Volume 12, Issue 6 (Nov - Dec 2018)                   mljgoums 2018, 12(6): 19-23 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Khaledi A, Fatemeh D, Javad Hosseini S M, Meskini M, Esmaeili D. Antimicrobial Resistance Pattern of Acinetobacter baumannii Strains Isolated from Intensive Care Unit Patients . mljgoums. 2018; 12 (6) :19-23
URL: http://mlj.goums.ac.ir/article-1-1129-en.html
1- Infectious Diseases Research Center, Kashan University of Medical Science, Kashan, Iran Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran
2- Department of Microbiology and Applied Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
3- Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
4- Department of Microbiology and Applied Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran , esm114@gmail.com
Abstract:   (7520 Views)
ABSTRACT
            Background and Objectives: Acinetobacter baumannii is an opportunistic pathogen that affects different groups of people, especially intensive care unit (ICU) patients. The prevalence of infections caused by this bacterium is very high. Today, prevalence of infections caused by multidrug-resistant (MDR) and extreme-drug resistant (XDR) strains is increasing. This study aimed to determine the antibiotic susceptibility pattern of A. baumannii isolates from ICU patients.
            Methods: This cross-sectional study was conducted from October 2014 to March 2015 on patients admitted to ICU of Imam Khomeini hospital in Tehran, Iran. Clinical samples of various sources were collected from patients. Isolates were detected and identified via microbiological and biochemical tests as well as PCR amplification of the blaOxa51 gene. Then, susceptibility testing was performed using the Kirby-Bauer disk diffusion test. Statistical analysis was performed with SPSS (version 22, Chicago, IL, USA) using Chi-square and Fisher’s exact tests.
            Results: Of the total of 62 clinical samples, 24 (39%) were respiratory samples and only three (6%) were cerebrospinal fluid samples. Most MDR and XDR strains were isolated from respiratory samples. The highest resistance rate was against ceftriaxone, ticarcillin and erythromycin (100%), while the lowest resistance rate was against to minocycline (20%).
            Conclusion: Owing to detection of high multi-drug resistance isolates in the present study, and importance of multi-drug resistance in A. baumannii, the identification of multi-drug resistance genes and their reporting to health care/treatment centers is important. Thus, it is recommended to perform susceptibility testing to help determine the most effective antibiotic(s) for the treatment of infections in ICU patients.
            Keywords:  Acinetobacter baumannii, MDR, XDR, ICU.
Full-Text [PDF 600 kb]   (616 Downloads)    
Type of Study: Original Paper |
Received: 2018/10/29 | Accepted: 2018/10/29 | Published: 2018/10/29 | ePublished: 2018/10/29

References
1. Talbot GH, Bradley J, Edwards JE, Gilbert D, Scheld M, Bartlett JG. Bad bugs need drugs: an update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America. Clinical Infectious Diseases. 2006; 42(5): 657-68. [DOI:10.1086/499819]
2. Fournier PE, Richet H, Weinstein RA. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clinical infectious diseases. 2006; 42(5): 692-9. [DOI:10.1086/500202]
3. Jeon B-C, Jeong SH, Bae IK, Kwon SB, Lee K, Young D, et al. Investigation of a nosocomial outbreak of imipenem-resistant Acinetobacter baumannii producing the OXA-23 β-lactamase in Korea. Journal of clinical microbiology. 2005; 43(5): 2241-5. DOI:10.1128/JCM.43.5.2241-2245.2005. [DOI:10.1128/JCM.43.5.2241-2245.2005]
4. Poirel L, Nordmann P. Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clinical Microbiology and Infection. 2006; 12(9): 826-36. DOI:10.1111/j.1469-0691.2006.01456.x. [DOI:10.1111/j.1469-0691.2006.01456.x]
5. Quale J, Bratu S, Landman D, Heddurshetti R. Molecular epidemiology and mechanisms of carbapenem resistance in Acinetobacter baumannii endemic in New York City. Clinical infectious diseases. 2003; 37(2): 214-20. [DOI:10.1086/375821]
6. Ernst EJ, Diekema DJ, BootsMiller BJ, Vaughn T, Yankey JW, Flach SD, et al. Are United States hospitals following national guidelines for the analysis and presentation of cumulative antimicrobial susceptibility data? Diagnostic microbiology and infectious disease. 2004; 49(2): 141-5. DOI:10.1016/j.diagmicrobio.2004.03.007. [DOI:10.1016/j.diagmicrobio.2004.03.007]
7. Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, et al. Multidrug resistant, extensively drug‐resistant and pandrug‐resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical Microbiology and Infection. 2012; 18(3): 268-81. doi: 10.1111/j.1469-0691.2011.03570.x. [DOI:10.1111/j.1469-0691.2011.03570.x]
8. Valenzuela JK, Thomas L, Partridge SR, van der Reijden T, Dijkshoorn L, Iredell J. Horizontal gene transfer in a polyclonal outbreak of carbapenem-resistant Acinetobacter baumannii. Journal of clinical microbiology. 2007;45(2):453-60. DOI:10.1128/JCM.01971-06. [DOI:10.1128/JCM.01971-06]
9. Turton J, Gabriel S, Valderrey C, Kaufmann M, Pitt T. Use of sequence‐based typing and multiplex PCR to identify clonal lineages of outbreak strains of Acinetobacter baumannii. Clinical microbiology and infection. 2007; 13(8): 807-15. DOI:10.1111/j.1469-0691.2007.01759.x. [DOI:10.1111/j.1469-0691.2007.01759.x]
10. Turton JF, Woodford N, Glover J, Yarde S, Kaufmann ME, Pitt TL. Identification of Acinetobacter baumannii by detection of the blaOXA-51-like carbapenemase gene intrinsic to this species. Journal of clinical microbiology. 2006; 44(8): 2974-6. doi: 10.1128/JCM.01021-06. [DOI:10.1128/JCM.01021-06]
11. Saghi H, Esmaeili D, Bahador A, Khaledi A, Dastjerdi FA. Study of Expression of the Gene Alpha-6 in Multidrug-Resistant Acinetobacter Baumannii against Thyme Essence with Real Time Pcr. Iranian Journal of Public Health. 2014; 43(2): 36.
12. Wanger A. Disk diffusion test and gradient methodologies. Antimicrobial Susceptibility Testing Protocols. 2007:53-73. DOI: 10.1201/9781420014495.ch3. [DOI:10.1201/9781420014495.ch3]
13. Alipour M, Halwani M, Omri A, Suntres ZE. Antimicrobial effectiveness of liposomal polymyxin B against resistant Gram-negative bacterial strains. International Journal of Pharmaceutics. 2008; 355(1): 293-8. doi: 10.1016/j.ijpharm.2007.11.035. [DOI:10.1016/j.ijpharm.2007.11.035]
14. Khaledi A, Elahifar O, Vazini H, Alikhani MY, Bahrami A, Esmaeili D, et al. Increasing Trend of Imipenem-Resistance Among Acinetobacter baumannii Isolated From Hospital Acquired Pneumonia in Northeast of Iran. Avicenna Journal of Clinical Microbiology and Infection. 2017;4(3): e45454. DOI: 10.5812/ajcmi.45454. [DOI:10.5812/ajcmi.45454]
15. Zarifi E, Eslami G, Khaledi A, Vakili M, Vazini H, Zandi H. Prevalence of ESBLs in Acinetobacter baumannii isolated from intensive care unit (ICU) of Ghaem hospital, Mashhad, Iran. Journal of Pure and Applied Microbiology. 2017;11(2):811-9. DOI: 10.22207/JPAM.11.2.20. [DOI:10.22207/JPAM.11.2.20]
16. Jain R, Danziger LH. Multidrug-resistant Acinetobacter infections: an emerging challenge to clinicians. Annals of Pharmacotherapy. 2004; 38(9): 1449-59. DOI:10.1345/aph.1D592. [DOI:10.1345/aph.1D592]
17. Iglesias dSH, Mirón CJ, Fresnadillo MM, Sáenz GM. Epidemiological study and effect on antimicrobial use in the genus Acinetobacter in a university hospital. Rev Esp Quimioter. 2004; 17(2): 177-83.
18. Morovat T, Bahram F, Mohammad E, Setareh S, Mohamad Mehdi F. Distribution of different carbapenem resistant clones of Acinetobacter baumannii in Tehran hospitals. The new microbiologica. 2009; 32(3): 265.
19. Henwood CJ, Gatward T, Warner M, James D, Stockdale MW, Spence RP, et al. Antibiotic resistance among clinical isolates of Acinetobacter in the UK, and in vitro evaluation of tigecycline (GAR-936). Journal of Antimicrobial Chemotherapy. 2002; 49(3): 479-87. [DOI:10.1093/jac/49.3.479]
20. Karmostaj A, Peerayeh SN, Salmanian AH. Emergence of Tigecycline resistant Acinetobacter baumannii from an intensive care unit (ICU) in Tehran. Jundishapur Journal of Microbiology. 2013; 6(3): 215-19. [DOI:10.5812/jjm.4710]
21. Liu J-W, Wang L-S, Cheng Y-J, Hsu G-J, Lu P-L, Liu Y-C, et al. In-vitro activity of tigecycline against clinical isolates of Acinetobacter baumannii in Taiwan. Int J Antimicrob Agents. 2008; 32 Suppl 3:S192-6. doi: 10.1016/S0924-8579(08)70027-X. [DOI:10.1016/S0924-8579(08)70027-X]
22. Bouchillon SK, Hoban DJ, Johnson BM, Stevens TM, Dowzicky MJ, Wu DH, et al. In vitro evaluation of tigecycline and comparative agents in 3049 clinical isolates: 2001 to 2002. Diagnostic microbiology and infectious disease. 2005; 51(4): 291-5. [DOI:10.1016/j.diagmicrobio.2004.11.006]

Add your comments about this article : Your username or Email:
CAPTCHA code

Send email to the article author


© 2007 All Rights Reserved | Medical Laboratory Journal