Abstract
<p><strong>Abstract</strong></p><p><strong>Purpose: </strong>To determine the pattern of antibiotic resistance in clinical isolates of Acinetobacter baumannii from ICU’s of tertiary care hospital in Karachi.</p><p><strong>Study Design: </strong>A case control study.</p><p><strong>Methods: </strong>Three hundred and fifteen clinical isolates of Acinetobacter baumannii collected from different ICUs were evaluated during 1 year period. The isolates were identified by morphology, growth and biochemical characteristics, susceptibility to a panel of anti-microbial agents in disc diffusion assay and molecular characterization by PCR using glt A and gyr B genes.</p><p><strong>Results: </strong>94% of Acinetobacter spp were detected as multi drug resistant (MDR) and sensitive to Polymixin B only. About 6% Acinetobacter spp were also MDR but sensitive to Polymixin B, Meropenem and Salbactum + Cefoperazone. All tested isolates exhibited differing resistance representation, as establish by medium incorporation – replica method, against different tested antibiotics, as follows: Amoxicillin – Cal-vulanic acid, Tazobactam, Ceftriaxone, Ceftazidime, Meropenem, Imipenem, Gentamicin, Amikacin, Chlo-ramphenicol, Cotrimoxazole, Tobramycin, Salbactam, Cefoperazone, Gentamicin and Amikacin. All the isolates of Acinetobacter baumannii were PCR positive for glt A and gyr B.</p><p><strong>Conclusions: </strong>Acinetobacter baumannii is the most frequently isolated and alarming pathogen in the health care system specifically for the patients in intensive care units (ICUs). Its survival in hospital environment is because of tolerance the antibiotics and antiseptic pressures. Multi drug resistance made this pathogen the lethal pathogen of this century to infect debilitated patients. There is a strict need to monitor the surveillance of global clones at institutional and or intra-institutional level for accurate treatment, precise prevention and batter control.</p>
Highlights
Acinetobacter baumannii is the most common isolate, among all nosocomial pathogens causing infectious epidemics in critically ill patients and prominent cause of high mortality and morbidity.[1,2] Currently Acinetobacter considered as the most harmful organism and a CURRENT PATTERN OF ANTIBIOTIC RESISTANCE IN CLINICAL ISOLATES OF ACINETOBACTER BAUMANNII major threat in clinical settings, reasoned its multidrug resistance, permissiveness to varied degree of pH, saline nature and moisture, and its inimitable capability to endure in most of nutrients deficient environments
A. baumannii, infections has turned into progressively problematic to handle due to the manifestation of multi-drug resistance among strains or frequently recommend antibacterial drugs.[5]. Such multi-drug resistant (MDR) strains of Acinetobacter are commonly sensitive to polymyxins alone i.e. colistin and olymyxin B; a group of antibacterial medicine which is more poisonous compared to current antibiotics in use and now-a-days drug of choice against Acinetobacter in developing countries
Frequency of Acinetobacter baumannii isolates in different types of specimen collected from the hospitalized patients: A. baumannii was isolated from 60% of patients with urinary catheters, 30% with different mechanical devices and 10% with central intravenous lines (Fig. 1)
Summary
Acinetobacter baumannii is the most common isolate, among all nosocomial pathogens causing infectious epidemics in critically ill patients and prominent cause of high mortality and morbidity.[1,2] Currently Acinetobacter considered as the most harmful organism and a CURRENT PATTERN OF ANTIBIOTIC RESISTANCE IN CLINICAL ISOLATES OF ACINETOBACTER BAUMANNII major threat in clinical settings, reasoned its multidrug resistance, permissiveness to varied degree of pH, saline nature and moisture, and its inimitable capability to endure in most of nutrients deficient environments. Acinetobacter species are aerobic gram – negative rods which can persist for longer time in the atmosphere and can affect healthcare workers if not handle properly.[4] A. baumannii, infections has turned into progressively problematic to handle due to the manifestation of multi-drug resistance among strains or frequently recommend antibacterial drugs.[5] Such multi-drug resistant (MDR) strains of Acinetobacter are commonly sensitive to polymyxins alone i.e. colistin and olymyxin B; a group of antibacterial medicine which is more poisonous compared to current antibiotics in use and now-a-days drug of choice against Acinetobacter in developing countries
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