Abstract
The objective of this work is to determine the epidemiological profile of Acinetobacter b aumannii (A.baumannii ) bacteremia in the microbiology laboratory of CHU Mohammed VI of Oujda and its antibiotic resistance rates. This is a retrospective and descriptive study of 27 months from June 24, 2016to September 19, 2018 including all positive blood cultures processed in the microbiology laboratory in accordance with REMIC (reference in medical microbiology)and EUCAST(European Committee on Antimicrobial Susceptibility Testing). Contaminated blood cultures were excluded. As results we collected 863 positive blood cultures, A. baumannii accounted for 7.41% (n = 64). 67% (n =43) of the strains were isolated from patients hospitalized in intensive care (adults, children and newborns). The two main risk factors described in patients with our series were wearing of intravascular device in 55% (n=35) Immunosuppression in 22% n=14). A. baumannii bacteremia was associated with care in 37.5% (n=24). 75% (n=48) of A. baumannii isolates were resistant to carbapenems. No strain of A. baumannii was resistant to colistin. In light of these results strengthening the control and prevention measures for healthcare associated infections would be the most reliable way to limit the spread of A. baumannii in our establishment.
Highlights
A baumannii is a Gram-negative, non -motile, strictly aerobic, non-fermentative, non-sporing, coccobacillus
67% (n=43) of the strains were isolated from patients hospitalized in the intensive care unit, by medical departments with 22% (n=14) of the isolates, and surgical departments with 5% (n=3) of the isolates, the hospital department was not specified for 6% (n=4) of the patients
Of the 64 strains of A. baumannii isolated in the microbiology laboratory, 87% were resistant to Ciprofloxacin and Gentamicin, 86% to Cefepime and Levofloxacin, 85% to Ceftazidime, Ticarcillin, and Ticarcillin/clavulanic acid combination, 75% (n=48) of A. baumannii isolates were resistant to carbapenems .No A. baumannii strain was resistant to colistin. ( Fig 1)
Summary
A baumannii is a Gram-negative, non -motile, strictly aerobic, non-fermentative, non-sporing, coccobacillus. The ability of A. baumannii to form biofilms contributes to its survival in adverse environmental conditions including hospital environments and medical devices[1]. Of particular importance is the ability of Acinetobacter to cause bacteremia , especially in critically ill patients, the clinical course of which may range from a benign transient bacteremia to fulminant septic shock [2]. The existence of multi-resistant strains places A. baumannii among the organisms that threaten the current therapeutic management and the choice of molecules during probabilistic treatment is a real challenge. Carbapenems have long been considered as the treatment of choice for Acinetobacter infections. Today, this class is threatened by the emergence of resistance, favored by its increasing use in connection with the emergence of multi-resistant enterobacteria. This class is threatened by the emergence of resistance, favored by its increasing use in connection with the emergence of multi-resistant enterobacteria. [3]
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