Resistance patterns of Multidrug resistant Acinetobacter baumannii in an ICU of a tertiary care hospital, Malaysia

Abstract

Backgrounds & Objective:Antimicrobial resistance is a major health problem worldwide in hospitals. The main contributing factors are exposures to broad-spectrum antimicrobials and cross-infections. Understanding the extent and type of antimicrobial use in tertiary care hospitals will aid in developing national antimicrobial stewardship priorities.Methods:In this study, we have analyzed the antimicrobial agents’ usage for acquisition of multidrug resistant using retrospective, cross-sectional, single-centre study in a multidisciplinary ICU at tertiary care hospital.Results:Acinetobacter baumannii (ACB) was isolated in various specimens from 662 patients. From these, 136 patients who were diagnosed with Ventilator-associated pneumonia (VAP) caused by ACB were included into the study. In our study, MDR strain accounts for 51% of all VAP cases caused by ACB. The development of ACB VAP were 10.5 + 6.4 days for MDR strains compared to susceptible organism (7.8 + 4.5 days) and had significantly longer ICU stay.Conclusion:The study concludes that prudent use of antimicrobial agents is important to reduce acquisition of MDR ACB.

A Systematic Review of the Burden of Multidrug-Resistant Healthcare-Associated Infections Among Intensive Care Unit Patients in Southeast Asia: The Rise of Multidrug-ResistantAcinetobacter baumannii

“…Of 8 studies reporting LOS, 7 reported that total hospital or ICU LOS tended to be longer for patients with MDR infections. For example, Janahiraman et al 25 found that, on average, patients infected with MDR-AB stayed in the ICU for an additional 15.3 days, compared to 17.9 days for those without MDR-AB. Importantly, not all studies performed statistical adjustments to minimize potential confounders between groups.…”

“…Our study has some limitations. First, LOS comparisons should be interpreted with caution because not all studies 25 , 40 performed statistical adjustments to eliminate confounder bias. Second, data regarding types of infection are limited.…”

Perception and practices of public hospital pharmacists towards the antimicrobial stewardship programme in the State of Selangor, Malaysia

“…Globally, the number of deaths attributable to antimicrobial resistance is projected to be 10 million annually by 2050 2. In addition, antimicrobial resistance has been associated with high mortality, substantial healthcare expenditure and prolonged hospital stay worldwide, including Malaysia (a developing country) 1–3…”

Analysis of applied empirical treatments against VAP caused by Acinetobacter baumannii

“…Spostrzeżenia te pokrywają się z danymi z piśmiennictwa, które wskazują, że u chorych z grup ryzyka, m.in. : poprzednio hospitalizowanych, poddanych wcześniejszej antybiotykoterapii [8], zabiegom operacyjnym, w podeszłym wieku, z przewlekłymi chorobami układu oddechowego, z chorobami układu krążenia, chorobami metabolicznymi, niewydolnością nerek, wątroby, występuje częstsze ryzyko izolacji drobnoustrojów lekoopornych [12,13], a poziom występowania zgonów sięga 61% [5] lub nawet 70% [4]. W niniejszej pracy ustalono, że zastosowane leczenie empiryczne chorych z VAP różniło się od zalecanych rekomendacji.…”