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Volume 20, Number 9—September 2014
Letter

Invasive Infection Caused by Carbapenem-Resistant Acinetobacter soli, Japan

Hiromitsu Kitanaka, Masa-aki Sasano, Satoru Yokoyama, Masahiro Suzuki, Wanchun Jin, Masami Inayoshi, Mitsuhiro Hori, Jun-ichi Wachino, Kouji Kimura, Keiko Yamada, and Yoshichika ArakawaComments to Author 
Author affiliations: Nagoya University Graduate School of Medicine, Aichi, Japan (H. Kitanaka, S. Yokoyama, W. Jin, J. Wachino, K. Kimura, K. Yamada, Y. Arakawa); Okazaki City Hospital, Aichi (M. Sasano, M. Inayoshi, M. Hori); Aichi Prefectural Institute of Public Health, Aichi (M. Suzuki)

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Figure

Results of double-disk synergy testing of the Acinetobacter soli isolate HK001 identified in a man in Japan. Testing was performed by using disks containing sodium mercaptoacetic acid (SMA) and the carbapenems imipenem, meropenem, and ertapenem. Apparent expansion of growth inhibition zone around a carbapenem disk placed near a SMA disk compared with that around a disk of carbapenem alone is seen on Mueller-Hinton agar if the isolate produces metallo-β-lactamases (2,3). When the edge-to-edge dis

Figure. Results of double-disk synergy testing of the Acinetobacter soli isolate HK001 identified in a man in Japan. Testing was performed by using disks containing sodium mercaptoacetic acid (SMA) and the carbapenems imipenem, meropenem, and ertapenem. Apparent expansion of growth inhibition zone around a carbapenem disk placed near a SMA disk compared with that around a disk of carbapenem alone is seen on Mueller-Hinton agar if the isolate produces metallo-β-lactamases (2,3). When the edge-to-edge distance between 2 disks containing a carbapenem and SMA, respectively, was kept at 5 mm, expansion of the growth inhibition zone became clearer than for those kept at a distance of 10 mm and 15 mm, regardless of carbapenems used. Vertical expansion of growth inhibition zones by the effect of SMA is indicated by arrows; ertapenem gave the clearest result when the disk distance was kept at 5 mm (top right panel), even though A. soli HK001 co-produces oxacillinase 58–like carbapenemase, which is hardly inhibited by SMA.

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