Antimicrobial susceptibility pattern of an emerging multidrug resistant <em>Acinetobacter baumannii </em>from intensive care units of a tertiary care hospital

Abstract

Introduction: Acinetobacter baumannii is one of the most challenging gram negative, lactose non-lactose fermenting bacilli with ability to cause nosocomial infections and develop resistance to many classes of antibiotics. Multidrug-resistant (MDR) A. baumannii is a well known agent causing life-threatening infections with limited therapeutic options. In recent years, the numbers of reported carbapenem-resistant Acinetobacter spp. are increasing, which has further narrowed the treatment options and emerging as extensively drug resistant (XDR) strain. There are only a few effective drugs such as colistin, polymyxin B, and tigecycline. But given the side effects and cost effectiveness, treatment of resistant nosocomial infections by A. baumanii is the biggest challenge for clinicians and policy makers all over the world.Aim:1. To know the antibiotic susceptibility pattern of Acinetobacter baumnii2. To know the prevalence of multidrug resistant Acinetobacter baumanii in critical areas of our tertiary care centre.Methodology: Clinical samples from both critical and non critical areas were processed routinely. Only non lactose fermenting colonies were included for the study and Acinetobacter baumanii isolates were identified using standard culture method and antibiotic susceptibility testing done by disk diffusion method.Results: Of 308 NLFs, 160 were Acinetobacter baumanii. 106 (66.25%) samples were from ICU and 54 (33.75%) from non critical areas. Commonest sample was endotracheal secretion 72(45%) followed by blood 38(23.75) and others. 70% of our isolates were resistant to Aminoglycosides. Among Fluoroquinolones, maximum resistance was shown for Ciprofloxacin. 59% of the isolates were resistant to Piperacillin-tazobactum and their resistance to Cephalosporins ranged from 60-80%. 42 (39.62% of our isolates were Multidrug resistant (MDR) and 19 (17.92%) were extensively drug resistant (XDR).Conclusion: Multidrug resistant and extensively drug resistant strains of Acinetobacter baumanii are on the rise and slowly getting established in our healthcare set up especially the critical areas. Treatment options are very few and limited. Thus leaving us with call to take stringent measures to stop the inadvertent use of antibiotics and to review our infection control policies.