Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature

Abstract

ObjectivesAcinetobacter baumannii is a bacterium responsible for health care-associated infections, and it frequently develops multiple drug resistance (MDR). The prevalence of antibiotic-resistant A. baumannii in Iran has increased, and this may cause significant clinical problems. Therefore, in order to elucidate the development of antibiotic resistance, we performed a systematic review of the literature published on antibiotic-resistant A. baumannii reported in Iran.MethodsThirty-six publications that met the criteria for inclusion were reviewed from an initial 87 papers. Selected papers published between 2008 and September 2014, were categorized on the basis of the sample collecting year been between 2001 and 2013.ResultsAnalysis of data revealed that, in general, there was an increase in antimicrobial resistance. During the initial time point of these studies (2001–2007) there was a high rate of resistance to all antibiotics, with the exception of carbapenems, lipopeptides, and aminoglycosides that had a low resistance rate in comparison with the others. Also, the resistance rate was increased in one group of these three antimicrobial groups from 2010 to 2013. In particular, there was an increase in resistance to carbapenems (imipenem and meropenem) from 2010–2011 and 2012–2013, whereas no significant change in the resistance rate of the other two antimicrobial groups (lipopeptides and aminoglycosides) during the study time was observed, although we did observe certain trends in amikacin (aminoglycoside group antibiotic) between 2011–2012 and 2012–2013.ConclusionThese findings indicate that antimicrobial resistance of A. baumannii in Iran has increased, which may very well affect the antimicrobial resistance of this organism worldwide. Based on these results, novel prevention and treatment strategies against A. baumannii infections are warranted. Furthermore, these data may assist in revising treatment guidelines and regional policies in care units to slow the emergence of antimicrobial resistance.

Polyclonal Distribution of blaOXA-23 Gene Among Acinetobacter baumannii Isolated from Intensive Care Unit Patients in Tehran; Pulsed-Field Gel Electrophoresis Analysis

“…According to the report from Moradi et al, the prevalence of MDR isolates between 2008 and 2016 was ranged from 32.7% to 93% (18). The isolation of MDR A. baumannii in the ICU is more common and several outbreaks have been reported from Asian and European countries (8,(18)(19)(20)(21). Antibiotic susceptibility testing in this study showed that 21.8% of patients were infected by resistant strains to all tested antibiotics.…”

“…In this study, resistance to carbapenems were up to 85% in ICU isolates and the rate of MDR isolates (resistant to beta-lactams, fluoroquinolones, and aminoglycosides) were 54.54%. According to the report from Moradi et al, the prevalence of MDR isolates between 2008 and 2016 was ranged from 32.7% to 93% (18). The isolation of MDR A. baumannii in the ICU is more common and several outbreaks have been reported from Asian and European countries (8,(18)(19)(20)(21).…”

Clinical Isolates of Acinetobacter baumannii From Tehran Hospitals: Pulsed-field Gel Electrophoresis Characterization, Clonal Lineages, Antibiotic Susceptibility, and Biofilm-forming Ability

“…Also In another study by karmostaji et al, 54.47% of the isolates were resistant to amikacin, 67.47% to imipenem, and 84.55% of the isolates were resistant to meropenem. Among the 123 isolates, 100 (81.3 %) had an acquired bla (29). The current study tried to evaluate the results of clonal lineage method with the results obtained by PFGE.…”

Antimicrobial Use, Prescribing, and Resistance in Selected Ten Selected Developing Countries: A Brief Overview

“…A systematic review suggested that generally there was an increase in AMDR in throughout the Iran. Researchers suggested that the need for effective surveillance program to prevent AMDR [67].…”