Background Carbapenems are important agents for treating nosocomial gram-negative infections. Carbapenem-resistant bacteria have become increasingly problematic in certain regions. This study determined the citywide prevalence and molecular epidemiological features of carbapenem-resistantAcinetobacter baumanniiandPseudomonas aeruginosain Brooklyn, NY. Methods All unique patient isolates ofA baumanniiandP aeruginosawere collected from 15 Brooklyn hospitals from July 1, 1999, through September 30, 1999. Antibiotic susceptibilities, the genetic relatedness of resistant isolates, and the relationship between antibiotic use and resistance rates were determined. Results A total of 419 isolates ofA baumanniiand 823 isolates ofP aeruginosawere collected. ForA baumannii, 53% were resistant to meropenem and/or imipenem, and 12% were resistant to all standard antibiotics. Ribotyping revealed that a single clone accounted for 62% of the samples and was isolated from patients at all 15 hospitals. The rate of carbapenem resistance was associated with cephalosporin use at each hospital (P= .004). ForP aeruginosa, 24% were resistant to imipenem, 5% to amikacin, and 15% to 29% to other antipseudomonal agents. Ribotyping revealed that 3 clones accounted for nearly half of the isolates and were shared by most hospitals. Conclusions Approximately 400 patients were infected or colonized with carbapenem-resistantA baumanniiandP aeruginosaduring a 3-month period in 1999. A few strains have spread widely throughout hospitals in this region. The prevalence of resistantA baumanniiseems to be correlated with cephalosporin use. Multiresistant hospital-acquired bacteria should be viewed as a serious public health issue rather than an individual hospital's problem. An intensive coordinated effort will be needed to effectively address this problem.
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Landman et al. (2002) studied this question.