PREVALENCE AND DRUG RESISTANCE IN ACINETOBACTER SP. ISOLATED FROM INTENSIVE CARE UNITS PATIENTS IN PUNJAB, INDIA
Keywords:Acinetobacter sp, Intensive care units, Nosocomial infections, Drug resistance
Objective: This study was designed to study the prevalence and antibiotic susceptibility patterns of Acinetobacter sp. as isolated from patients lodged in intensive care units (ICUs) of a tertiary care hospital, Ludhiana, Punjab, India.
Methods: The clinical samples were simultaneously streaked on Blood agar and MacConkey agar. The identification of the bacterial isolates was carried out with the aid of Gram stain, motility test and along with a combination of other commonly employed biochemical tests. The antimicrobial susceptibility testing (AST) of all the bacterial isolates was carried out on Muller-Hinton agar through Kirby-Bauer disc diffusion method.
Results: Acinetobacter sp. formed a fair allowance contributing at 42% among all ICU culture positive samples. The respiratory tract samples had a major share at 63.15% for all samples attributed to be positive for Acinetobacter sp. nosocomial etiology. The antibiotic sensitivity pattern portrayed that more than 95% of Acinetobacter sp. isolates were multiple drug resistant (MDR) whereas >50% Acinetobacter sp. showed extensive drug resistant (XDR). The last resort for such Acinetobacter sp. nosocomial infections is left to colistin and polymyxin B.
Conclusion: Acinetobacter sp. is a highly prevalent microorganism among ICU patients of Ludhiana, Punjab, India, while its potential to acquire resistance toward commonly used antibiotics represents it as a grave threat to the health-care industry, therefore signifying the need for its regular monitoring in the health-care setups.
Kauffman C. Acinetobacter species. Infect Dis Advis 2017;2017:609604. Available from: https://www.infectiousdiseaseadvisor.com/infectious-diseases/Acinetobacter species/article/609604.
Ochei J, Kolhatkar A. Medical Laboratory Science, Theory and Practice. 1st ed. New Delhi: Tata McGraw-Hill Publishing Company Limited; 2000. p. 712.
Doughari HJ, Ndakidemi PA, Human IS, Benade S. The ecology, biology and pathogenesis of Acinetobacter spp.: An overview. Microbe Environ 2011;26:101-12.
Gautam V, Singhal L, Ray P. Burkholoderia cepacia complex: Beyond Pseudomonas and Acinetobacter. Indian J Med Microbiol 2011;29:4 12.
Montefour K, Frieden J, Hurst S, Helmich C, Headley D, Martin M, et al. Acinetobacter baumannii: An emerging multidrug-resistant pathogen in critical care. Crit Care Nurse 2008;28:15-25.
Cisneros JM, RodrÃguez-BaÃ±o J, FernÃ¡ndez-Cuenca F, Ribera A, Vila J, Pascual A, et al. Risk-factors for the acquisition of imipenem-resistant Acinetobacter baumannii in Spain: A nationwide study. Clin Microbiol Infect 2005;11:874-9.
Falagas ME, Kopterides P. Risk factors for the isolation of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa: A systematic review of the literature. J Hosp Infect 2006;64:7-15.
Medina J, Formento C, Pontet J, Curbelo A, Bazet C, Gerez J, et al. Prospective study of risk factors for ventilator-associated pneumonia caused by Acinetobacter species. J Crit Care 2007;22:18-27.
Katsaragakis S, Markogiannakis H, Toutouzas KG, Drimousis P, Larentzakis A, Theodoraki EM, et al. Acinetobacter baumannii infections in a surgical intensive care unit: Predictors of multidrug resistance. World J Surg 2008;32:1194-202.
Lemuel LD, Marshall DR, Pratap S, Hulette RB. Multidrug resistant Acinetobacter baumannii: A descriptive study in a city hospital. BMC Infect Dis 2010;10:196.
Seifert H, Strate A, Pulverer G. Nosocomial bacteremia due to Acinetobacter baumannii. Clinical features, epidemiology, and predictors of mortality. Med (Baltimore) 1995;74:340-9.
Kwon KT, Oh WS, Song JH, Chang HH, Jung SI, Kim SW, et al. Impact of imipenem resistance on mortality in patients with Acinetobacter bacteraemia. J Antimicrob Chemother 2007;59:525-30.
Sunenshine RH, Wright MO, Maragakis LL, Harris AD, Song X, Hebden J, et al. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis 2007;13:97-103.
Nandi D, Arjuna A. Acinetobacter main cause of hospital acquired infections: A review. Asian J Pharm Clin Res 2017;10:53-6.
CDC (Centers for Disease Control and Prevention). Collection, Handling, and Shipment of Microbiological Specimens. Available from: https://www.stacks.cdc.gov/view/cdc/44272.
Collee JG, Frase AG, Marmion BP, Simmons A. Laboratory strategy in the diagnosis of infective syndromes. In: Mackie and McCartney Practical Medical Microbiology. 14th ed. India: Elsevier Health Sciences; 1996. p. 84-90.
Betty AF, Daniel FS, Alice SW. Bailey and Scottâ€™s Diagnostic Microbiology. 12th ed. Philadelphia: Elsevier; 2007.
CLSI (Clinical and Laboratory Standards Institute). Performance Standards for Antimicrobial Susceptibility Testing. 27th ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2017. Available from: http://www.facm.ucl.ac.be/intranet/CLSI/CLSI-2017-M100-S27.pdf.
Vaja K, Kavathia GU, Goswami YS, Chouhan S. A prevalence study of Acinetobacter species and their sensitivity pattern in a tertiary care hospital Rajkot city of Gujarat (India): A hospital based study. IOSR J Pharm Biol Sci 2016;15:54-8.
Colle JG, Fraser AG, Marmion BP, Simmons A. Practical Medical Microbiology. 14th ed. New York: Churchill Livingstone; 1996. p. 294 6.
Koneman EW, Allen SD, Jande WM, Schreckenberger PC, Winn WC Jr. Colour Atlas and Text Book Diagnostic Microbiology. 5th ed. Baltimore: Lippincott; 1997. p. 286-7.
Dent LL, Marshall DR, Pratap S, Hulette RB. Multidrug resistant Acinetobacter baumannii: A descriptive study in a city hospital. BMC Infect Dis 2010;10:196.
Bernards AT, Harinck HI, Dijkshoom L, Van der Reijden TJ, Van den Broek PJ. Persistant Acinetobacter baumannii? Look inside your medical equipment. Infect Control Hosp Epidemiol 2004;25:1002-4.
Bhattacharyya S, Bhattacharyya I, Rit K, Mukhopadhyay PK, Dey JB, Ganguly U, et al. Antibiogram of Acinetobacter spp. isolated from various clinical specimens in a tertiary care hospital in West Bengal, India. Biomed Res 2013;24:43-6.
Sudhaharan S, Lakshmi V, Padmaja K. Prevalence of multidrug resistant Acinetobacter baumannii in clinical samples in a tertiary care hospital. Int J Infect Control 2015;11:1-5.
Siau H, Yuen, KY, Wong SSY. The epidemiology of Acinetobacter infections in Hong Kong. J Med Microbiol 1996;44:340-7.
Asensio A, Canton R, Vague J, Calbo-Torrecillas F, Herruzo R, Arribas JL, et al. Prevalence of infection by Carbapenem resistant A. baumanni in Spain (1999-2005). Enferm Infect Microbiol Clin 2008;26:199-204.
Jaggi N, Sissodia P, Sharma L. Acinetobacter baumannii isolates in a tertiary care hospital: Antimicrobial resistance and clinical significance. J Microbiol Infect Dis 2012;2:57-63.
Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: Emergence of a successful pathogen. Clin Microbiol Rev 2008;21:538-82.
Joshi SG, Litake GM, Satpute MG, Telang NV, Ghole VS, Niphadkar KB. Clinical and demographic features of infection caused by Acinetobacter species. Indian J Med Sci 2006;60:351-60.
Walsh TR, Toleman MA, Poirel L, Nordmann P. Metallobetalactamases: The quiet before the storm? Clin Microbiol Rev 2005;18:306-25.
Towner KJ. Acinetobacter: An old friend, but a new enemy. J Hosp Infect 2009;73:355-63.
Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in healthcare facilities. Clin Infect Dis 2006;42:692-9.
Hu Q, Hu Z, Li J, Tian B, Xu H, Li J. Detection of OXA-type carbapenemases and integrons among carbapenem resistant Acinetobactor baumannii in a teaching hospital in China. J Basic Microbiol 2011;51:467-72.
Gupta E, Mohanty S, Sood S, Dhavan B, Das BK, Kapil A. Emerging resistance to carbapenems in a tertiary care hospital in North India. Indian J Med Res 2006;124:95-8.
Gaur A, Gang A, Prakash P, Anupurba S, Mohapatra TM. Observations on carbapenem resistance by minimum inhibitory concentration in nosocomial isolates of Acinetobacter species. J Health Popul Nutr 2008;26:183-8.
Lautenbach E, Synnestvedt M, Weiner MG, Bilker WB, Vo L, Schein J, et al. Epidemiology and impact of imipenem resistance in Acinetobacter baumannii. Infect C Hosp Epidemiol 2009;30:1186-92.
Clinical Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 16th Informational Suppl. Wayne PA. Clinical Laboratory Standards Institute (CLSI); 2006.
Yau W, Owen RJ, Poudyal A, Bell JM, Turnidge JD, Yu HH, et al. Colistin heteroresistance in multidrug-resistant Acinetobacter baumannii clinical isolates from the western pacific region in the SENTRY antimicrobial surveillance programme. J Infect 2009;58:138 44.
How to Cite
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.