Carbapenem-resistant Acinetobacter baumannii (CRAB) are an increasing infectious threat in hospitals. We investigated the clinical epidemiology of CRAB infections vs. colonization in patients, and examined the mechanisms of resistance associated with elevated minimum inhibitory concentrations (MICs) for carbapenems. From January to June 2009, 75 CRAB strains were collected. CRAB infection was significantly associated with malignancy and a high APACHE II score. The most dominant resistance mechanism was ISAba1 preceding OXA-51, producing strains with overexpression of efflux pump. Strains carrying blaOXA-23-like enzymes had higher carbapenem MICs than those carrying blaOXA-51-like enzymes; however, the presence of multiple mechanisms did not result in increased resistance to carbapenems. There was no difference in the resistance mechanisms in strains from infected and colonized patients. The majority of strains were genetically diverse by DNA macrorestriction although there was evidence of clonal spread of four clusters of strains in patients.

Cytomegalovirus (CMV) disease is a frequent opportunistic infection that usually occurs in the late stages of HIV infection as a result of reactivation of a latent infection. We report a case of a 23-year-old man with acute retroviral syndrome complicated by coexisting CMV pneumonia and CMV hepatitis, which were documented by histopathological examination. His CMV pneumonia and hepatitis were assumed to be primary CMV diseases owing to the absence of CMV IgG antibody. To the best of our knowledge, this is the first case of simultaneous CMV pneumonia and hepatitis occurring as primary CMV diseases during primary HIV infection. This case indicates that invasive CMV diseases such as pneumonia and hepatitis should be considered even in patients with primary HIV infection.

Infections in immunocompromised patients are often difficult to treat, even with currently available antimicrobial agents. An understanding of the effects of antibiotic therapy on the host's immune response is therefore important when deciding on the clinical management of such patients. Antimicrobial agents which lack immunodepressive effects and/or potentiate the immune response are the goal of current research into the treatment of infections in immunocompromised patients. The effects of cefodizime (1-250 micrograms/mL) in vitro on some functional activities of leucocytes and on colony formation by granulocyte monocyte progenitors were studied to investigate the effects of the antibiotic on the host's immune response. A marked enhancement in the lymphocyte transformation reaction was observed in cells exposed to cefodizime. This effect was dose-dependent. Cefodizime had no significant effect on antibody-dependent cell cytotoxicity or on natural killer cell-mediated cytotoxicity. The chemotactic activity of neutrophils was not influenced by the presence of cefodizime (P > 0.05). The phagocytic activity of neutrophils was significantly increased by cefodizime (P > 0.01). Cefodizime significantly stimulated, in a dose-dependent manner, colony formation by granulocyte-monocyte progenitors (P < 0.01). Results suggest that cefodizime has certain stimulatory effects on immunocompetent cells such as enhancing the transformation reaction of lymphocytes, neutrophil phagocytosis and colony formation by granulocyte-monocyte progenitors. Further studies are required to clarify the mechanisms responsible for these effects.