Antimicrobial Susceptibility Pattern of Acinetobacter Baumannii and Rate of Carbapenem Resistance at a Tertiary Care Hospital in Karachi

Authors

  • Shomaila Malik
  • Faisal Hanif
  • Nadia Midhat Zehra
  • Hina Wasti
  • Saman Nadeem
  • Tahseen Ahmed Khan

Keywords:

Acinetobacter baumannii, Carbapenems, Frequency, Antimicrobial susceptibility pattern

Abstract

Objective:To know frequency of carbapenem resistance in Acinetobacter baumannii and its antimicrobial susceptibility
pattern at PNS Shifa Hospital Karachi.
Methodology:This study was carried out at PNS Shifa Hospital, Karachi, from 1st January 2015 till 31st October
2016. Samples from patients having different sites of infection were received in the laboratory from different wards
of hospital and inoculated on culture plates. After 24 hours incubation, identification of non-lactose fermenter
colonies of Acinetobacter baumannii was done by conventional methods. Antimicrobial susceptibility was recorded
for ß-lactam group of antimicrobials, ß-lactam/ß-lactamase inhibitor combination group, tetracyclines, fluoroquinolones
and aminoglycosides as per CLSI guidelines.
Results: During the study period, a total of 117 Acinetobacter baumannii isolates were identified from culture of
different samples representing 5.0% of all bacterial isolates (n=2352) and 7.5% of all Gram-negative bacilli (n=1559)
throughout the hospital. Out of one hundred and seventeen isolates, 52.1% (n=62) were found carbapenem resistant.
Higher percentages of Acinetobacter baumannii were isolated among samples received from medical wards (26.4%).
Percentage of Acinetobacter baumannii isolated was highest from the blood culture specimens (22.2%). Isolates
showed higher resistance against ceftriaxone (84.6%) followed by cotrimoxazole (65.8%) and ciprofloxacin (63.2%).
Comparatively low resistance against doxycycline and minocycline (23.9%), and tigecycline (38.9%) was observed.
Resistance pattern to other antimicrobials was gentamycin (54.7%), amikacin (55.6%), piperacillin-tazobactam
(48.7%), cefoperazone-sulbactam (51.35%), meropenem (52.1%) and imipenem (52.1%).
Conclusion: Carbapenem resistance in Acinetobacter baumannii is increasing and therapeutic options left to treat
are highly toxic especially for patients with co-morbidities.
Keywords: Acinetobacter baumannii, Carbapenems,

References

Manchanda V, Sinha S, Singh N. Multidrug resistant Acinetobacter. J Glob Infect Dis. 2010; 2(3):291-304.

Uwingabiye J, Frikh M, Lemnouer A, Bssaibis F, Belefquih B, Maleb A, et al. Acinetobacter infections prevalence and frequency of the antibiotics resistance: comparative study of intensive care units versus other hospital units. Pan Afr Med J. 2016; 23:191-201

Zhong Q, Xu W, Wu Y, Xu H. Clonal Spread of Carbapenem Non-susceptible Acinetobacter baumannii in an Intensive Care Unit in a Teaching Hospital in China. Ann Lab Med. 2012; 32(6):413-9.

Hammoudi D, Moubareck CA, Hakime N, Houmani M, Barakat A, Najjar Z, et al. Spread of imipenem-resistant Acinetobacter baumannii co-expressing OXA-23 and GES-11 carbapenems in Lebanon. Int J Infect Dis. 2015; 36: 56-61.

Maragakis LL, Perl TM. Antimicrobial Resistance: Acinetobacter baumannii: Epidemiology, Antimicrobial Resistance, and Treatment Options. Clin Infect Dis. 20 08; 46(8):1254–63.

Fournier PE, Richet H, Weinstein RA. The Epidemiology and Control of Acinetobacter baumannii in Health Care Facilities. Clin Infect Dis. 2006; 42(5):692-9.

Thom KA, Johnson JK, Lee MS, Harris AD. Environ- mental contamination because of multidrug-resistant Acinetobacter baumannii surrounding colonized or infected patient. Am J Infect Control 2011; 39(9):711-5

Liu CP, Shih SC, Wang NY, Wu AY, Sun FJ, Chow SF, et al. Risk factors of mortality in patients with carbapenem

-resistant Acinetobacter baumannii bacteremia. J Micro- biol Immunol Infect. 2014.

Hussein NH, Al-Mathkhury HJF, Sabbah MA. Identification of Imipenem-Resistant Genes in Acinetobacter baumannii Isolated from Baghdad Hospitals. J Med Microb Diagn. 2014; 3(6):170.

Al-Dorzi HM, Asiri AM, Shimemri A,Tamim HM, Al Johani SM, Dabbagh TA et al. Impact of empiri- cal antimicrobial therapy on the outcome of critically ill patients with Acinetobacter bacteremia. Ann Thorac Med. 2015; 10(4):256-262.

Clinical and Laboratory Standards institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 26th ed. Wayne, PA: 2016.

Silva GD, Domingues S. Insights on the Horizontal Gene Transfer of Carbapenemase Determinants in the Opportunistic Pathogen Acinetobacter baumannii. Micro- organisms. 2016; 4(3):29.

Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, et al. Multidrug-resistant, exten- sively drug-resistant and pan-drug-resistant bacteria: an international expert proposal for interim standard defin- itions for acquired resistance. Clin Infect. 2012; 18(3): 268–81.

Guo N, Xue W, Tang D, Ding J, Zhao B. Risk factors and outcomes of hospitalized patients with blood infections caused by multidrug-resistant Acinetobacter baumannii complex in a hospital of Northern China. Am J Infect Control 2016; 44(4):37-9.

Park SY, Choo JW, Kwon SH, Yu SN, Lee EJ, Kim TH, et al. Risk factors for mortality in patients with Acinet- obacter baumannii bacteremia. Infect Chemother. 2013; 45(3):325.

Altun HU, Yagci S, Bulut C, Sahin H, kinikli S, Adiloglu AK et al. Antimicrobial Susceptibilities of Clinical Acinetobacter baumannii Isolates With Different Genotypes. Jundishapur J Microbiol. 2014; 7(12):13347.

Kapoor K, Jain S, Jajoo M, Dublish S, Dabas V, Manc- handa V. Risk Factors and Predictors of Mortality in Critically ill Children with Extensively-Drug Resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit. Iran J Pediatr. 2014; 24(5):569-74.

Javed A, Zafar A, Ejaz H, Zubair M. Frequency and antimicrobial susceptibility of Acinetobacter species isolated from blood samples of paediatric patients. Pak J Med Sci. 2012; 28(3):363-6.

Liu Q, Li W, Feng Y, Tao C. Efficacy and Safety of Polymyxins for the Treatment of Acinectobacter baumannii Infection: A Systematic Review and Meta- Analysis. PLoS ONE. 2014; 9(6).

Van TD, Dinh Q-D, Vu PD, Nguyen TV, Pham CV, Dao TT, et al. Antibiotic susceptibility and molecular epidemiology of Acinetobacter calcoaceticus–baumannii complex strains isolated from a referral hospital in nor- thern Vietnam. J Glob Antimicrob Resist. 2014; 2(4):3 18-21.

Tunyapanit W, Pruekprasert P, Laoprasopwattana K, Chelae S. Antimicrobial susceptibility of Acinetobacter baumannii isolated from hospital patients. Sci Asia. 2014; 40(1):28.

Baadani AM, Thawadi SI, El-Khizzi NA, Omrani AS. Prevalence of colistin and tigecycline resistance in Acin- etobacter baumannii clinical isolates from 2 hospitals in Riyadh Region over a 2-year period. 2013; 34(3):248-53.

Chu H, Zhao L, Wang M, Liu Y, Gui T, Zhang J. Sulbactam-based therapy for Acinetobacter baumannii infection: a systematic review and meta-analysis. Braz J Infect Diseas. 2013; 17(4):389-94

Kempf M, Djouhri-Bouktab L, Brunel J-M, Raoult D, Rolain J-M. Synergistic activity of sulbactam combined with colistin against colistin-resistant Acinetobacter baumannii. Int J Antimicrob Agents. 2012; 39(2):180-1.

Cai Y, Chai D, Wang R, Liang B, Bai N. Colistin resi- stance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies. J Antimicrob Chemother. 2012; 67(7):1607-15

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Published

2017-06-05

How to Cite

Malik, S. ., Hanif, F. ., Zehra, N. M. ., Wasti, H. ., Nadeem, S. ., & Khan, T. A. . (2017). Antimicrobial Susceptibility Pattern of Acinetobacter Baumannii and Rate of Carbapenem Resistance at a Tertiary Care Hospital in Karachi. Journal of Bahria University Medical and Dental College, 7(2), 86–90. Retrieved from https://jbumdc.bahria.edu.pk/index.php/ojs/article/view/242

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