Multi-drug resistance of blood stream, urinary tract and surgical site nosocomial infections of Acinetobacter baumannii and Pseudomonas aeruginosa among patients hospitalized at Felegehiwot Referral Hospital, Northwest Ethiopia: A cross-sectional study

Abstract

Background: Multi-drug resistant (MDR) Acinetobacter baumannii and Pseudomonas aeruginosa are major causes of nosocomial infections globally. They are the current World Health Organization critical priority pathogens for resistance, AMR surveillance and discovery of new antibiotics. However, there is paucity of data on nosocomial infections (NIs) caused by such superbugs in Ethiopia. Therefore, this study determined the magnitude and profile of nosocomial MDR Acinetobacter baumannii and Pseudomonas aeruginosa infections among patients hospitalized at Felegehiwot referral hospital, Northwest Ethiopia. Methods: A cross-sectional study was conducted at Felegehiwot referral hospital from April 1 to July 31, 2018. A total of 238 patients with blood stream, urinary tract and surgical site NIs were enrolled conveniently. Either blood, urine and wound swab specimens were collected and processed using standard bacteriological procedures.A.baumannii and P.aeruginosa isolates were identified using standard bacteriological techniques and confirmed by automated Vitek2 Compact. Antimicrobial susceptibility testing on isolates was performed using the disk diffusion technique.The results interpreted as per the standard zone sizes of Clinical and Laboratory Standards Institute. Chi-square test was done to determine associations among variables. P.value < 0.05 was considered statistical significant. Results:The median age of participants was 29 years. Overall, 20 (8.4%) of patients had nosocomial MDR A.baumannii and P.aeruginosa infections.The proportion of nosocomial MDR blood stream, urinary tract and surgical site infections were 13 (8.9%), 5 (8.3%) and 2 (6.3%), respectively. Patients with NI has lower mean age (24.9 years) (P=0.035). All isolates of NIs were from patients with intravenous catheterization. The frequency of NI was 9(3.8 %) for MDR A.baumannii and 11 (4.6%) for MDR P.aeruginosa. A.baumannii and P.aeruginosa isolates were 100% MDR.All isolates of A.baumannii and P.aeruginosa were 100% resistant to ampecillin and piperacillin. A.baumannii isolates were 33.3% and 44.5% resistance against meropenem and ciprofloxacin, respectively while P.aeruginosa isolates revealed 36.4% and 45.5% resistance against ciprofloxacin and meropenem, respectively. Conclusions: Health care associated MDR A.baumannii and P.aeruginosa infections are critical problems in the study area. Therefore, urgent focused interventions required to contain the spreading of MDR NIs. Treatment of NIs for patients on health care should be guided by antimicrobial susceptibility testing.

Assessment of antibiotic resistance of infectious agents in patients with pneumonia in tertiary critical care unit and effect on clinical outcomes

“…In this study, the low number of microorganisms produced also significantly affects this results and also we did not plan particularly to assign the risk factors for the acquisition of resistant microbial agents. Conditions such as immunosuppression, use of invasive mechanical ventilation, prolonged length of ICU and hospital stay, poor or restricted respiratory function, patients exposure to high‐risk devices or surgical procedures and prior treatment with broad‐spectrum antibiotics may cause high Acinetobacter baumannii infection rate which is one of the resistant microorganisms 15,16 …”

“…Conditions such as immunosuppression, use of invasive mechanical ventilation, prolonged length of ICU and hospital stay, poor or restricted respiratory function, patients exposure to high-risk devices or surgical procedures and prior treatment with broad-spectrum antibiotics may cause high Acinetobacter baumannii infection rate which is one of the resistant microorganisms. 15,16 The antimicrobial susceptibility of Acinetobacter species isolated throughout a 10-year in Taiwan was presented and the rate of susceptibility to tigecycline and colistin was 97.7% and 99.8%, and the susceptibility rate of carbapenem-resistant isolates to these drugs was 98.1% and 100%, respectively. 17 An other study showed that the incidence of resistance to imipenem in Acinetobacter baumannii was estimated to 11%.…”

Smaller Copper Oxide Nanoparticles have More Biological Effects Versus Breast Cancer and Nosocomial Infections Bacteria

“…Breast cancer is the second leading cause of death among women all around the world. NIs and cancer lead to increased morbidity, mortality, cost, and hospitalization, as well as inflicting staff and economic pressure to the health centers (Motbainor et al, 2020). The rapid emergence of antibiotic-resistant bacteria has affected the efficacy of infectious disease treatment and the health of millions of patients worldwide (Kajihara et al, 2020).…”

Efflux Pump Activity and Mutations Driving Multidrug Resistance in Acinetobacter baumannii at a Tertiary Hospital in Pretoria, South Africa

“…e bacterium causes pneumonia, bacteraemia, septicaemia [5], meningitis [6], and urinary tract infections [7] often seen in patients undergoing invasive procedures such as urinary catheter, tracheal intubation, and those with underlying conditions [2]. A. baumannii has demonstrated several antimicrobial resistance mechanisms [8][9][10] against antibiotics such as aminoglycosides, carbapenems, fluoroquinolones, cephalosporins, tetracyclines, sulbactams, rifampicins [9], as well as colistin [11][12][13] and tigecycline [8,14], the so called last resort drugs used to treat its infections [8,[11][12][13][14].…”