Abstract
BACKGROUND: Multi drug resistant Acinetobacter species is a rapidly emerging pathogen in health care settings and has limited the options for effective treatment. It is increasingly reported as the cause of outbreaks and nosocomial infections such as blood-stream infections, ventilator-associated pneumonia, urinary tract infections and wound infections. AIM: The present study was undertaken to isolate and identify the multi drug resistant (MDR) and extensively drug resistant (XDR) Acinetobacter species. DESIGN AND SETTINGS: This is a prospective study conducted over a period of two years (September 2009 to August 2011) in a tertiary care hospital. Clinical samples were collected from both indoor and outdoor patients, irrespective of age and sex. MATERIALS AND METHODS: Three hundred non duplicate clinical isolates of Acinetobacter species were processed for species identification by standard Microbiological procedures. Antimicrobial susceptibility of these isolates was performed by Kirby-Bauer disc diffusion method. RESULTS: Of the 300 isolates, 224 (74.6%) were identified as A. baumannii followed by A. lwoffii 73/300 (24.3%) and A. haemolyticus 3/300 (1%). Majority of the isolates were recovered from ICU patients 183/300 (61%), followed by patients admitted in wards 93/300 (31%) and 24/300 (8%) isolates were from outdoor patients. Out of 300, 153 (51%) isolates were XDR and 11% were MDR. Only about 10% of the isolates were sensitive to β-lactams and 30-40% of the strains were sensitive to aminoglycosides and fluoroquinolones. None of the isolate was resistant to cefoperazone sulbactam, ceftriaxone sulbactam and polymyxins. Statistically significant difference (p value <0.001) was noticed between antibiotic resistance of A. baumannii and A. lwoffii. CONCLUSION: The increasing trends towards antibiotic resistance reflect the extensive use of antibiotics in hospitals which in turn exerts selective pressure on Acinetobacter in hospital environment. Therefore, by judicial use of antibiotics these drug resistant nosocomial Acinetobacter infections can be minimized to some extent.
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