Prevalence of antibiotic-resistant Acinetobacter baumannii in a 1000-bed tertiary care hospital in Tehran, Iran

Abstract

Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections. Acinetobacter baumannii usually causes respiratory tract, urinary tract, blood stream and surgical site infections. They are of increasing importance because of its ability to rapidly develop resistance to the major groups of antibiotics. There are few data available on the antimicrobial susceptibility of A. baumannii in Iran. During the period of study from July 2005 to November 2006, a total of 88 strains of A. baumannii were isolated from clinical specimens obtained from patients hospitalized in an Iranian 1000-bed tertiary care hospital. Conventional bacteriological methods were used for identification of A. baumannii. Susceptibility testing was performed by the method recommended by Clinical Laboratory and Standards Institute (CLSI). The majority of isolates were from respiratory tract specimens. The organism showed high rate of resistance to ceftriaxone (90.9%), piperacillin (90.9%), ceftazidime (84.1%), amikacin (85.2%) and ciprofloxacin (90.9%). Imipenem was the most effective antibiotic against A. baumannii and the rate of resistance for imipenem was 4.5%. The second most effective antibiotic was tobramycin, and 44.3% of A. baumannii isolates were resistant to this antibiotic. In conclusion, our study showed that the rate of resistance in A. baumannii to imipenem was low. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay and drug resistance.

Non fermentative gram negative bacilli as nosocomial pathogens: Identification and antibiotic sensitivity in clinical samples of indoor patients

“…The sex distribution is comparable and is in concordance with a study done by Rahbar et al 12 . This may be attributed to the fact that health care -associated infections do not have a discernible sex predilection.…”

“…In India, very few studies on Acinetobacter species have been reported and in view of their increasing importance in nosocomial infections, further studies are warranted in this part of world. In our study prevalence of Acinetobacter baumannii was 33%, which was comparable to many studies 9,11,12,15 in which the prevalence was reported to be in the range of 28% to 36%. .…”

“…12 The higher age group was more affected as these HAIs have a predilection for severely ill and immune compromised people.…”

“…18 Meropenem was the drug with highest sensitivity against Pseudomonas and Acinetobacter both in the present study, which was supported by other studies. 12,19 Both of them were found to be most resistant against aztreonam.…”

“…Other studies have also reported higher incidences from ICUs. 9,12 Tracking nosocomial infections by site has become difficult in the last few years because of shorter inpatient stays. For example, the average postoperative stay, now approximately 5 days, is usually shorter than the incubation period for many infectious diseases.…”