Two clonally related Acinetobacter baumannii isolates, A1 and A2, were obtained from the same patient. Isolate A2, selected after an imipenem-containing treatment, showed reduced susceptibility to carbapenems. This resistance pattern was related to insertion of the ISAba1 element upstream of the naturally occurring bla(OXA-66) carbapenemase gene as demonstrated by sequencing, reverse transcription-PCR analysis, and inactivation of the bla(OXA-66) gene.
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Figueiredo et al. (2009) studied this question.
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