Abstract
The aim of the present investigation was to characterize the prevalence of extended-spectrum β-lactamases (ESBLs) and metallo β-lactamases (MBLs), and to study the antibiotic susceptibility profile among 250 clinical isolates of Acinetobacter baumannii. Phenotypic characterization was carried out by double disc synergy method and the prevalence of ESBLs and MBLs antibiotic resistant determinants were analyzed with Polymerase Chain Reaction (PCR). Susceptibility studies were performed by disc diffusion method according to Clinical and Laboratory Standards Institute guidelines 2009. Among the two hundred fifty isolates, two hundred nine isolates (83.6%) were positive for ESBLs whereas one hundred sixty seven isolates (79.9%) were positive for both ESBLs and MBLs. Moreover, five isolates (2.3%) which were positive for MBL on disc diffusion test, but negative in PCR showed MBL activity by spectrophotometric assay. Susceptibility study showed that all of the isolates were found to be more susceptible to ceftriaxone plus ethylenediaminetetraacetate plus sulbactam (90-93%), followed by meropenem (50-53%), imipenem (42-45%), cefoperazone plus sulbactam (40-42%), piperacillin plus tazobactam (38-42%) and amoxicillin plus clavulanic acid (28-31%). Among the ESBLs, TEM-types were varied from 82 to 87% followed by SHV-types (67-78%), CTX-M types (60 to 67) and OXA types (51 to 56%) in all of the isolates. Among the MBLs, NDM-1 varied from 40 to 49% followed by IMP-1 (51 to 55%), VIM-1 (55 to 59%) and KPC (47 to 55%) in all of the isolates. Moreover, results of the present study revealed that all of the clinical isolates were susceptible to ceftriaxone plus EDTA plus sulbactam and can be a potent antibacterial agent for the treatment of severe bacterial infections caused by A. baumannii.
Highlights
Acinetobacter species are aerobic gram-negative organism being responsible for various types of infections such as pneumonia, urinary tract infection and septicemia [1,2,3,4]
It has been reported that Acinetobacter species accounts for 10% of community-acquired bacteraemia in Kenyan hospital and the prevalence of antibiotic resistance among Acinetobacter baumannii isolates in Syria have been increasing in recent years [5,6]
We studied the susceptibility of different antibiotics and compared it with a newly launched patent protected drug having a non-antibiotic adjuvant along with β-lactam and β-lactamase inhibitor which altogether termed as ceftriaxone plus ethylenediamine tetraacetic acid disodium (EDTA) plus sulbactam
Summary
Acinetobacter species are aerobic gram-negative organism being responsible for various types of infections such as pneumonia, urinary tract infection and septicemia [1,2,3,4]. It has been reported that Acinetobacter species accounts for 10% of community-acquired bacteraemia in Kenyan hospital and the prevalence of antibiotic resistance among Acinetobacter baumannii isolates in Syria have been increasing in recent years [5,6]. The overall prevalence of nosocomial infections in hospital intensive care units due to A. baumannii varies from 2 to 10% [7]. The infections caused by Acinetobacter are often treated with cephalosporins including ceftazidime, ceftriaxone, aminoglycosides such as tobramycin and amikacin, carbapenems, and tetracycline. To date, most strains of A. baumannii have become increasingly resistant to almost all these currently available antibacterial agents [4]
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