Multi-drug resistant Acinetobacter species from various clinical samples in a tertiary care hospital from South India

Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal. Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better understanding of antibiotic resistance threat and enables physicians to select the most appropriate antibiotics.

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Bacteriological Profile of Ventilator Associated Pneumonia in a Tertiary Care Hospital of South India with Special Reference to Multi Drug Resistant Pathogens

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2017.611.065 ◽

2017 ◽

Vol 6 (11) ◽

pp. 541-548 ◽

Cited By ~ 1

Author(s):

Amit Khelgi ◽

A.G. Prathab

Keyword(s):

Special Reference ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Ventilator Associated Pneumonia ◽

Care Hospital ◽

Drug Resistant ◽

Bacteriological Profile

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Multi-drug-resistant tuberculosis: the experience of an urban tertiary care hospital in South India using automated BACTEC 460 TB

Tropical Doctor ◽

10.1258/td.2011.110247 ◽

2011 ◽

Vol 42 (1) ◽

pp. 35-37 ◽

Cited By ~ 4

Author(s):

Baijayanti Mishra ◽

Smitha Mary Rockey ◽

Soham Gupta ◽

Hiresave Srinivasa ◽

Sethumadhavan Muralidharan

Keyword(s):

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis

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PREVALENCE AND ANTIBIOTIC SUSCEPTIBILITY OF ACINETOBACTERIN A TERTIARY CARE HOSPITAL IN CHENNAI, INDIA

International Journal of Current Pharmaceutical Research ◽

10.22159/ijcpr.2021v13i1.40803 ◽

2021 ◽

pp. 35-40

Author(s):

ANGELINE ANJALI A. ◽

ABIRAMASUNDARI V. K.

Keyword(s):

Antibiotic Susceptibility ◽

Tertiary Care Hospital ◽

Therapeutic Option ◽

Tertiary Care ◽

Fourth Generation ◽

Clinical Samples ◽

Care Hospital ◽

Acinetobacter Species ◽

Medical College ◽

Acinetobacter Infection

Objective: The present study is to determine the prevalence and antibiotic susceptibility of Acinetobacter species in samples collected from patients in tertiary care hospital in Chennai. Methods: A total of17,827patient’s clinical samples were collected from various wards and ICUs of Saveetha Medical College and Hospital, Chennai, Tamilnadu over a period of 7 mo [between January 2020 and July 2020]. All samples were tested in the microbiology lab of Saveetha Medical College and Hospital using standard operating procedures. Results: Out of 17,827 samples, 2,816 were culture positive. 122 of the isolates tested positive for Acinetobacter spp.and 81.1% of the isolates belonged to Acinetobacterbaumannii. Most of the infection occurred in the age group of 21-40 y and predominantly in female patients (female, male ratio 1.9:1).General wards contributed to 54.9% of the Acinetobacter infection, followed by ICU(27%) and OPD(18%). Maximum isolates were recovered from urine(34.4%) and endotracheal secretions(29.5%).60.7% of the Acinetobacterspp were multidrug-resistant(MDR)i.e. resistant to more than 3 antibiotic group.In our study, most Acinetobactersppwere resistant to penicillin(46-100%), third and fourth generation cephalosporin (36-61.5%), carbapenems (34.4-82.8%)and quinolones(39.3-46.7%). None of the isolates were resistant to colistin. 93.4% ofisolates were sensitive to tigecycline and 87.7% sensitive to amikacin. Conclusion: Our study observed a high incidence of MDR inAcinetobacterspp, which is in line with most of the research findings in recent times. Most of Acinetobacterspp were resistant to penicillin, third and fourth generation cephalosporins, quinolones, carbapenems,which is alarming as it leaves fewer options for the line of treatment. Some strains were sensitive to cefepime, ceftazidime, piperacillin-tazobactam, levofloxacin, imipenem and meropenem. Considering the increasing MDR nature of Acinetobacterspp a combination of the former along with colistin, tigecycline, amikacin(which have shown more than 85% sensitivity) would need to be studied.Also, strict measures to control the spread of Acinetobacter infection, better management of antibiotics usage and newer therapeutic option for treatment need to be looked at.

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