sporadic isolates of Acinetobacter baumannii by repetitive element PCR-mediated DNA fingerprinting.

In 1990, there was a significant increase in the number of lower respiratory tract infections and surgical wound infections in the adult intensive care units of our tertiary care teaching hospital caused by Acinetobacter baumannii compared with the number in 1989. During the 5-month period from April through August 1990, 84 isolates of A. baumannii were recovered from 50 hospitalized patients. Biotyping, comparison of antibiograms, plasmid analysis, and DNA polymorphisms of 20 isolates from 20 different patients, determined by the use of repetitive element PCR with primers aimed at repetitive extragenic palindromic sequences and enterobacterial repetitive intergenic consensus sequences, were used to investigate this apparent outbreak. Biotyping, antibiograms, plasmid analysis, and enterobacterial repetitive intergenic consensus PCR were not useful epidemiologically. Repetitive element PCR-mediated DNA fingerprinting using repetitive extragenic palindromic primers discriminated between epidemic and sporadic strains of A. baumannii and demonstrated four discrete clusters which were unique epidemiologically.

Pneumonia caused by Nocardia nova and Aspergillus fumigatus after cardiac transplantation.

Nocardia nova, a newly established species of the Nocardia asteroides complex, has recently been characterized as a human pathogen. This report of a case of pneumonia caused by Nocardia nova and Aspergillus fumigatus in a patient after cardiac transplantation is the first reported infection caused by Nocardia nova following its detailed description. Accurate identification and susceptibility testing of the Nocardia nova isolate allowed successful oral therapy with clarithromycin when therapy with sulfisoxazole was not tolerated.