A Study of prevalence and Antimicrobial Resistance of Acinetobacter Species in a Tertiary Care Hospital, Chidambaram, India
Corresponding Author(s) : J. Sunitha
sunithajayaraman@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 10 No. 4 (2022): 2022 Volume -10 - Issue 4
Abstract
Acinetobacter species has emerged as one of the most important hospital pathogens which are becoming increasingly multi drug-resistant. They cause outbreaks in intensive care units and health care units. A cross-sectional study was conducted to assess the prevalence and antibiotic susceptibility pattern of Acinetobacter spp isolated from various clinical samples collected from 720 patients admitted in all wards and intensive care units of the hospital for one year (September 2021 to August 2022). Out of 720 samples, 390 (54%) showed significant growth. These 390 positive cultures were further processed for identification and out of these positive cultures, 93 (23.8%) Acinetobacter spp were isolated. The majority of Acinetobacter spp 46 (49%) were isolated from the Intensive Care Unit (ICU) followed by Surgery ward 18 (19%), Medicine ward 15 (16%) and Orthopaedics ward 5 (5%). Among the 93 isolates of Acinetobacter, 100% sensitivity was to Colistin and 96% to Polymyxin B followed by Meropenem (81%), Levofloxacin (78%), Cefoperazone-Sulbactam (73%), Ampicillin-Sulbactam (68%), Ceftazidime (48%), Norfloxacin (40%), Piperacillin-Tazobactam (39%), Ciprofloxacin (35%), Gentamicin (32%), Amikacin (32%), Cefepime (29%), Cefotaxime (16%). High levels of resistance were seen for Cefotaxime (84%) and Cefepime (71%). Acinetobacter isolated in this study showed multidrug-resistant patterns mostly in ICU patients. To avoid multidrug resistance, antibiotics should be used judiciously. The importance of hand washing and the use of disinfectants to prevent the transmission of infection in health care setup has to be emphasized.
Keywords
Acinetobacter spp, Prevalence, Antibiotic resistance, Intensive care units, Multidrug resistance.
1.
J. Sunitha, G. Shanthi, A. Sivaranjani. A Study of prevalence and Antimicrobial Resistance of Acinetobacter Species in a Tertiary Care Hospital, Chidambaram, India. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2022 Nov. 24 [cited 2025 Jul. 11];10(4):442-8. Available from: https://ijamscr.com/ijamscr/article/view/1265
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References
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1. Howard A, O'Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: an emerging opportunistic pathogen. Virulence. 2012 May 1;3(3):243-50. doi: 10.4161/viru.19700.
2. Lahiri KK, Mani NS, Purai SS. Acinetobacter spp as Nosocomial Pathogen: Clinical Significance and Antimicrobial Sensitivity. Med J Armed Forces India. 2004 Jan;60(1):7-10. doi: 10.1016/S0377-1237(04)80148-5. Epub 2011 Jul 21. PMID: 27407568; PMCID: PMC4923491.
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4. Khanna A, Khanna M, Aggarwal A. Serratia marcescens- a rare opportunistic nosocomial pathogen and measures to limit its spread in hospitalized patients. J ClinDiagn Res. 2013 Feb;7(2):243-6. doi: 10.7860/JCDR/2013/5010.2737.
5. Manchanda V, Sanchaita S, Singh N. Multidrug resistant Acinetobacter. J Glob Infect Dis. 2010 Sep;2(3):291-304. doi: 10.4103/0974-777X.68538.
6. George M. Eliopoulos, Lisa L. Maragakis, Trish M. Perl, Acinetobacter baumannii: Epidemiology, Antimicrobial Resistance, and Treatment Options, Clinical Infectious Diseases, Volume 46, Issue 8, 15 April 2008, Pages 1254–1263, https://doi.org/10.1086/529198.
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8. VanLooveren M, Goossens H. ARPAC steering Group. Antimicrobial resistance of Acinetobacter species in Europe. Clin Microbial Infect. 2004; 10(8): 684-704.
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10. Al Bshabshe, A., Joseph, M. R., Al Hussein, A., Haimour, W., & Hamid, M. E. (2016). Multidrug resistance Acinetobacter species at the intensive care unit, Aseer Central Hospital, Saudi Arabia: A one year analysis. Asian Pacific journal of tropical medicine, 9(9), 903-908.
11. Raina D, Sharma N, Mahawal B et al. Speciation and antibiotic resistance pattern of Acinetobacter spp in a tertiary care hospital in Uttarakhand. IntJourn of Med Research & Health Sci. 2016; 5(4): 89-96.
12. Malathy, K. (2015). Identification, Speciation, Antibiogram and Molecular Characterization of Acinetobacter Isolated from Various Clinical Samples received in Microbiology Laboratory, Thanjavur Medical College and Hospital (Doctoral dissertation, Thanjavur Medical College, Thanjavur).
13. Rajkumari, S., Pradhan, S., Sharma, D., & Jha, B. (2020). Prevalence and Antibiogram of Acinetobacter Species Isolated from Various Clinical Samples in a Tertiary Care Hospital. Journal of College of Medical Sciences-Nepal, 16(1), 26-32.
14. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 22nd informational supplement, CLSI document M100-S22. Wayne PA: Clinical and Laboratory Standards Institute; 2014.
15. Sarshar, M., Behzadi, P., Scribano, D., Palamara, A. T., &Ambrosi, C. (2021). Acinetobacter baumannii: an ancient commensal with weapons of a pathogen. Pathogens, 10(4), 387.
16. Rangel, K., Chagas, T. P. G., & De-Simone, S. G. (2021). Acinetobacter baumannii infections in times of COVID-19 pandemic. Pathogens, 10(8), 1006.
17. Alotaibi, T., Abuhaimed, A., Alshahrani, M., Albdelhady, A., Almubarak, Y., & Almasari, O. (2021). Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience. SAGE Open Medicine, 9, 20503121211001144.
18. Ababneh, Q., Abulaila, S., &Jaradat, Z. (2022). Isolation of extensively drug resistant Acinetobacter baumannii from environmental surfaces inside intensive care units. American Journal of Infection Control, 50(2), 159-165.
19. Gupta, N., Gandham, N., Jadhav, S., & Mishra, R. N. (2015). Isolation and identification of Acinetobacter species with special reference to antibiotic resistance. Journal of natural science, biology, and medicine, 6(1), 159.
20. Mohammed, S. H., Ahmed, M. M., AbdAlameer Abd Alredaa, N., HaiderAbdAlabbas, H., Mohammad Ali, Z. D., Abed Al-Wahab, Z. Z., ... & Yahya Abid Zaid, N. (2022). Prevalence of Acinetobacter Species Isolated from Clinical Samples Referred to Al-Kafeel Hospital, Iraq and Their Antibiotic Susceptibility Patterns from 2017-2021. Iranian Journal of Medical Microbiology, 16(1), 76-82.
21. Albayrak, H., Bayraktar, M. T., &Zeyrek, F. Y. (2021). Antibiotic Resistance Profile of Acinetobacter Species Isolated from Blood Cultures of Inpatients in Harran University Hospital. Harran ÜniversitesiT?pFakültesiDergisi, 18(2), 165-169.
22. Dash, M., Padhi, S., Pattnaik, S., Mohanty, I., &Misra, P. (2013). Frequency, risk factors, and antibiogram of Acinetobacter species isolated from various clinical samples in a tertiary care hospital in Odisha, India. Avicenna Journal of Medicine, 3(04), 97-102.
23. https://1library.net/document/7q01nmvz-multivariate-analysis-acinetobacter-species-tertiary-care-hospital.html.
24. Gajdács, M., Burián, K., &Terhes, G. (2019). Resistance levels and epidemiology of non-fermenting gram-negative bacteria in urinary tract infections of inpatients and outpatients (RENFUTI): a 10-year epidemiological snapshot. Antibiotics, 8(3), 143.
References
1. Howard A, O'Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: an emerging opportunistic pathogen. Virulence. 2012 May 1;3(3):243-50. doi: 10.4161/viru.19700.
2. Lahiri KK, Mani NS, Purai SS. Acinetobacter spp as Nosocomial Pathogen: Clinical Significance and Antimicrobial Sensitivity. Med J Armed Forces India. 2004 Jan;60(1):7-10. doi: 10.1016/S0377-1237(04)80148-5. Epub 2011 Jul 21. PMID: 27407568; PMCID: PMC4923491.
3. Sikora A, Zahra F. Nosocomial Infections. [Updated 2022 Sep 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559312/.
4. Khanna A, Khanna M, Aggarwal A. Serratia marcescens- a rare opportunistic nosocomial pathogen and measures to limit its spread in hospitalized patients. J ClinDiagn Res. 2013 Feb;7(2):243-6. doi: 10.7860/JCDR/2013/5010.2737.
5. Manchanda V, Sanchaita S, Singh N. Multidrug resistant Acinetobacter. J Glob Infect Dis. 2010 Sep;2(3):291-304. doi: 10.4103/0974-777X.68538.
6. George M. Eliopoulos, Lisa L. Maragakis, Trish M. Perl, Acinetobacter baumannii: Epidemiology, Antimicrobial Resistance, and Treatment Options, Clinical Infectious Diseases, Volume 46, Issue 8, 15 April 2008, Pages 1254–1263, https://doi.org/10.1086/529198.
7. Young LS, Sabel AL, Price CS et al. Epidemiologic, clinical and economic evaluation of an outbreak of multidrug resistant Acinetobacter baumannii infections in a surgical intensive unit. Infect Control Hosp Epidemiol. 2007; 28(11): 1247-54.
8. VanLooveren M, Goossens H. ARPAC steering Group. Antimicrobial resistance of Acinetobacter species in Europe. Clin Microbial Infect. 2004; 10(8): 684-704.
9. Callie Camp, Owatha L. Tatum, A Review of Acinetobacter baumannii as a Highly Successful Pathogen in Times of War, Laboratory Medicine, Volume 41, Issue 11, November 2010, Pages 649–657, https://doi.org/10.1309/LM90IJNDDDWRI3RE.
10. Al Bshabshe, A., Joseph, M. R., Al Hussein, A., Haimour, W., & Hamid, M. E. (2016). Multidrug resistance Acinetobacter species at the intensive care unit, Aseer Central Hospital, Saudi Arabia: A one year analysis. Asian Pacific journal of tropical medicine, 9(9), 903-908.
11. Raina D, Sharma N, Mahawal B et al. Speciation and antibiotic resistance pattern of Acinetobacter spp in a tertiary care hospital in Uttarakhand. IntJourn of Med Research & Health Sci. 2016; 5(4): 89-96.
12. Malathy, K. (2015). Identification, Speciation, Antibiogram and Molecular Characterization of Acinetobacter Isolated from Various Clinical Samples received in Microbiology Laboratory, Thanjavur Medical College and Hospital (Doctoral dissertation, Thanjavur Medical College, Thanjavur).
13. Rajkumari, S., Pradhan, S., Sharma, D., & Jha, B. (2020). Prevalence and Antibiogram of Acinetobacter Species Isolated from Various Clinical Samples in a Tertiary Care Hospital. Journal of College of Medical Sciences-Nepal, 16(1), 26-32.
14. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 22nd informational supplement, CLSI document M100-S22. Wayne PA: Clinical and Laboratory Standards Institute; 2014.
15. Sarshar, M., Behzadi, P., Scribano, D., Palamara, A. T., &Ambrosi, C. (2021). Acinetobacter baumannii: an ancient commensal with weapons of a pathogen. Pathogens, 10(4), 387.
16. Rangel, K., Chagas, T. P. G., & De-Simone, S. G. (2021). Acinetobacter baumannii infections in times of COVID-19 pandemic. Pathogens, 10(8), 1006.
17. Alotaibi, T., Abuhaimed, A., Alshahrani, M., Albdelhady, A., Almubarak, Y., & Almasari, O. (2021). Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience. SAGE Open Medicine, 9, 20503121211001144.
18. Ababneh, Q., Abulaila, S., &Jaradat, Z. (2022). Isolation of extensively drug resistant Acinetobacter baumannii from environmental surfaces inside intensive care units. American Journal of Infection Control, 50(2), 159-165.
19. Gupta, N., Gandham, N., Jadhav, S., & Mishra, R. N. (2015). Isolation and identification of Acinetobacter species with special reference to antibiotic resistance. Journal of natural science, biology, and medicine, 6(1), 159.
20. Mohammed, S. H., Ahmed, M. M., AbdAlameer Abd Alredaa, N., HaiderAbdAlabbas, H., Mohammad Ali, Z. D., Abed Al-Wahab, Z. Z., ... & Yahya Abid Zaid, N. (2022). Prevalence of Acinetobacter Species Isolated from Clinical Samples Referred to Al-Kafeel Hospital, Iraq and Their Antibiotic Susceptibility Patterns from 2017-2021. Iranian Journal of Medical Microbiology, 16(1), 76-82.
21. Albayrak, H., Bayraktar, M. T., &Zeyrek, F. Y. (2021). Antibiotic Resistance Profile of Acinetobacter Species Isolated from Blood Cultures of Inpatients in Harran University Hospital. Harran ÜniversitesiT?pFakültesiDergisi, 18(2), 165-169.
22. Dash, M., Padhi, S., Pattnaik, S., Mohanty, I., &Misra, P. (2013). Frequency, risk factors, and antibiogram of Acinetobacter species isolated from various clinical samples in a tertiary care hospital in Odisha, India. Avicenna Journal of Medicine, 3(04), 97-102.
23. https://1library.net/document/7q01nmvz-multivariate-analysis-acinetobacter-species-tertiary-care-hospital.html.
24. Gajdács, M., Burián, K., &Terhes, G. (2019). Resistance levels and epidemiology of non-fermenting gram-negative bacteria in urinary tract infections of inpatients and outpatients (RENFUTI): a 10-year epidemiological snapshot. Antibiotics, 8(3), 143.
2. Lahiri KK, Mani NS, Purai SS. Acinetobacter spp as Nosocomial Pathogen: Clinical Significance and Antimicrobial Sensitivity. Med J Armed Forces India. 2004 Jan;60(1):7-10. doi: 10.1016/S0377-1237(04)80148-5. Epub 2011 Jul 21. PMID: 27407568; PMCID: PMC4923491.
3. Sikora A, Zahra F. Nosocomial Infections. [Updated 2022 Sep 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559312/.
4. Khanna A, Khanna M, Aggarwal A. Serratia marcescens- a rare opportunistic nosocomial pathogen and measures to limit its spread in hospitalized patients. J ClinDiagn Res. 2013 Feb;7(2):243-6. doi: 10.7860/JCDR/2013/5010.2737.
5. Manchanda V, Sanchaita S, Singh N. Multidrug resistant Acinetobacter. J Glob Infect Dis. 2010 Sep;2(3):291-304. doi: 10.4103/0974-777X.68538.
6. George M. Eliopoulos, Lisa L. Maragakis, Trish M. Perl, Acinetobacter baumannii: Epidemiology, Antimicrobial Resistance, and Treatment Options, Clinical Infectious Diseases, Volume 46, Issue 8, 15 April 2008, Pages 1254–1263, https://doi.org/10.1086/529198.
7. Young LS, Sabel AL, Price CS et al. Epidemiologic, clinical and economic evaluation of an outbreak of multidrug resistant Acinetobacter baumannii infections in a surgical intensive unit. Infect Control Hosp Epidemiol. 2007; 28(11): 1247-54.
8. VanLooveren M, Goossens H. ARPAC steering Group. Antimicrobial resistance of Acinetobacter species in Europe. Clin Microbial Infect. 2004; 10(8): 684-704.
9. Callie Camp, Owatha L. Tatum, A Review of Acinetobacter baumannii as a Highly Successful Pathogen in Times of War, Laboratory Medicine, Volume 41, Issue 11, November 2010, Pages 649–657, https://doi.org/10.1309/LM90IJNDDDWRI3RE.
10. Al Bshabshe, A., Joseph, M. R., Al Hussein, A., Haimour, W., & Hamid, M. E. (2016). Multidrug resistance Acinetobacter species at the intensive care unit, Aseer Central Hospital, Saudi Arabia: A one year analysis. Asian Pacific journal of tropical medicine, 9(9), 903-908.
11. Raina D, Sharma N, Mahawal B et al. Speciation and antibiotic resistance pattern of Acinetobacter spp in a tertiary care hospital in Uttarakhand. IntJourn of Med Research & Health Sci. 2016; 5(4): 89-96.
12. Malathy, K. (2015). Identification, Speciation, Antibiogram and Molecular Characterization of Acinetobacter Isolated from Various Clinical Samples received in Microbiology Laboratory, Thanjavur Medical College and Hospital (Doctoral dissertation, Thanjavur Medical College, Thanjavur).
13. Rajkumari, S., Pradhan, S., Sharma, D., & Jha, B. (2020). Prevalence and Antibiogram of Acinetobacter Species Isolated from Various Clinical Samples in a Tertiary Care Hospital. Journal of College of Medical Sciences-Nepal, 16(1), 26-32.
14. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 22nd informational supplement, CLSI document M100-S22. Wayne PA: Clinical and Laboratory Standards Institute; 2014.
15. Sarshar, M., Behzadi, P., Scribano, D., Palamara, A. T., &Ambrosi, C. (2021). Acinetobacter baumannii: an ancient commensal with weapons of a pathogen. Pathogens, 10(4), 387.
16. Rangel, K., Chagas, T. P. G., & De-Simone, S. G. (2021). Acinetobacter baumannii infections in times of COVID-19 pandemic. Pathogens, 10(8), 1006.
17. Alotaibi, T., Abuhaimed, A., Alshahrani, M., Albdelhady, A., Almubarak, Y., & Almasari, O. (2021). Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience. SAGE Open Medicine, 9, 20503121211001144.
18. Ababneh, Q., Abulaila, S., &Jaradat, Z. (2022). Isolation of extensively drug resistant Acinetobacter baumannii from environmental surfaces inside intensive care units. American Journal of Infection Control, 50(2), 159-165.
19. Gupta, N., Gandham, N., Jadhav, S., & Mishra, R. N. (2015). Isolation and identification of Acinetobacter species with special reference to antibiotic resistance. Journal of natural science, biology, and medicine, 6(1), 159.
20. Mohammed, S. H., Ahmed, M. M., AbdAlameer Abd Alredaa, N., HaiderAbdAlabbas, H., Mohammad Ali, Z. D., Abed Al-Wahab, Z. Z., ... & Yahya Abid Zaid, N. (2022). Prevalence of Acinetobacter Species Isolated from Clinical Samples Referred to Al-Kafeel Hospital, Iraq and Their Antibiotic Susceptibility Patterns from 2017-2021. Iranian Journal of Medical Microbiology, 16(1), 76-82.
21. Albayrak, H., Bayraktar, M. T., &Zeyrek, F. Y. (2021). Antibiotic Resistance Profile of Acinetobacter Species Isolated from Blood Cultures of Inpatients in Harran University Hospital. Harran ÜniversitesiT?pFakültesiDergisi, 18(2), 165-169.
22. Dash, M., Padhi, S., Pattnaik, S., Mohanty, I., &Misra, P. (2013). Frequency, risk factors, and antibiogram of Acinetobacter species isolated from various clinical samples in a tertiary care hospital in Odisha, India. Avicenna Journal of Medicine, 3(04), 97-102.
23. https://1library.net/document/7q01nmvz-multivariate-analysis-acinetobacter-species-tertiary-care-hospital.html.
24. Gajdács, M., Burián, K., &Terhes, G. (2019). Resistance levels and epidemiology of non-fermenting gram-negative bacteria in urinary tract infections of inpatients and outpatients (RENFUTI): a 10-year epidemiological snapshot. Antibiotics, 8(3), 143.