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Acinetobacter baumannii Strains Isolated from Various Clinical Samples of Patients Admitted to the Intensive Care Unit and Four-Year Resistance Profiles

Yıl 2023, Cilt: 20 Sayı: 3, 560 - 565, 31.12.2023
https://doi.org/10.35440/hutfd.1336319

Öz

Background: Intensive care units are the most frequently affected areas by infections caused by Acinetobacter baumannii. Due to its rapid development of antimicrobial resistance, causes serious therapeutic problems. The aim of this study is to determine antibiotic susceptibilities of A. baumannii strains isolated from intensive care units over a four-year period.
Materials and Methods: A. baumannii strains isolated from various samples sent from intensive care units to the medical microbiology laboratory between January 2018 and December 2021 were included in the study. Bacterial identification and antibiotic susceptibility tests were performed using standard microbiological met-hods and automated systems. Antibiotic resistance data from 2018 to 2021 were compared using the Chi-square and Fisher's Exact test, and p<0.05 was considered statistically significant.
Results: A total of 1900 A. baumannii strains were included in the study. These strains were most commonly isolated from tracheal aspirate culture samples (1011; 53%). Among the intensive care units, it was determined that it was most frequently isolated from the Anesthesiology and Reanimation intensive care unit (697; 37%). When comparing the years 2018 and 2021, an increase in antibiotic resistance was observed in A. baumannii. The most significant resistance increase was found in amikacin, trimethoprim/sulfamethoxazole, and levof-loxacin (p<0.001).
Conclusions: Our study revealed high antibiotic resistance among A. baumannii strains. Regular monitoring and reporting of antibiotic susceptibility results will enable physicians to establish antibiotic usage policies and take infection control measures.

Kaynakça

  • 1. Gallego L. Acinetobacter baumannii: Factors Involved in its High Adaptability to Adverse Environmental Conditions. J Microbiol Exp. 2016;3:00085.
  • 2. Sannathimmappa MB, Nambiar V, Aravindakshan R. Antibiotic Resistance Pattern of Acinetobacter baumannii Strains: A Retrospective Study from Oman. Saudi J Med Med Sci. 2021;9:254–60.
  • 3. Hrenovic J, Durn G, Goic-Barisic I, Kovacic A. Occurrence of an environmental Acinetobacter baumannii strain similar to a clinical isolate in paleosol from Croatia. Appl Environ Microbiol. 2014;80:2860–6.
  • 4. Abbo A, Navon-Venezia S, Hammer-Muntz O, Krichali T, Siegman-Igra Y, Carmeli Y. Multidrug-resistant Acinetobacter baumannii. Emerg Infect Dis. 2005;11:22–9.
  • 5. Ashuthosh KC, Hegde A, Rao P, Manipura R. Multidrug-resistant Acinetobacter baumannii – The modern menace: a retrospective study in a tertiary hospital in Mangalore. Infect Drug Resist. 2020;13:2181–7.
  • 6. Antunes LCS, Visca P, Towner KJ. Acinetobacter baumannii: Evolution of a global pathogen. Pathog Dis. 2014;71:292–301.
  • 7. Uwingabiye J, Lemnouer A, Baidoo S, Frikh M, Kasouati J, Maleb A, et al. Intensive care unit-acquired Acinetobacter baumannii infections in a Moroccan teaching hospital: Epidemiology, risk factors and outcome. Germs. 2017;7:193–205.
  • 8. Ashuthosh KC, Hegde A, Rao P, Manipura R. Multi-drug resistant Acinetobacter baumannii – The modern men-ace: A retrospective study in a tertiary hospital in Mangalore. Infect Drug Resist 2020;13:2181 7.
  • 9. Çalişkan A, Kirisçi O. Antibiotic sensitivity and multiple antibiotic resistance of Acinetobacter infections in a state hospital in the period 2013-2018. Turk Hij ve Deney Biyol Derg. 2020;77:487–92.
  • 10. Duran H, Ceken N, Atik B. Yoğun Bakım Ünitelerinden İzole Edilen Acinetobacter baumannii Suşlarının Direnç Profili: Beş Yıllık Çalışma. Mustafa Kemal Üniv Tıp Derg. 2021;12:199–204.
  • 11. Gales AC, Seifert H, Gur D, Castanheira M, Jones RN, Sader HS. Antimicrobial Susceptibility of acinetobacter calcoaceticus-acinetobacter baumannii complex and stenotrophomonas maltophilia clinical isolates: Results from the SENTRY Antimicrobial Surveillance Program (1997-2016). Open Forum Infect Dis. 2019;6:S34–46.
  • 12. Savcı Ü, Özveren G, Yenişehirli G, Bulut Y, Özdaş S. Klinik örneklerden izole edilen Acinetobacter baumannii suşlarının invitro duyarlılık durumları. Turk Journal of Clin and Lab. 2015;6:24-9.
  • 13. Castilho SRA, Godoy CSDM, Guilarde AO, Cardoso JL, André MCP, Junqueira-Kipnis AP, et al. Acinetobacter baumannii strains isolated from patients in intensive care units in Goiânia, Brazil: Molecular and drug susceptibility profiles. PLoS One. 2017;12:1–13.
  • 14. Cisneros JM, Rodriguez-Baño J. Nosocomial bactermia due to Acinetobacter baumannii: Epidemiology, clinical features and treatment. Clin Microbiol Infect. 2002;8:687–93.
  • 15. Ntusi NB, Badri M, Khalfey H, Whitelaw A, Oliver S, Piercy J, et al. ICU-associated Acinetobacter baumannii colonisa-tion/infection in a high HIV prevalence resource-poor setting. PLoS One. 2012;7:e52452.
  • 16. Rezaee P, Hamzeh A, Mohammadi M. Acinetobacter bau-mannii antibiotics resistance in Iran. J Bacteriol Mycol Open Access. 2019;7:159 62.
  • 17. Falagas ME, Mourtzoukou EG, Polemis M, Vatopoulos AC, Greek System for Surveillance of Antimicrobial Resistance Trends in antimicrobial resistance of Acinetobacter bau-mannii clinical isolates from hospitalised patients in Greece and treatment implications. Clin Microbiol Infect. 2007;13:816–819.
  • 18. T.C. Sağlık Bakanlığı. Ulusal Sağlık Hizmeti İlişkili Enfeksiyonlar Sürveyans Ağı (USHİESA) Etken Dağılımı ve Antibiyotik Direnç Raporu 2020. https://hsgm.saglik.gov.tr/depo/birimler/ Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/ETKEN_ DAGILIM_VE_DIRENC_2020.pdf. 2021. p. 1–42.
  • 19. Arslan Gülen T, İmre A, Ödemiş İ, Kayabaş Ü. Acinetobacter baumannii Infections and Antibiotic Resistance in Hospitalized Patients in an Education and Research Hospital: A Six-Year Analysis. Flora J Infect Dis Clin Microbiol. 2020;25:563–71.
  • 20. Liu JY, Wang FD, Ho MW, Lee CH, Liu JW, Wang JT, et al. In vitro activity of aminoglycosides against clinical isolates of Acinetobacter baumannii complex and other nonfermentative Gram-negative bacilli causing healthcare-associated bloodstream infections in Taiwan. J Microbiol Immunol Infect. 2016;49:918–23.
  • 21. Benamrouche N, Lafer O, Benmahdi L, Benslimani A, Amhis W, Ammari H, et al. Phenotypic and genotypic characterization of multidrug-resistant Acinetobacter baumannii isolated in Algerian hospitals. J Infect Dev Ctries. 2021;14:1395–401.
  • 22. Maraki S, Mantadakis E, Mavromanolaki VE, Kofteridis DP, Samonis G. A 5-year Surveillance Study on Antimicrobial Re-sistance of Acinetobacter baumanni Clinical Isolates from a Tertiary Greek Hospital. Infect Chemother. 2016;48:190-8.
  • 23. Şirin MC, Ağuş N, Yılmaz N, Derici YK, Hancı SY, Bayram A, Şamlıoğlu, P. Yoğun bakım ünitelerinden izole edilen Pseudo-monas aeruginosa ve Acinetobacter baumannii suşlarında an-tibiyotik direnç profillerinin yıllar içindeki değişimi. Int J Clin Exp Med. 2015;6:279-285.
  • 24. Özekinci T, Habip Z, Önder N, Koçoğlu ME. 2015-2018 Yıllarında İzole Edilen Acinetobacter Baumannii Suşlarinda Antibiyotik Di-renci. Van Tıp Derg. 2020;27:340-4.
  • 25. Chopra S, Galande A. A fluoroquinolone-resistant Acinetobacter baumannii without the quinolone resistance-determining region mutations. J Antimicrob Chemother. 2011;66:2668–70.
  • 26. Lob SH, Hoban DJ, Sahm DF, Badal RE. Regional differences and trends in antimicrobial susceptibility of Acinetobacter baumannii. Int J Antimicrob Agents. 2016;47:317-23.
  • 27. Şay Coşkun US. Investigation of antibiotic resistance in carbapenem resistant Acinetobacter baumannii isolates. Ankem Derg. 2018;32:37–44.
  • 28. Uğur M, Genç S. Yoğun Bakım Ünitelerinden İzole Edilen Aci-netobacter baumannii ve Pseudomonas aeruginosa Suşlarının Üç Yıllık Direnç Profili. Turk J Intensive Care. 2019;17:130-7
  • 29. Dursun A, Özsoylu S, Kılıç H, Ulu Kılıç A, Akyıldız BN. Antibiotic Susceptibilities of Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii Strains Isolated from Patients in the Pediatric Intensive Care Unit. Turk J Intensive Care. 2018;16:109–14.
  • 30. Çolakoğlu Ş, Alışkan HE, Göçmen JS. The Antibiotic Susceptibility Profile of Acinetobacter baumannii and Pseudomonas aeruginosa Strains Isolated from the Blood Cultures (2012-2014). Türk Mikrobiyol Cem Derg. 2014;44:132–8.

Yoğun Bakım Ünitelerinde Yatan Hastaların Çeşitli Klinik Örneklerinden İzole Edilen Acinetobacter baumannii Suşları ve Dört Yıllık Direnç Profilleri

Yıl 2023, Cilt: 20 Sayı: 3, 560 - 565, 31.12.2023
https://doi.org/10.35440/hutfd.1336319

Öz

Amaç: Yoğun bakım üniteleri Acinetobacter baumannii'nin neden olduğu enfeksiyonlardan en sık etkilenen alanlardır. Hızlı bir şekilde antimikrobiyal direnç geliştirme eğilimi nedeniyle ciddi terapötik sorunlara yol açmaktadır. Bu çalışmanın amacı yoğun bakım ünitelerinden izole edilen Acinetobacter baumannii suşlarının dört yıllık süreçteki antibiyotik duyarlılıklarını belirlemektir.
Materyal ve Metod: Ocak 2018–Aralık 2021 yılları arasında yoğun bakım ünitelerinden tıbbi mikrobiyoloji laboratuvarına gönderilen çeşitli örneklerden izole edilen Acinetobacter baumannii suşları çalışmaya dahil edilmiştir. Bakteri tanımlanması ve antibiyotik duyarlılık testleri standart mikrobiyolojik yöntemler ve otomatize sistemler kullanılarak yapılmıştır. Antibiyotik direncinde 2018 ile 2021 yılı verileri Ki-Kare ve Fisher Exact test ile karşılaştırılmış ve p<0.05 anlamlı olarak kabul edilmiştir.
Bulgular: Toplam 1900 Acinetobacter baumannii suşu çalışmaya dahil edilmiştir. Bu suşlar en sık trakeal aspirat kültür örneklerinden (1011; %53) izole edilmiştir. Yoğun bakım arasında da en sık Anesteziyoloji ve Reanimasyon yoğun bakım ünitesinden (697; %37) izole edildiği saptanmıştır. 2018 yılı ile 2021 yılı karşılaştırıldığında Acinetobacter baumannii’de antibiyotiklere karşı direnç oranının arttığı görülmüştür. İstatistiksel olarak en anlamlı direnç artışı amikasin, trimetoprim/ sulfametoksazol ve levofloksasinde saptanmıştır (p<0.001).
Sonuç: Çalışmamızda Acinetobacter baumannii suşlarında antibiyotiklere direncin yüksek olduğu görülmektedir. Antibiyotik duyarlılık sonuçlarının düzenli olarak takip edilmesi ve raporlanması, hekimlerin antibiyotik kullanım politikalarını belirlemelerine ve enfeksiyon kontrol önlemleri almalarına olanak tanıyacaktır.

Kaynakça

  • 1. Gallego L. Acinetobacter baumannii: Factors Involved in its High Adaptability to Adverse Environmental Conditions. J Microbiol Exp. 2016;3:00085.
  • 2. Sannathimmappa MB, Nambiar V, Aravindakshan R. Antibiotic Resistance Pattern of Acinetobacter baumannii Strains: A Retrospective Study from Oman. Saudi J Med Med Sci. 2021;9:254–60.
  • 3. Hrenovic J, Durn G, Goic-Barisic I, Kovacic A. Occurrence of an environmental Acinetobacter baumannii strain similar to a clinical isolate in paleosol from Croatia. Appl Environ Microbiol. 2014;80:2860–6.
  • 4. Abbo A, Navon-Venezia S, Hammer-Muntz O, Krichali T, Siegman-Igra Y, Carmeli Y. Multidrug-resistant Acinetobacter baumannii. Emerg Infect Dis. 2005;11:22–9.
  • 5. Ashuthosh KC, Hegde A, Rao P, Manipura R. Multidrug-resistant Acinetobacter baumannii – The modern menace: a retrospective study in a tertiary hospital in Mangalore. Infect Drug Resist. 2020;13:2181–7.
  • 6. Antunes LCS, Visca P, Towner KJ. Acinetobacter baumannii: Evolution of a global pathogen. Pathog Dis. 2014;71:292–301.
  • 7. Uwingabiye J, Lemnouer A, Baidoo S, Frikh M, Kasouati J, Maleb A, et al. Intensive care unit-acquired Acinetobacter baumannii infections in a Moroccan teaching hospital: Epidemiology, risk factors and outcome. Germs. 2017;7:193–205.
  • 8. Ashuthosh KC, Hegde A, Rao P, Manipura R. Multi-drug resistant Acinetobacter baumannii – The modern men-ace: A retrospective study in a tertiary hospital in Mangalore. Infect Drug Resist 2020;13:2181 7.
  • 9. Çalişkan A, Kirisçi O. Antibiotic sensitivity and multiple antibiotic resistance of Acinetobacter infections in a state hospital in the period 2013-2018. Turk Hij ve Deney Biyol Derg. 2020;77:487–92.
  • 10. Duran H, Ceken N, Atik B. Yoğun Bakım Ünitelerinden İzole Edilen Acinetobacter baumannii Suşlarının Direnç Profili: Beş Yıllık Çalışma. Mustafa Kemal Üniv Tıp Derg. 2021;12:199–204.
  • 11. Gales AC, Seifert H, Gur D, Castanheira M, Jones RN, Sader HS. Antimicrobial Susceptibility of acinetobacter calcoaceticus-acinetobacter baumannii complex and stenotrophomonas maltophilia clinical isolates: Results from the SENTRY Antimicrobial Surveillance Program (1997-2016). Open Forum Infect Dis. 2019;6:S34–46.
  • 12. Savcı Ü, Özveren G, Yenişehirli G, Bulut Y, Özdaş S. Klinik örneklerden izole edilen Acinetobacter baumannii suşlarının invitro duyarlılık durumları. Turk Journal of Clin and Lab. 2015;6:24-9.
  • 13. Castilho SRA, Godoy CSDM, Guilarde AO, Cardoso JL, André MCP, Junqueira-Kipnis AP, et al. Acinetobacter baumannii strains isolated from patients in intensive care units in Goiânia, Brazil: Molecular and drug susceptibility profiles. PLoS One. 2017;12:1–13.
  • 14. Cisneros JM, Rodriguez-Baño J. Nosocomial bactermia due to Acinetobacter baumannii: Epidemiology, clinical features and treatment. Clin Microbiol Infect. 2002;8:687–93.
  • 15. Ntusi NB, Badri M, Khalfey H, Whitelaw A, Oliver S, Piercy J, et al. ICU-associated Acinetobacter baumannii colonisa-tion/infection in a high HIV prevalence resource-poor setting. PLoS One. 2012;7:e52452.
  • 16. Rezaee P, Hamzeh A, Mohammadi M. Acinetobacter bau-mannii antibiotics resistance in Iran. J Bacteriol Mycol Open Access. 2019;7:159 62.
  • 17. Falagas ME, Mourtzoukou EG, Polemis M, Vatopoulos AC, Greek System for Surveillance of Antimicrobial Resistance Trends in antimicrobial resistance of Acinetobacter bau-mannii clinical isolates from hospitalised patients in Greece and treatment implications. Clin Microbiol Infect. 2007;13:816–819.
  • 18. T.C. Sağlık Bakanlığı. Ulusal Sağlık Hizmeti İlişkili Enfeksiyonlar Sürveyans Ağı (USHİESA) Etken Dağılımı ve Antibiyotik Direnç Raporu 2020. https://hsgm.saglik.gov.tr/depo/birimler/ Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/ETKEN_ DAGILIM_VE_DIRENC_2020.pdf. 2021. p. 1–42.
  • 19. Arslan Gülen T, İmre A, Ödemiş İ, Kayabaş Ü. Acinetobacter baumannii Infections and Antibiotic Resistance in Hospitalized Patients in an Education and Research Hospital: A Six-Year Analysis. Flora J Infect Dis Clin Microbiol. 2020;25:563–71.
  • 20. Liu JY, Wang FD, Ho MW, Lee CH, Liu JW, Wang JT, et al. In vitro activity of aminoglycosides against clinical isolates of Acinetobacter baumannii complex and other nonfermentative Gram-negative bacilli causing healthcare-associated bloodstream infections in Taiwan. J Microbiol Immunol Infect. 2016;49:918–23.
  • 21. Benamrouche N, Lafer O, Benmahdi L, Benslimani A, Amhis W, Ammari H, et al. Phenotypic and genotypic characterization of multidrug-resistant Acinetobacter baumannii isolated in Algerian hospitals. J Infect Dev Ctries. 2021;14:1395–401.
  • 22. Maraki S, Mantadakis E, Mavromanolaki VE, Kofteridis DP, Samonis G. A 5-year Surveillance Study on Antimicrobial Re-sistance of Acinetobacter baumanni Clinical Isolates from a Tertiary Greek Hospital. Infect Chemother. 2016;48:190-8.
  • 23. Şirin MC, Ağuş N, Yılmaz N, Derici YK, Hancı SY, Bayram A, Şamlıoğlu, P. Yoğun bakım ünitelerinden izole edilen Pseudo-monas aeruginosa ve Acinetobacter baumannii suşlarında an-tibiyotik direnç profillerinin yıllar içindeki değişimi. Int J Clin Exp Med. 2015;6:279-285.
  • 24. Özekinci T, Habip Z, Önder N, Koçoğlu ME. 2015-2018 Yıllarında İzole Edilen Acinetobacter Baumannii Suşlarinda Antibiyotik Di-renci. Van Tıp Derg. 2020;27:340-4.
  • 25. Chopra S, Galande A. A fluoroquinolone-resistant Acinetobacter baumannii without the quinolone resistance-determining region mutations. J Antimicrob Chemother. 2011;66:2668–70.
  • 26. Lob SH, Hoban DJ, Sahm DF, Badal RE. Regional differences and trends in antimicrobial susceptibility of Acinetobacter baumannii. Int J Antimicrob Agents. 2016;47:317-23.
  • 27. Şay Coşkun US. Investigation of antibiotic resistance in carbapenem resistant Acinetobacter baumannii isolates. Ankem Derg. 2018;32:37–44.
  • 28. Uğur M, Genç S. Yoğun Bakım Ünitelerinden İzole Edilen Aci-netobacter baumannii ve Pseudomonas aeruginosa Suşlarının Üç Yıllık Direnç Profili. Turk J Intensive Care. 2019;17:130-7
  • 29. Dursun A, Özsoylu S, Kılıç H, Ulu Kılıç A, Akyıldız BN. Antibiotic Susceptibilities of Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii Strains Isolated from Patients in the Pediatric Intensive Care Unit. Turk J Intensive Care. 2018;16:109–14.
  • 30. Çolakoğlu Ş, Alışkan HE, Göçmen JS. The Antibiotic Susceptibility Profile of Acinetobacter baumannii and Pseudomonas aeruginosa Strains Isolated from the Blood Cultures (2012-2014). Türk Mikrobiyol Cem Derg. 2014;44:132–8.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Tıbbi Bakteriyoloji
Bölüm Araştırma Makalesi
Yazarlar

Arzu Kayış 0000-0002-0061-1907

Zerife Orhan 0000-0003-2154-3074

Burak Küçük 0000-0001-5596-3347

Adem Doğaner 0000-0002-0270-9350

Murat Aral 0000-0002-3576-4380

Erken Görünüm Tarihi 23 Kasım 2023
Yayımlanma Tarihi 31 Aralık 2023
Gönderilme Tarihi 1 Ağustos 2023
Kabul Tarihi 9 Ekim 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 20 Sayı: 3

Kaynak Göster

Vancouver Kayış A, Orhan Z, Küçük B, Doğaner A, Aral M. Yoğun Bakım Ünitelerinde Yatan Hastaların Çeşitli Klinik Örneklerinden İzole Edilen Acinetobacter baumannii Suşları ve Dört Yıllık Direnç Profilleri. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(3):560-5.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty