Epidemiology of Acinetobacter baumannii Isolates in an Intensive Care Unit in Kazakhstan

Year 2018, Volume: 08 Issue: 03, 83 - 88, 15.09.2018

Nelya Bissenova Aigerim Yergaliyeva

https://doi.org/10.5799/jmid.458451

Abstract

    ABSTRACT

Objective: Objectives: Acinetobacter
baumannii is an important pathogen of infections in many hospitals,
especially in intensive care unit patients, conditioned difficulty to control
spread and treatment. The objective of the present study is to report the
prevalence and antibiotic resistance rates of A. baumannii strains in ICU patients during a five-year period in a
tertiary care hospital in Kazakhstan.

Methods: Consecutive,
non – duplicate isolates of A. baumannii
were collected and processed during the course of routine diagnostic work up
from adult patients hospitalized in ICU. Identification of isolates and
antibiotic susceptibility testing were performed by Vitek 2 automated system.

Results: In
total 325 A. baumannii strains were
evaluated. The most frequent of strains were from tracheostomy tubes (67
isolates, 22.1%), followed by tracheal aspirates (58 isolates, 19.1%) and
urinary tract (47, 15.5%). The prevalence of A. baumannii strains in ICU was significantly increased from 6.9%
in 2011 to 34.1% to 2015 (p=0.002). Most of testing isolates were 96.7% and
higher resistant to cephalosporins, carbapenems, quinolones. Lower resistance
50% and highest was obtained to aminoglycosides.

Conclusion: we report for the first time in Central Kazakhstan the
prevalence and resistance rates of A.
baumannii in ICU in a single tertiary hospital. The present report is
alarming because the increasing resistance can lead to no alternative situation
on the choice of drugs for the casual treatment of infections caused by
extremely resistant A. baumannii
strains. J Microbiol Infect Dis 2018; 8(3):83-88.

Keywords

Acinetobacter baumannii, carbapenems, increasing resistance, intensive care, prevalence

References

• 1. Paul M, Weinberger M, Siegman-Igra Y, et al. Acinetobacter baumannii: emergence and spread in Israeli hospitals 1997-2002. J Hosp Infect 2005; 60:256-260. 2. Gaynes R, Edwards JR. National Nosocomial Infections Surveillance System. Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis 2005; 41:848-854. 3. Cheon S, Kim M.J, Yun SJ, Moon J.Y, Kim Y.S. Controlling endemic multidrug-resistant Acinetobacter baumannii in intensive care units using antimicrobial stewardship and infection control. Korean J Intern Med 2016; 31(2): 367-374. 4. Manchanda V, Sanchaita S, Singh NP. Multidrug Resistant Acinetobacter. J Glob Infect Dis 2010; 2(3): 291-304. 5. Eliopoulos G.M, Maragakis L.L,Perl T.M. Acinetobacter baumannii: Epidemiology, antimicrobial resistant and treatment options. Clin Infect Dis 2008; 46 (8): 1254-1263. 6. Cisneros JM, Rodriguez-Bano J, Fernandez-Cuenca F, et al. Risk-factors for the acquisition of imipenem-resistant Acinetobacter baumannii in Spain: a nationwide study. Clin Microbiol Infect 2005; 11:874-879. 7. Baran G, Erbay A, Bodur H, et al. Risk factors for nosocomial imipenem-resistant Acinetobacter baumannii infections. Intern J Infect Dis 2008; 12:16-21. 8. Kollef MH, Niederman MS. Why Acinetobacter baumannii a problem for critically ill patients? Intensive Care Med 2015, 41:2170-2172. 9. Shorr AF, Zilberberg MD, Micek ST, Kollef MH. Predictors of hospital mortality among septic ICU patients with Acinetobacter spp. bacteremia: a cohort study. BMC Infect Dis 2014; 14:572. 10. Shakibaie MR, Adeli S, Salehi MH. Antibiotic resistance patterns and extended-spectrum β-lactamase production among Acinetobacter spp. isolated from an ICU of a hospital in Kerman, Iran. Antimicrob Resist Infect Control 2012; 1:1-8. 11. Guidelines of standards for microbiologic tests in the laboratory of clinical microbiology. Astana.2008:11-12 12. Patwardhan RB, Dhakephalkar PK, Niphadkar KB, Chopade BA. A study on nosocomial pathogens in ICU with special reference to multiresistant Acinetobacter baumanniiharbouring multiple plasmids. Indian J Med Res 2008; 178-187. 13. Brkic DV, Stanko A.P, Plesko S, Tripkovic V, Bedenic B. Acinetobacter baumannii microbiological and phenotypic characteristics of isolates from Intensive Care Unit of the Department of Internal Medicine at the University Hospital Centre in Zagreb over a four-year period. Signa Vitae 2015; 10(1):13-15. 14. Omer MI, Gumaa SA, Hassan AA, et al. Prevalence and resistance profile of Acinetobacter baumannii clinical isolates from a Private Hospital in Khartoum, Sudan. American J Microb Research 2015; 3(2): 76-79. 15. 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(2): 57-63. 16. Uwingabiye J, Frikh M, Lemnouer A. et al Acinetobacter infections prevalence and frequency of the antibiotics resistance: comparative study of intensive care units versus other hospital units. Pan Afr Med J 2016; 23: 191. 17. Villers D, Espase E, Coste-Burel M, et al. Nosocomial Acinetobacter baumannii infections: Microbiological and clinical epidemiology. Ann Intern Med 1998; 129:182-189. 18. Dijkshoorn L, Nemec A, Seifert H. An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol 2007; 12:939-951. 19. Begum S, Hasan F, Hussain S, Shah A. A. Prevalence of multi drug resistant Acinetobacter baumannii in the clinical samples from Tertiary Care Hospital in Islamabad, Pakistan. Pak J Med Sci 2013; 29(5): 1253–1258. 20. Jones M, Donegan N, Saiines S, et al. Acinetobacter in sternal surgical site infections after cardiac surgery: Case control to determine significance and outcome. Am J Infect Control 2005; 33:169-170. 21. Duszyńska W, Rosenthal V.D, Szczęsny A. et al Urinary tract infections in intensive care unit patients - a single-centre, 3-year observational study according to the INICC project. Anaesthesiology Intensive Therapy 2016; 48(1):1. 22. Izadpour F, Ranjbari N, Aramesh M. et al. An investigation of antibacterial resistance patterns among Acinetobacter baumannii and Pseudomonas aeruginosa isolates collected from ICU of a University-affiliated hospital in Ahvaz, Iran. Jundishapur J Microbiol 2016; 9(8):e35624. 23. Celik C, Gozel M, Dayi F. Increasing antimicrobial resistance in nosocomial pathogens; multidrug-resistant, extensively drug-resistant and pandrug-rsistant Acinetobacter baumannii. J Microbiol Infect Dis 2014; 4 (1):7-12. 24. Yadegarinia D, Abedy S, Gachkar L, Roodsari S. Prevalence and drug resistance of Acinetobacter baumannii in ICU of a teaching hospital. J Appl Environ Biol Sci 2013; 3(9):22-27. 25. Yüce A, Yapar N, Kutsoylu OE. Evaluation of antibiotic resistance patterns of Pseudomonas aeruginosa and Acinetobacter spp. strains isolated from intensive care patients between 2000-2002 and 2003-2006 periods in Dokuz Eylul University Hospital, Izmir. Mikrobiyol Bul 2009; 43:195-202. 26. Eser ÖK, Ergin A, Hasçelik G. Antimicrobial resistance and existence of metallo-beta-lactamase in Acinetobacter species isolated from adult patients. Mikrobiyol Bul 2009; 43:383-390. 27. Aliakbarzade K, Farajnia S, Karimi Nik A, Zarei F, Tanomand A. Prevalence of Aminoglycoside Resistance Genes in Acinetobacter baumannii Isolates. Jundishapur J Microbiol 2014; 7(10):e11924. 28. Akers KS., Chaney C, Barsoumian A. Aminoglycoside resistance and susceptibility testing errors in Acinetobacter baumannii-calcoaceticus complex. J Clin Microb 2010; 48:1132-1138.