Antibiotic resistance pattern of Acinetobacter baumannii strains: A retrospective study from Oman.

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Date: Sept-Dec 2021
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 3,556 words
Lexile Measure: 1780L

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Byline: Mohan. Sannathimmappa, Vinod. Nambiar, Rajeev. Aravindakshan

Background: Multidrug-resistant (MDR) Acinetobacter baumannii is of serious health concern and associated with high mortality. Data regarding the antibiotic resistance pattern of A. baumannii strains in Oman is limited. Objectives: To determine the antibiotic resistance pattern of A. baumannii from various clinical samples in a tertiary care hospital in the North-Batinah region of Oman. Methods: A. baumannii isolates recovered from various clinical samples in the Microbiology laboratory of Sohar Hospital, Oman, during 2015-2019 were retrospectively analyzed. Organism identification and their antibiotic resistance patterns were performed as recommended by the Clinical and Laboratory Standards Institute. Results: A total of 1890 A. baumannii nonduplicate isolates were found from clinical samples of 1326 patients. The isolates were more frequently isolated from elderly patients (40%) and in-patient department patients (67%). Infection/colonization was more common among patients treated in the medicine, intensive-care unit, and surgery departments. A. baumannii strains were highly resistant (50-83%) to most of the tested antibiotics, with the highest against ceftriaxone (83%) and ceftazidime (75%), and lowest against colistin (1%) and tigecycline (8%). Among the isolates, 67% (1265) were MDR strains. Of these, 22%, 32% and 16% were resistant to all six, five and four classes of the tested antibiotics. Conclusion: The study found that the frequency of isolation of MDR A. baumannii isolates in the northern region of Oman is high.

Introduction

The emergence and continued spread of antimicrobial-resistant bacterial pathogens is a serious concern worldwide.[1],[2] Acinetobacter baumannii is a dangerous opportunistic nosocomial pathogen that has emerged in recent years as an important cause of a wide range of infections such as ventilator-associated pneumonia, surgical wound infection, meningitis, and urinary tract infection, especially in immunocompromised patients.[3],[4] Its ability to exist and survive in dry and humid surfaces, particularly in the hospital surfaces and equipment, makes controlling the nosocomial transmission extremely difficult.[5],[6] In addition, recent emergence of multidrug-resistant (MDR), extensively drug resistant (XDR), and pandrug-resistant clones of A. baumannii in hospital settings and the rapid dissemination of these strains among hospitalized patients has become a serious problem worldwide, as they are difficult to treat and are associated with high mortality.[3],[6],[7],[8],[9]

In Oman, a recent surveillance report from the Royal Hospital, Muscat, showed an increasing trend in MDR A. baumannii infection.[10] Another study conducted at Sultan Qaboos University, Muscat, showed a rise in infections associated with nonfermenters such as Pseudomonas and Acinetobacter .[11] A molecular characterization analysis of MDR A. baumannii strains from all six GCC nations revealed that 69% of MDR strains carrying genes encode for OXA-23 and OXA-40 enzymes, which can confer it's resistance against the majority of antibiotics including carbapenems used for treating A. baumannii infections.[11]

The prevalence and antibiotic susceptibility pattern of A. baumannii shows inter- and intra-national variations. Knowledge regarding local prevalence, predisposing factors, and the antibiotic susceptibility pattern of A. baumannii and other MDR pathogens is important for better management of infections.[9] From Oman, there is a limited knowledge regarding the prevalence and antibiotic susceptibility pattern of A. baumannii ....

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Gale Document Number: GALE|A675174544