Hospital-Acquired Infection by Carbapenem-Resistant Acinetobacter Species in ICUs in Assiut, Egypt

Abstract

The genus Acinetobacter is one of the main fears of hospital-acquired infection (HAI) wide-reaching mostly in ICUs. Objectives: This study aimed to identify the incidence of carbapenem-resistant Acinetobacter (CRA) HAI in Assiut University Hospitals ICU and determine their antimicrobial susceptibility profile. Methodology:The study included 1204 clinical samples from 928 patients with HAI and 625 environmental samples. Carbapenemase production was detected phenotypically by MIC determination using imipenem, meropenem and doripenem E-test, modified Hodge test, combined disc test and double disc synergy test (DDST). OXA genes (bla OXA-51 , bla OXA-23 , bla OXA-24 , and bla OXA-58 ) and MβL genes (bla SIM-1 , bla VIM , and bla IMP-1 ) were investigated genotypically by PCR. Results: Out of total 60 Acinetobacter isolates, 55 (91.7%) were extensively drug-resistant (XDR) and 5 (8.3%) were multi-drug resistant (MDR). 93.3% of Acinetobacter isolates were resistant to imipenem and meropenem, and 90% were resistant to doripenem. The prevalence of bla genes in isolates were bla OXA-51 (93.3%), bla , bla , bla OXA-58 (10%), bla SIM-1 (46.7%), and bla VIM (8.3%). bla IMP-1 was not detected in any isolate. Conclusion: CRA infections were considerable in our ICUs. The high prevalence of XDR Acinetobacter spp. observed in our study was very alarming and requires critical intervention. METHODOLOGY Specimen collection:This study was conducted on 1204 clinical samples obtained from 928 patients with HAI who were hospitalized in different ICUs of Assiut University Hospitals. Samples included endotracheal aspirates (n= 546), sputum (n= 218), blood (n= 217), urine (n= 161), throat swabs (n= 35), wound swabs (n= 24), ear swab

Biofilm Formation by Acinetobacter Species Isolated from Intensive Care Units: Unveiling the Impact on Antibiotic Resistance

“…exhibited a higher resistance rate against levofloxacin (83.3%), along with resistance rates ranging from 61.2% to 72.3% for all tested cephalosporins, carbapenems, and aminoglycosides, while the resistance rate for TMP-SMX was 55.6%. In a different study, it was observed that 100% of the test isolates were resistant to piperacillin, ceftazidime, cefepime, and aztreonam, with a 94.5% resistance rate to ciprofloxacin that is consistent with our study 20 . The high level of antibiotic resistance observed in our study could be linked to the selective pressure exerted by the frequent use of these drugs in our hospitals, as well as the ability of Acinetobacter to rapidly acquire resistance genes through horizontal gene transfer.…”

“…The incidence rate of XDR and MDR isolates in our study was 82% and 16%, respectively. Similarly, a study from Egypt noticed that 91.7% of isolates were XDR and 8.3% of them were MDR 20 . Another study conducted by Khalifa et al 27 revealed that 50% of Acinetobacter isolates were XDR and 16.6% were MDR.…”