Prevalence Rate and Antibiotic Resistance of Acinetobacter Species Isolated from the Patients Hospitalized in Alzahra Hospital, Isfahan, Iran, 2013-2014

Document Type : Original Article (s)

Authors

1 Associate Professor, Nosocomial Infections Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences. Isfahan, Iran

3 Associate Professor, Tropical and Infectious Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Acinetobacter infections are of nosocomial infections with a significant increase in antibiotic resistance in recent years. Since the infection in hospitalized patients, especially patients hospitalized in intensive care units and patients with secondary immune deficiency can be associated with high morbidity and mortality rates. Hence, the aim of this study was to determine the prevalence and patterns of antibiotic resistance in Acinetobacter species isolated from patients hospitalized in the Alzahra hospital, Isfahan, Iran.Methods: In a cross-sectional study, hospital records of all patients with Acinetobacter nosocomial infection who were hospitalized in Alzahra hospital during 2012 to 2013 were studied. The pattern of antibiotic resistance was determined in all the patients and isolated Acinetobacter were analyzed based on clinical and demographic characteristic.Findings: 495 cases with nosocomial infection of Acinetobacter were studied. The most antibiotic resistance was seen for ampicillin-sulbactam (21.1%) and amikacin (13.1%). In addition, the frequency of resistance to ciprofloxacin, cefoxitin, cefotaxime, and meropenem were 5.4, 4.8, 2.0, 1.7 and 1.3 percent, respectively. All the samples were sensitive to cefazolin, cefepime, ceftazidime, gentamicin, nitrofurantoin and tazocin and co-trimoxazole. Resistance to amikacin was different based on the sex, hospitalization, ward and source of sampling; resistance to ampicillin was different based on the source of sampling; resistance to ampicillin-sulbactam was different based on the sex; resistance to cefoxitin was different based on the sex; and finally, resistance to ciprofloxacin was different based on the source of sampling.Conclusion: According to our study, Acinetobacter infection is one of the most prevalent nosocomial infections but a considerable part of samples are sensitive to general antibiotics. High sensitivity to general antibiotics probably is due to the source of infection. In the other hand, contamination with staff’s hands is the most common way for infection transition. Thus, programming for prevention and control of infection transfer must be done in all hospitals.

Keywords

References

  1. Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis 2006; 42(5): 692-9.
  2. Lolans K, Rice TW, Munoz-Price LS, Quinn JP. Multicity outbreak of carbapenem-resistant Acinetobacter baumannii isolates producing the carbapenemase OXA-40. Antimicrob Agents Chemother 2006; 50(9): 2941-5.
  3. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012; 18(3): 268-81.
  4. Gaynes R, Edwards JR. Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis 2005; 41(6): 848-54.
  5. Rhomberg PR, Jones RN. Contemporary activity of meropenem and comparator broad-spectrum agents: MYSTIC program report from the United States component (2005). Diagn Microbiol Infect Dis 2007; 57(2): 207-15.
  6. Tatman-Otkun M, Gurcan S, Ozer B, Shokrylanbaran N. Annual trends in antibiotic resistance of nosocomial Acinetobacter baumannii strains and the effect of synergistic antibiotic combinations. New Microbiol 2004; 27(1): 21-8.
  7. Sunenshine RH, Wright MO, Maragakis LL, Harris AD, Song X, Hebden J, et al. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis 2007; 13(1): 97-103.
  8. Rhomberg PR, Jones RN. Summary trends for the Meropenem Yearly Susceptibility Test Information Collection Program: a 10-year experience in the United States (1999-2008). Diagn Microbiol Infect Dis 2009; 65(4): 414-26.
  9. Mera RM, Miller LA, Amrine-Madsen H, Sahm DF. Acinetobacter baumannii 2002-2008: increase of carbapenem-associated multiclass resistance in the United States. Microb Drug Resist 2010; 16(3): 209-15.
  10. Pournaras S, Markogiannakis A, Ikonomidis A, Kondyli L, Bethimouti K, Maniatis AN, et al. Outbreak of multiple clones of imipenem-resistant Acinetobacter baumannii isolates expressing OXA-58 carbapenemase in an intensive care unit. J Antimicrob Chemother 2006; 57(3): 557-61.
  11. Playford EG, Craig JC, Iredell JR. Carbapenem-resistant Acinetobacter baumannii in intensive care unit patients: risk factors for acquisition, infection and their consequences. J Hosp Infect 2007; 65(3): 204-11.
  12. Manikal VM, Landman D, Saurina G, Oydna E, Lal H, Quale J. Endemic carbapenem-resistant Acinetobacter species in Brooklyn, New York: citywide prevalence, interinstitutional spread, and relation to antibiotic usage. Clin Infect Dis 2000; 31(1): 101-6.
  13. Peleg AY, Franklin C, Bell JM, Spelman DW. Emergence of carbapenem resistance in Acinetobacter baumannii recovered from blood cultures in Australia. Infect Control Hosp Epidemiol 2006; 27(7): 759-61.
  14. Lesho E, Wortmann G, Moran K, Craft D. Fatal Acinetobacter baumannii infection with discordant carbapenem susceptibility. Clin Infect Dis 2005; 41(5): 758-9.
  15. Fazeli H, Motallebi-Rad T, Nasr Esfahani B, Solgi H, Nazari F. Prevalence and antibiotic resistance pattern of acinetobacter species isolated from Al-Zahra Hospital in Isfahan, Iran. J Isfahan Med Sch 2013; 493-501. [In Persian].
Journal of Isfahan Medical School
Volume 33, Issue 367 - Serial Number 367
November and December 2016
Pages 2374-2380

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History

  • Receive Date: 03 October 2015
  • Revise Date: 20 May 2024
  • Accept Date: 06 April 2022

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