Multidrug-Resistant Acinetobacter baumannii Clone, France

Emerging infectious agents and the forensic pathologist: the New Mexico model. Hantavirus pulmonary syndrome. Patho-genesis of an emerging infectious disease. Disease. Guidelines to implement medical examiner/coroner-based surveillance for fatal infectious diseases and bioter-rorism (" Med-X "). To the Editor: Acinetobacter baumannii is an opportunistic pathogen that is a source of nosocomial infections, mostly pneumonia (1). Treatment of infections caused by A. baumannii is becoming a serious clinical concern as this microorganism becomes increasingly resistant to multiple antimicrobial drugs (2). A. baumannii resistance to carbapen-ems is mostly associated with production of carbapenem-hydrolyzing class D β-lactamases and metallo-β-lactamases (2). New Delhi metallo-β-lactamase 1 (NDM-1) is one of the most recently discovered metallo-β-lactamases among various gram-negative species, including A. baumannii (3). We recently reported the recovery of NDM-1–producing A. baumannii isolates throughout Europe (4). In that study, the genetic background of several strains was identified and corresponded to sequence types (STs) 1, 25 and 85. The ST85 clone was isolated in France from 2 patients previously hospitalized in Algeria (4,5). The present study was initiated by the recent isolation of 6 more NDM-1–producing A. baumannii linked with North Africa. To determine the extent of spread of this organism from Africa to France, we genetically analyzed 8 other NDM-1-producing A. baumannii isolates collected from different towns in France during 2011– 2012. Of these 8 isolates, 6 were from patients previously hospitalized in different cities in Algeria (including Algiers, Setif, Constantine, and Tlem-cen), 1 from a patient previously hospitalized in Tunisia, and 1 from a patient previously hospitalized in Egypt. These 8 isolates came from 2 clinical samples (blood cultures and wound) from 6 screening rectal swab samples collected at the time of hospital admission (online Technical Appendix,