Abstract
Acinetobacter species are gram negative non fermenters, which are important nosocomial pathogens involved in various outbreaks in hospitals due to widespread resistance to majority antibiotics. The aim of this study is to speciate Acinetobacter isolated from clinical samples, to assess the antibiotic sensitivity pattern and to detect the production of metallo-β-lactamase by double disc synergy test. The study was conducted in the department of microbiology, A. J Institute of Medical Sciences. All clinical samples were subjected to gram stain & cultured; the Acinetobacter isolates obtained were subjected to antibiogram. Those isolates that showed Imipenem resistant were further tested for production of metallo-β-lactamase by double disc synergy test. Out of 6625 culture positive isolates, 414 (36.1%) were identified biochemically to belong to Acinetobacter species. Of the 414 cases, 393 (94.9%) were further identified to be Acinetobacter baumannii and the remaining 21 (5.1%) to be Acinetobacter lwoffi. Acinetobacter lwoffii showed 100% sensitivity to all the drugs. Of the 393 Acinetobacter baumannii isolates 109 (27.7%) showed resistant to Imipenem. Out of these 109 isolates, 65 (59.63%) were positive for metallo-β-lactamase production by double disk synergy test. The speciation is highly demanding and laborious but it’s important to be demonstrated due to difference in the antibiotic susceptibility pattern. Carbapenem resistant Acinetobacter nosocomial strains in ICUs are detected to be more resistant to antibiotics. As shown in this study the metallo-β-lactamase producing A.baumannii isolates were 59.63% and therapeutic options were limited. Therefore early identification of metallo-β-lactamase producers is of great importance to start appropriate treatment and to control the spread.
Highlights
Acinetobacter species are gram negative non fermenters which are considered as opportunistic pathogens that colonize patients with reduced host immunity
When resistance to different classes of antibiotics were analysed, we found that 35.8% of the isolates were Multidrug resistance (MDR)
The infection being high in hospitalized patients and the isolation rate has been increased from clinical sample
Summary
Acinetobacter species are gram negative non fermenters which are considered as opportunistic pathogens that colonize patients with reduced host immunity. It causes various clinical infections such as septicemia, pneumonia, urinary tract infections, meningitis and wound infections. Infections caused by Acinetobacter are difficult to treat because of the widespread resistance of these bacteria to majority of antibiotics. They exhibit resistance to beta-lactamase and cephalosporin’s and to carbapenems. Carbapenem resistance in Acinetobacter is may be due to various causes such as - reduced expression of outer membrane proteins (29kDa, 33-36kDa) and carbapenamases–beta lactamases 3, 30. Speciation of the isolates and their antibiogram is helpful in epidemiological point of view, at hospitals and community level to create a baseline data for the early management of cases and to prevent further spread of the MDR isolates
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