ANTIMICROBIAL RESISTANCE AND MOLECULAR CHARACTERIZATION OF ACINETOBACTER BAUMANNII ISOLTES FROM HOSPITAL AQUIRED INFECTION IN INTENSIVE CARE UNIT
Main Article Content
Keywords
...................
Abstract
In intensive care units (ICUs), hospital-acquired infections (HAIs) are a major contributor to morbidity and mortality. Because A. baumannii can thrive in a hospital setting, form biofilms, and quickly develop multidrug and carbapenem resistance, which limits treatment options, it has become a prominent ICU infection.
Aims: The present study aimed to determine the prevalence, antimicrobial resistance pattern, and molecular characteristics of Acinetobacter baumannii isolates recovered from hospital-acquired infections in ICU patients.
Materials and Methods: A cross-sectional observational study was carried out in the Department of Microbiology at the Index Medical College Hospital and Research Center in Indore (M.P). Standard microbiological techniques were used to process 360 clinical samples from adult ICU patients with suspected HAIs (≥48 hours of admission). PCR targeting the blaOXA-51 gene and phenotypic testing were used to validate the identification of A.baumannii. According to CLSI recommendations, the Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing, and MIC determination was used to confirm carbapenem resistance. Assays for biofilm formation and molecular detection of the carbapenemase genes blaIMP, blaVIM, and blaNDM were carried out.
Results: Out of 360 ICU samples analyzed, 126 (35.0%) were positive for Acinetobacter baumannii, with respiratory and wound-related specimens being the most common sources of isolation. Infections were more frequent in male patients and predominantly affected individuals aged 41–60 years. Mechanical ventilation was the major risk factor, followed by urinary catheterization and prolonged ICU stay.
Conclusion: Multidrug-resistant A.baumannii is highly prevalent in ICU-associated HAIs, which emphasizes the critical need for ongoing antimicrobial resistance surveillance, molecular monitoring, and strict infection control measures to stop its spread and enhance clinical outcomes.
References
2. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev. 2008;21(3):538–582.
3. Howard A, O’Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: an emerging opportunistic pathogen. Virulence. 2012;3(3):243–250.
4. Jawad A, Seifert H, Snelling AM, Heritage J, Hawkey PM. Survival of Acinetobacter baumannii on dry surfaces: comparison of outbreak and sporadic isolates. J Clin Microbiol. 1998;36(7):1938–1941.
5. Queenan AM, Bush K. Carbapenemases: the versatile β-lactamases. Clin Microbiol Rev. 2007;20(3):440–458.
6. Poirel L, Nordmann P. Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clin Microbiol Infect. 2006;12(9):826–836.
7. Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis. 2006;42(5):692–699.
8. Higgins PG, Dammhayn C, Hackel M, Seifert H. Global spread of carbapenem-resistant Acinetobacter baumannii. J Antimicrob Chemother. 2010;65(2):233–238.
9. Sarkar S, Das S, Chatterjee M, Chandra N, Banerjee S. Prevalence and antimicrobial susceptibility pattern of Acinetobacter baumannii isolates in intensive care units of a tertiary care hospital in Eastern India. Indian J Med Microbiol. 2014;32(4):403–406.
10. Garnacho-Montero J, Amaya-Villar R, Fernández-García A, Ortiz-Leyba C. Acinetobacter baumannii ventilator-associated pneumonia: epidemiological and clinical findings. Intensive Care Med. 2015;41(5):892–900.
11. Agarwal J, Gupta S, Kumar A. Emergence of carbapenem-resistant Acinetobacter baumannii in a tertiary care hospital in India. J Infect Dev Ctries. 2012;6(6):480–485.
12. Rao RS, Karthika RU, Singh SP, Shashikala P, Kanungo R, Jayachandran S, et al. Correlation between biofilm production and multiple drug resistance in imipenem resistant clinical isolates of Acinetobacter baumannii. Indian J Med Microbiol. 2016;34(3):367–373.
13. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev. 2008;21(3):538–582.
14. Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165(7):867–903.
15. Singh R, Saxena S, Verma SK, Singh A. Distribution and antimicrobial resistance pattern of Acinetobacter baumannii in ICU patients. J Lab Physicians. 2020;12(2):89–94.
16. Howard A, O’Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: an emerging opportunistic pathogen. Virulence. 2012;3(3):243–250.
17. Manchanda V, Sanchaita S, Singh NP. Multidrug resistant Acinetobacter. J Glob Infect Dis. 2010;2(3):291–304.
18. Kumar A, Sharma S, Goyal A, Gupta N. Clinical profile and outcome of Acinetobacter baumannii infections in ICU patients. Int J Med Microbiol Trop Dis. 2017;3(2):65–70.
19. Mohanty S, Maurya V, Gaind R, Deb M. Phenotypic characterization and antimicrobial resistance profile of Acinetobacter baumannii in a tertiary care hospital. Indian J Med Res. 2021;153(4):466–471.
20. Lee HY, Chen CL, Wu SR, Huang CW, Chiu CH. Risk factors and outcome analysis of Acinetobacter baumannii complex bacteremia in critically ill patients. Crit Care Med. 2013;41(6):1354–1362.
21. Falagas ME, Karveli EA, Kelesidis I, Kelesidis T. Community-acquired Acinetobacter infections. Eur J Clin Microbiol Infect Dis. 2007;26(12):857–868.
22. Dash M, Padhi S, Mohanty I, Panda P, Parida B. Antimicrobial resistance pattern of Acinetobacter baumannii in a tertiary care hospital in Eastern India. J Clin Diagn Res. 2018;12(6):DC01–DC04.
23. Falagas ME, Kopterides P. Risk factors for the isolation of multi-drug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa: a systematic review of the literature. J Hosp Infect. 2016;64(1):7–15.
24. Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):2323–2329.
25. Kollef MH, Golan Y, Micek ST, Shorr AF, Restrepo MI. Appraising contemporary strategies to combat multidrug resistant Gram-negative bacterial infections. Proc Am Thorac Soc. 2012;8(1):28–35.
26. Garcia-Garmendia JL, Ortiz-Leyba C, Garnacho-Montero J, Jiménez-Jiménez FJ, Pérez-Paredes C, Barrero-Almodóvar AE, et al. Risk factors for Acinetobacter baumannii nosocomial bacteremia in critically ill patients: a cohort study. Clin Infect Dis. 2001;33(7):939–946.
27. Bergogne-Bérézin E, Towner KJ. Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Microbiol Rev. 1996;9(2):148–165.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Hemant Kumar
PhD Scholar, Department of Microbiology, Index Medical College, Hospital & Research Centre, Indore, (M.P) India (Malwanchal University) Email – [email protected]
Dr. Harshada Shah
Research supervisor , Department of Microbiology, Index Medical College, Hospital & Research Centre, Indore (M.P)India. (Malwanchal University) [email protected]
Neha Rani
PhD Scholar, Department of Microbiology, Index Medical College, Hospital & Research Centre, Indore, India. (Malwanchal University) Email- [email protected]
