Molecular Identification and Antimicrobial Resistance Profile of Acinetobacter baumannii Isolated From Nosocomial Infections of a Teaching Hospital in Isfahan, Iran

Abstract

Background: Multidrug resistant (MDR) and extensively drug resistant (XDR) Acinetobacter baumannii are among important causes of nosocomial infections and cause therapeutic problems worldwide. The emergence of extensively drug-resistant A. baumannii (XDRAB) cause serious threats to hospital acquired infections (HAI) worldwide and further limit the treatment options. Objectives: The current study aimed to identify and isolate the MDR and XDR Acinetobacter baumannii from different wards of a teaching hospital in Isfahan, Iran, and determine the susceptibility pattern of these bacteria. Materials and Methods: One hundred and twenty one (121) isolates of A. baumannii collected from a teaching hospital in Isfahan, Iran, within eight months (between September 2013 and April 2014) were included in the current study. The samples were isolated from different wards and different specimens. To confirm the species of A. baumannii, Polymerase chain reaction (PCR)was conducted to identify bla oxa-51 gene. Disk diffusion method was employed to evaluate antimicrobial susceptibility against cefotaxime, ceftriaxone, ampicillin-sulbactam, cefepime, meropenem, tobramycin, amikacin, tetracycline, ciprofloxacin, trimethoprim-sulfamethoxazole, and aztreonam. Results: Among the 121 isolated A. baumannii, 44% and 56% were isolated from female and male, respectively. Samples cultured from the trachea (36%), urine (15%), blood (10%), wound (10%), cerebrospinal fluid (7%), bronchial (4%) and the others (18%). Most of the isolates (50%) were obtained from intensive care unit (ICU). Isolated A. baumannii showed high resistance to the evaluated antibiotics except ampicillinsulbactam, which showed only 33.9% resistance. Also, 62.8% and 100% of the isolates were identified as XDR and MDR. Conclusions:The result of the current study showed the growing number of nosocomial infections associated with XDR A. baumannii causing difficulties in antibiotic therapy. Resistant strains increasingly cause public health problems; therefore, their early detection is essential for healthcare centers.

Antimicrobial susceptibility pattern of acinetobacter isolates from patients in Kenyatta National Hospital, Nairobi, Kenya

“…Consequently, high level of resistance (71-86%) to the commonly used antibiotics was noted in isolates from these units. These findings concur with results from similar studies conducted in India [18], Iran [20] and Sudan [21]. Several factors including immunosuppressed hosts, previous use of antibiotics, patients with severe underlying diseases, duration of hospital stay, the increasingly invasive diagnostic procedures and more frequent use of antibiotics in ICU have been shown to contribute to the occurrence of Acinetobacter and especially A. baumannii [1, 22].…”

Distribution and Expression of Efflux Pump Gene and Antibiotic Resistance in Acinetobacter baumannii

“…Acinetobacter baumannii have evolved to a clinically important nosocomial pathogen because of the increasing frequency of pan drug-resistant (PDR), extensively-drug resistant (XDR), and multidrug-resistant (MDR) strains (25,26). In some studies, maximum resistance was seen against cefotaxime, cefepime, ciprofloxacin, piperacillintazobactam, ceftazidime, imipenem and meropenem, which was similar to other studies (27)(28)(29)(30).…”

Frequency of Class 1 integron and genetic diversity of Acinetobacter baumannii isolated from medical centers in Kermanshah

“…is alert pathogens, mostly in ICUs and is related with outbreaks of infection, which require epidemiologic monitoring as a measure for controlling nosocomial infection. [ 11 ] In this study, the majority of Acinetobacter spp. was isolated from the ICU.…”