Study of Imipenem and Colistin resistance rates of isolated Acinetobacter baumannii from hospitalized patients in Imam Reza and Ghaem hospitals of Mashhad through E-test

Document Type : Original Article

Authors

1 Instructor, Department of Bacteriology, School of Paramedical, Mashhad University of Medical Sciences, Mashhad, Iran.

2 B.Sc. in Laboratory Science, School of Paramedical, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant professor, Department of Bacteriology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Acinetobacter baumannii is one of the primary causes of nosocomial infections. Furthermore, the increment of antibiotic resistance has raised concerns about the proper therapeutic approach to this problem. This study aimed to determine the susceptibility of A.baumannii to colistin and imipenem through minimal inhibitory concentration (MIC).
Methods: In this study, 2745 samples (2745 plate) were collected from patients in different wards of Ghaem Hospital and Imam Reza Hospital in Mashhad between October 2015 and September 2016. In the case of a specimen was wound, after disinfection of the wound surface using a sterile swab from the inferior part of the sample, middle stream urine was collected in sterile container, and the bronchial specimen was taken by the doctor by syringe. In this study, 100 A.baumannii were isolated from 100 hospitalized patients at Imam Reza and Ghaem hospitals of Mashhad, By Biochemical tests (Kligler iron agar, Lysine, urea indole) diagnostic and then disc diffusion method, and E-test strips were utilized to evaluate infection, antibiotic susceptibility, and MIC, respectively.
.Results: The obtained results of disc diffusion showed that all isolates were resistant to imipenem, which was also confirmed by E-test strips. Moreover, all isolates were sensitive to colistin. The obtained colistin MIC was 0.25μg/ml for one sample and ≤2μg/ml for others; which were considered sensitive according to the Clinical and Laboratory Standards Institute standards.
Conclusion: The high resistance of A.baumannii to imipenem was indicative of resistance pattern changes of this bacteria and insufficiency of the mentioned antibiotic for treatment. However, colistin is still effective and should be prescribed more carefully to prevent resistant strains spread.

Keywords

References

  1. Rodriguez Guardado A, Maradona JA, Asensi V, Carton JA, Perez F, Blanco A, et al. Postsurgical meningitis caused by Acinetobacter baumannii: study of 22 cases and review of the literature. Rev Clin Esp 2001; 201(9):497-500.
  2. Wang KW, Chang WN, Huang CR, Tsai NW, Tsui HW, Wang HC, et al. Post-neurosurgical nosocomial bacterial meningitis in adults: microbiology, clinical features, and outcomes. J Clin Neurosci 2005; 12(6):647-50.
  3. Dijkshoorn L, Nemec A, Seifert H. An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol 2007; 5(12):939-51.
  4. Poirel L, Nordmann P. Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clin Microbiol Infect 2006; 12(9):826-36.
  5. Kempf M, Rolain JM. Emergence of resistance to carbapenems in Acinetobacter baumannii in Europe: clinical impact and therapeutic options. Int J Antimicrob Agents 2012; 39(2):105-14.
  6. Hsueh PR, Teng LJ, Chen CY, Chen WH, Yu CJ, Ho SW, et al. Pandrug-resistant Acinetobacter baumannii causing nosocomial infections in a university hospital, Taiwan. Emerg Infect Dis 2002; 8(8):827-32.
  7. Li J, Rayner CR, Nation RL, Owen RJ, Spelman D, Tan KE, et al. Heteroresistance to colistin in multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2006; 50(9):2946-50.
  8. Olaitan AO, Berrazeg M, Fagade OE, Adelowo OO, Alli JA, Rolain JM. Emergence of multidrug-resistant Acinetobacter baumannii producing OXA-23 carbapenemase, Nigeria. Int J Infect Dis 2013; 17(6):e469-70.
  9. Falagas ME, Rafailidis PI. Nephrotoxicity of colistin: new insight into an old antibiotic. Clin Infect Dis 2009; 48(12):1729-31.
  10. Cai Y, Chai D, Wang R, Liang B, Bai N. Colistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies. J Antimicrob Chemother 2012; 67(7):1607-15.
  11. Moffatt JH, Harper M, Adler B, Nation RL, Li J, Boyce JD. Insertion sequence ISAba11 is involved in colistin resistance and loss of lipopolysaccharide in Acinetobacter baumannii. Antimicrob Agents Chemother 2011; 55(6):3022-4.
  12. Moffatt JH, Harper M, Harrison P, Hale JD, Vinogradov E, Seemann T, et al. Colistin resistance in Acinetobacter baumannii is mediated by complete loss of lipopolysaccharide production. Antimicrob Agents Chemother 2010; 54(12):4971-7.
  13. Ghasemian R, Ahanjan M, Fatehi E, Shokri M. Prevalence and antibiotic resistance pattern of acinetobacter isolated from patients admitted in ICUs in Mazandaran, Northern Iran. Global J Health Sci 2016; 8(11):54569.
  14. Tunyapanit W, Pruekprasert P, Laoprasopwattana K, Chelae S. Antimicrobial susceptibility of Acinetobacter baumannii isolated from hospital patients. Sci Asia 2014; 40:28-34.
  15. Sohail M, Rashid A, Aslam B, Waseem M, Shahid M, Akram M, et al. Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management. Rev Soc Bras Med Trop 2016; 49(3):300-4.
  16. Safari M, Saidijam M, Bahador A, Jafari R, Alikhani MY. High prevalence of multidrug resistance and metallo-beta-lactamase (MbetaL) producing Acinetobacter baumannii isolated from patients in ICU wards, Hamadan, Iran. J Res Health Sci 2013; 13(2):162-7.
  17. Moisoiu A, Ionita M, Sarbu L, Stoica C, Grigoriu L. Antibiotic resistance of Acinetobacter baumannii strains isolated from clinical specimens in the "Marius Nasta" Pneumology Institute, Bucharest. Pneumologia 2014; 63(2):109-11.
  18. Sinirtas M, Akalin H, Gedikoglu S. Investigation of colistin sensitivity via three different methods in Acinetobacter baumannii isolates with multiple antibiotic resistance. Int J Infect Dis 2009; 13(5):e217-20.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 21, Issue 11
January 2019
Pages 32-36

Files

Share

How to cite

Statistics