In Vitro Efficacy of Tetracyclines Against Multi Drug Resistant Acinetobacter Baumannii Amongst Intensive Care Patients

Abstract

Objective: To determine the anti-microbial susceptibility and frequency of A.baumannii, especially focusing the efficacy of Doxycycline and Minocycline against multi drug resistant (MDR) and extremely drug resist ant (XDR) A.baumannii in atertiary care hospital.
 Study Design: It was a descriptive cross sectional study.
 Place and Duration of Study: Study conducted at the department of Pathology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi Pakistan from Jan 2020 to Dec 2021.
 Methodology: It was a descriptive cross sectional study conducted at the department of Pathology Armed Forces Institute of Cardiology (AFIC) and National Institute of Heart Diseases, Rawalpindi (NIHD) from Jan 2020 to Dec 2021. Data was collected by non-probability consecutive sampling. Antimicrobial susceptibility was assessed for A.baumanni isolated from hospital setting.
 Results: 6239 culture specimens were received from different wards of AFIC. Out of these 1439 (23 %) yielded growth of different pathogens. Amongst 1439 positive cultures, 167 (11.6 %) were A.baumannii. Multi drug resistant (MDR) A.baumannii were 9(5.4%), extremely drug resistant (XDR) 152(91%) and pan drug resistant (PDR) were 6(3.6%). Antibiotic susceptibility of A. baumannii revealed highest resistance for cephalosporins and carbapenems about 162(97%), ampicillin and beta lactamase inhibitor combinations about 157(94%), quinolones 152(91%), aminoglycosides 134(80%) and Trimethoprim+sulfamethoxazole 131(78%). The least resistance observed from tetracyclines group of antibiotics which was 34(20%) from Minocycline and 54(32%) from Doxycycline.
 Conclusion: A high resistant pattern was observed for A.baumanni against cephalosporins, carbapenems, ampicillin, beta lactamase inhibitor combinations, quinolones, aminoglycosides and Trimethoprim+sulfamethoxazole. Comparatively tetracycline antimicrobials i.e. minocycline and doxycycline were found to be less resistant than others to manage MDR and XDR cases.