Abstract
Acinetobacter baumannii is considered a critical healthcare problem for patients in intensive care units due to its high ability to be multidrug-resistant to most commercially available antibiotics. The current study is at aimed at isolating and identifying the clinical isolates of A. baumannii from different samples and investigating the antibiotic resistance of isolates. Isolation and diagnosis of bacteria were achieved by conventional techniques, including routine and selective culture media (Chrome agar), biochemical test, EPI 20E, and VITEK-2. These methods were basically considered as a gold standard for identification of A. baumannii infections from different clinical sources, and culture positive isolates were tested for antibiotic susceptibility using a modified Kirby–Bauer method. A total of 375 clinical specimens were collected from different infections in some hospitals in Mosul and Erbil cities/Iraq from Sep 2020 to Jan 2021. Overall, 41 isolates were identified as A. baumannii using conventional and biochemical methods, and then confirmed by VITEK-2 system. Our results established that only 41(14.4%) isolates were diagnosed as A. baumannii, and most of these isolates were from burns (36.5%), surgical wounds (34.1%), and sputum (14.6%). However, it was identified in CSF, blood, and urine samples with lower percentages (7.3%, 4.8%, and 2.4%, respectively). The clinical isolates of A. baumannii showed high to moderate resistance to Piperacillin (97.5%), Piperacillin/ Tazobactam., Ceftazidime (87.8%), Meropenem (85.3%), Tri/slphamethoxazole (82.9%), Levofloxacin (80.4%), Imipenem, Ciprofloxacin (78%), Gentamycin (75.6%), Amikacin (73.1%), Netilmicin (68.2%), Tobramycin (60.9%) and Tetracycline (31.7%). However, two antimicrobial agents which were Colistin and Tigecycline produced 0 and 2.4 % resistance to A. baumannii respectively, which were considered the most used choices to treat A. baumannii infections.
 The current findings suggest that automated Vitek 2 system is the most common method to accurately detect the isolates and evaluate multi-drug resistant A. baumannii among patients.
Highlights
Acintobacter baumannii (A. baumannii ) is a non-fermenting coccobacilli; oxidase negative, aerobic bacilli and human opportunistic extracellular pathogen originating from hospital acquired infections to be known as a nosocomial infection [1,2]
The clinical isolates of A. baumannii showed high to moderate resistance to Piperacillin (97.5%), Piperacillin/ Tazobactam., Ceftazidime (87.8%), Meropenem (85.3%), Tri/slphamethoxazole (82.9%), Levofloxacin (80.4%), Imipenem, Ciprofloxacin (78%), Gentamycin (75.6%), Amikacin (73.1%), Netilmicin (68.2%), Tobramycin (60.9%) and Tetracycline (31.7%)
It was noticed that the vast majority of A. baumannii showed a high level of resistance to most of antibiotics such as Piperacillin (97.5%), Piperacillin/ Tazobactam, Ceftazidime (87.8%), Meropenem (85.3%), Tri/slphamethoxazole (82.9%), Levofloxacin (80.4%), Imipenem, Ciprofloxacin (78%), Gentamycin (75.6%), Amikacin (73.1%), Netilmicin (68.2%) and Tobramycin (60.9%)
Summary
Acintobacter baumannii (A. baumannii ) is a non-fermenting coccobacilli; oxidase negative, aerobic bacilli and human opportunistic extracellular pathogen originating from hospital acquired infections to be known as a nosocomial infection [1,2]. Most of A. baumannii bacteria were isolated from the patients of ICU who used mechanical ventilation and catheterization, which are considered risk factors that lead to biofilm formation in A. baumannii infection [3]. Hospital furniture such as patients’ mattresses, bed railings, curtains, stethoscopes, computers, and telephones were the main sources of A. baumannii infection, where this bacterium was isolated [4]. Acinetobacter species caused many diseases such as pneumonia, bacteremia, UTIs, skin and soft tissue infections leading to high escalation of morbidity and mortality [6]. A. baumannii was collected from different sources such as, damaged skins and soft tissues with second and third burn grades. An American study on injured soldiers showed that A. baumannii was frequently isolated from serious injuries for instance, open tibia fractures which occurred in the wars accidents of Iraq and Afghanistan [7]
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