High Proportions of Multidrug-Resistant Acinetobacter spp. Isolates in a District in Western India: A Four-Year Antibiotic Susceptibility Study of Clinical Isolates

Abstract

The purpose of the study was to determine the proportions of multidrug-resistant (MDR) Acinetobacter spp. isolates from the district of Nashik in Western India during the period from 2011–2014. Antibacterial susceptibility testing of isolates from inpatients and outpatients was performed using Kirby–Bauer disc diffusion method to determine inhibitory zone diameters. Proportions of non-susceptible isolates were calculated from the antibacterial susceptibility data. MDR was defined as an isolate being non-susceptible to at least one antibacterial agent in at least three antibacterial categories. The change in proportions of MDR isolates; extended-spectrum β-lactamase (ESBL)-producing isolates; and non-susceptible isolates to specific antibacterial categories over calendar time was investigated by logistic regression. The proportions of MDR and ESBL-producing isolates ranged from 89.4% to 95.9% and from 87.9% to 94.0%; respectively. The proportions of non-susceptible isolates to aminoglycosides; carbapenems; antipseudomonal penicillins/β-lactamase inhibitors; cephalosporins; folate pathway inhibitors; or penicillins/β-lactamase inhibitors exceeded 77.5%. Proportions of fluoroquinolone and tetracycline non-susceptible isolates ranged from 65.3% to 83.3% and from 71.3% to 75.9%; respectively. No changes in trends were observed over time; except for a decreasing trend in fluoroquinolone non-susceptible isolates (OR = 0.75 (95% CI, 0.62–0.91)). Significantly higher proportions of non-susceptible; MDR and ESBL-producing isolates were found among isolates from the respiratory system compared to isolates from all other specimen types (p < 0.05). High proportions of MDR Acinetobacter spp. isolates were observed in the period from 2011–2014. Antimicrobial stewardship programmes are needed to prevent the emergence and spread of antibiotic resistance.

Antimicrobial resistance of acinetobacter baumannii infection of lower respiratory tract and mortality – A cross-sectional study from a tertiary care teaching hospital in Kerala

“…Studies have demonstrated that carbapenem resistant strains can become resistant to all antibiotics [20,22]. Proportion of multi drug resistance was 85.7% (95% CI: 77.1% to 94.3%) which is comparable to reports from Varanasi in North India (88%) and Nashik in western India (89.4% to 95.9% over four years) [12,23]. The highest proportion of resistance was to piperacillin-tazobactam (95%) in this study.…”

“…The highest proportion of resistance was to piperacillin-tazobactam (95%) in this study. In a study from Nashik, the proportions of resistant strains to most of the antibiotics were above 77.5% [23]. Longer duration of ICU stay and mechanical ventilation were seen to be factors associated with acquisition of carbapenam resistant strains in our study.…”

Prevalence of infections with antibiotic-resistant Acinetobacter baumannii in different clinical samples from hospitals in Erbil

“…In addition, antibiotic resistance was lowest with colistin 100% susceptible Table 4. The increase in global reports of A. baumannii and antimicrobial resistance accompanying, particularly in the health-careassociated infections and the majority of hospital infections has elevated an alarm (Pourhajibagher et al, 2016, Odsbu et al, 2018, specifically in critical care areas, which are responsible for the most severe nosocomial outbreaks (Moradi et al, 2015) Many studies have revealed that A. baumannii which has emerged worldwide as a pathogen causing serious infections in the hospital has the capability to persist in the hospital milieu for a long period of time, colonize subjects and can progress into a true pathogen at any time (Uwingabiye et al, 2016). Infections caused by A. baumannii have an undesirable impression on clinical consequences and treatment expenses.…”

High Prevalence and Endemicity of Multidrug Resistant Acinetobacter spp. in Intensive Care Unit of a Tertiary Care Hospital, Varanasi, India

“…have been studied to be the commonest isolate from respiratory site in an ICU with 63.8% infections being acquired in the ICU and MDR antibiotic profile in 70% of such isolates [ 26 ]. An increase in proportion of MDR Acinetobacter from 89.4% to 95.9% over a period of 5 years has been demonstrated in a study with significant proportion of these MDR isolates being isolated from respiratory samples [ 27 ]. A study from Poland over 10 years period has reported Acinetobacter spp.…”