Infection with Acinetobacter baumannii in an intensive care unit in the Western part of Romania

Abstract

BackgroundAcinetobacter baumannii is one of the main causes of morbidity and mortality in critical condition patients. The pathogen’s ability to survive under a wide range of environment conditions and to persist for long periods of time on areas represents a frequent cause of endemic infection hotbeds especially in the Intensive Care Unit.The objectives of the study are: determining the 5-year incidence of A. baumannii infection in patients admitted in the ICU which needed mechanical ventilation; the analysis of these cases regarding pathological antecedents; processing the data regarding these cases; gradual analysis of the susceptibility/resistance of isolated A. baumannii strains; observing the emergence of A. baumannii infection in patients transferred into the ICU.MethodsWe have performed an observational retrospective study regarding the incidence of Acinetobacter baumannii infections in the Intensive Care Unit of the Hospital of Infectious Diseases and Pneumophtisiology “Victor Babes” Timisoara, Clinic II Infectious Diseases, during June 2011 – June 2015.ResultsWe have identified a high prevalence of Acinetobacter baumannii infection, with an average period of 6 days. Bronchial suction was the most common pathological product in the study (90 % of the cases). Resistance to antimicrobials has been determined: the lowest resistance was recorded for ampicillin + sulbactam (81.1 %), and the highest resistance rate was recorded for ceftazidime and imipenem (94.6 % each). When comparing resistance to third generation cephalosporins, the difference was not statistically significant (94.6 % for ceftazidime vs. 86.5 % for cefoperazone, p = 0.117). Within the present study we were able to observe a significantly high resistance of the germ to carbapenems, with a good sensitivity to aminoglycosides, and to colistin. Only one strain of Acinetobacter baumannii was resistant to all classes of tested antibiotics.ConclusionsGenerally, carbapenems represented the elective treatment in severe infections; however, the number of carbapenem-resistant Acinetobacter baumannii strains is growing, dramatically reducing therapeutic options, fact that brings back to our attention reusing colistin, although the administration of this antibiotic has been limited due to new antibiotics classes.

Antimicrobial susceptibility pattern of acinetobacter isolates from patients in Kenyatta National Hospital, Nairobi, Kenya

“…Our findings on resistance to the commonly prescribed cephalosporins are consistent with results from several previous studies in other parts of the world showing high resistance to third and fourth generation cephalosporins, for instance a survey in tertiary hospitals in Colombia, Turkey, Romania, and Sudan reported resistance to cefotaxime, ceftazidime, and cefepime with proportions ranging from 84% to 98% [21, 22, 27, 28]. In contrast, similar studies in the Netherlands and India reported resistance rate of 16%-56% to ceftazidime and cefepime [29, 30]. The high resistance to Beta-lactam antibiotics in Acinetobacter species especially A. baumannii is most likely associated with the production of B-lactamases including TEM-1 , TEM-2 and CARB-5, AR-1 , ACE-1, 2, 3, 4 and the ESBL whose genes are either chromosomally or plasmid located.…”

Prevalence and Antibiotic Susceptibility of Acinetobacterin a Tertiary Care Hospital in Chennai, India

“…Our findings on resistance to the commonly prescribed cephalosporins namely ceftazidime and cefepime (36.1%-43.4%) are consistent with results from several previous studies in the Netherlands [18], USA [17] and India [19], which reported resistance rate of 16%-56% to ceftazidime and cefepime. Studies in Pakistan [20] have reported very high resistance to ceftazidime and cefepime (both 99.2%), which could be due to extensive use of antibiotics.…”

Analysis of global prevalence of antibiotic resistance in Acinetobacter baumannii infections disclosed a faster increase in OECD countries

“…This is likely due to the fact that colistin has been limited from being used during the last several decades due to nephrotoxicity. Now, colistin has been revaluated for treatment of MDR A. baumannii for its low resistance 33 . However, resistance to colistin is also emerging.…”