Abstract
Acinetobacter baumannii can cause a wide range of infections, including bacteremia, pneumonia, urinary tract infection, peritonitis, etc. This organism is becoming resistant to a large group of antibiotics, especially β-lactam antibiotics. The reason for multi-drug resistance may be the production of extended- spectrum β-lactamses (ESBLs), carbapenemases/metallo β-lactamases or AmpC β-lactamases. The aim of the present study was to determine the prevalence of multi-drug resistant Acinetobacter baumannii isolated from the patients in Surgical Intensive Care Units (SICUs) of Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. A total of 91 A. baumanni isolates were collected from PIMS during the period from February 2011 to December 2011. The antibiotic susceptibility testing was performed by standard disc diffusion method as recommended by CLSI. Combination disc method, Modified Hodge test, EDTA disc synergy test and AmpC disc test were performed for detection of ESBLs, carbapenemases, metallo β-lactamases, and AmpC β-lactamases, respectively. The prevalence of MDRs was reported 100% among A. baumannii. The antibiotic susceptibility profile showed that minocycline and tigecycline were the most effective drugs against A. baumannii. Almost all of A. baumannii isolates were carbapenemase and metallo β-lactamase producers. AmpC prevalence was observed in 41.76%, while none of the isolates was ESBL producer. Antibiogram and minimal inhibitory concentrations (MICs) indicated tetracycline is relatively effective against A. baumanii. Increased frequency of multi-drug resistance supports the need for continuous surveillance to determine prevalence and evolution of these enzymes in Pakistan.
Highlights
Hospital-acquired infections are a major challenge to patient safety
In intensive care units (ICUs) in the United States, gram-negative bacteria account for about 70% of these types of infections, and similar data are reported from other parts of the world.[2]
In large surveillance studies from the United States, between 5 and 10% of cases of ICU-acquired pneumonia were due to A. baumannii
Summary
Hospital-acquired infections are a major challenge to patient safety. It is estimated that, a total of 1.7 million hospital-acquired infections occurred (4.5 per 100 admissions every year), and almost 99,000 deaths were associated with a hospital-acquired infection, making hospital-acquired infections the sixth leading cause of death in the United States Hospital-acquired infections are most commonly associated with invasive medical devices or surgical procedures.[1]. Global data reveals that multidrug-resistant A. baumannii is emerging as a common hospital-and community-acquired infection that is difficult to treat It is a very resistant and aggressive organism that infects patients with weakened defenses like ICU patients and those with invasive devices.[3] In large surveillance studies from the United States, between 5 and 10% of cases of ICU-acquired pneumonia were due to A. baumannii. Acinetobacter baumannii can cause a wide range of infections, including bacteremia, pneumonia, urinary tract infection, peritonitis, etc This organism is becoming resistant to a large group of antibiotics, especially β-lactam antibiotics. The aim of the present study was to determine the prevalence of multi-drug resistant Acinetobacter baumannii isolated from the patients in Surgical Intensive Care Units (SICUs) of Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan.
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