Emerging importance of acinetobacter and its antibiogram in the recent era

Abstract

Background: Acinetobacter is widely distributed in nature as saprophytes. Recently, they have emerged as a nosocomial pathogen
due to its ability for survival in the hospital environment on a wide range of dry and moist surface. They cause pneumonia, urinary
tract infection (UTI), and surgical site infection (SSI) where drain tips are inserted, endocarditis, meningitis, peritonitis, and
bacteremia. Antibiotic susceptibility pattern of Acinetobacter may vary geographically. Due to multidrug resistance patterns of
Acinetobacter, it is imperative to know the institutional prevalent susceptibility profiles.
Aims and Objectives: This study was conducted to isolate Acinetobacter species from various clinical samples, to determine the
antibiotic susceptibility pattern and to carry out the epidemiological investigation of the isolates.
Materials and Methods: The study was conducted in a tertiary care hospital, over a period of 2 years. After identification, the
speciations of Acinetobacter isolates were done by biochemical tests and by VITEK 2. Antibiotic susceptibility was determined by
disc diffusion method. Extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) production were detected
by the combined disc diffusion test. An epidemiological study of Acinetobacter was carried out.
Results: Of 5096 infected samples, 505 (9.9%) were non-fermenting Gram-negative bacilli, among which 170 (33.8%) were
found to be Acinetobacter. The highest numbers of isolates were Acinetobacter baumannii, followed by Acinetobacter lwoffii,
Acinetobacter radioresistance, Acinetobacter calcoaceticus, Acinetobacter Haemolyticus, and Acinetobacter ursingii. Highest
incidences of susceptibility were to imipenem (60%), chloramphenicol, and gentamicin. ESBL and MBL productions were detected
in 23% and 17%, respectively.
Conclusion: A high level of antibiotic resistance was observed in this study and maximum isolation rate was in SSI. Most of
the patients had high-risk factors such as prolonged hospitalization, indwelling catheters, and orthopedics implants in situ or
other catheterization and diabetes. The analysis of susceptibility pattern will be useful in understanding the epidemiology of this
organism in our hospital setup.