scholarly journals High antibiotic resistance and mortality with Acinetobacter species in a tertiary hospital, Nepal

2021 ◽  
Vol 11 (1) ◽  
pp. 13-17
Author(s):  
M. Mahto ◽  
M. Chaudhary ◽  
A. Shah ◽  
K. L. Show ◽  
F. L. Moses ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Significant Proportion ◽  
Polymyxin B ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Cross Sectional ◽  
Acinetobacter Species

SETTING: Nepal Mediciti Hospital, Bhainsepati, Lalitpur, NepalOBJECTIVES: To determine antimicrobial resistance patterns, and the number and proportion of multidrug-resistant (MDR-) and extensively drug-resistant (XDR-) cases among all patients with Acinetobacter isolates between September 2018 and September 2019.DESIGN: This was a hospital laboratory-based, cross-sectional studyRESULTS: Acinetobacter spp. (n = 364) were more common in respiratory (n = 172, 47.3%) and invasive samples such as blood, body fluids (n = 95, 26.1%). Sensitivity to AWaRe (Access, Watch and Reserve) Group antibiotics (tigecycline, polymyxin B, colistin) remained high. MDR (resistance to at least three classes of antimicrobial agents) (n = 110, 30.2%) and XDR (MDR plus carbapenem) (n = 87, 23.9%) isolates were most common in the Watch Group of antibiotics and found in respectively 99 (31.0%) and 78 (24.5%) patients (n = 319). Infected patients were more likely to be aged >40 years (n = 196, 61.4%) or inpatients (n = 191, 59.9%); 76 (23.8%) patients had an unfavourable outcome, including death (n = 59, 18.5%).CONCLUSION: A significant proportion of MDR and XDR isolates was found; nearly one patient in five died. Robust hospital infection prevention and control measures (particularly for respiratory and invasive procedures) and routine surveillance are needed to reduce infections and decrease the mortality rate. Tigecycline, polymyxin B and colistin should be cautiously used only in MDR and XDR cases.

scholarly journals Frequency and Antimicrobial Susceptibility Pattern of Pseudomonas Aeruginosa in Human Pus Samples at Holy Family Hospital Rawalpindi

2021 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Kazmi A
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Antibiotic Susceptibility ◽  
Antimicrobial Agents ◽  
Antibiotic Sensitivity ◽  
Recovery Process ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resistant Strains

Background: Nosocomial infections are great threat for hospitalized patients and Pseudomonas aeruginosa has emerged as one of the most potent nosocomial pathogens along with its diverse mechanisms to counter the various antimicrobial agents such as aminoglycosides, fluoroquinolones, monobactems, third generation cephalosporins, carbapenams and broad- spectrum penicillins. P. aeruginosa is one of the well-known pyogenic bacteria and is 3rd leading cause of pyogenic infections with the variable frequency depending on geographical region and clinical setting. P. aeruginosa is intimately associated with pyogenic nosocomial infections. Objectives: Since multidrug resistant strains of P. aeruginosa have posed serious threats and are frequently implicated in nosocomial infections. Methods: Pus swab were sampled under aseptic conditions and cultured on blood and Muller Hinton agar. Gram reaction, pigment production, Oxidase, indole reaction and citrate test were used to confirm isolate. Antibiotic susceptibility was performed b Kirby Bauer technique. Results compiled by us in this cross sectional study, showed 58 cases of P. aeruginosa out of 289 cases. This included 43% males and 57% females. Majority of the patients were of young age, with mean age 38 years. Antibiotic sensitivity revealed resistance to gentamicin was 50%, amikacin was 64%, ciprofloxacin and Aztronem 66%, Cefaparazone 69%, Tzaocin 71% and meropenem and sulzone was 79%. While Colistin and Ceftazidime were the most effective in 85% and 89% of cases respectively. The multidrug resistant strains of P. aeruginosa infections accounted for 32.76% of total P. aeruginosa infections. This study reveals high prevalence of multidrug resistant organisms at the set of our study. Based on this study, we suggest adopting the strategies to minimize the risk of nosocomial infections to slow down the rapidly growing multidrug resistance. These strategies may include, stricter antiseptic measures, fastening the recovery process and reducing the hospital stay and considering other alternates. Besides this, we would like to suggest the precise use of antibiotic susceptibility facility to reduce the nosocomial infection associated complications.

scholarly journals Pattern of Anti-Microbial Sensitivity and Resistance against Salmonella Species in a Tertiary Hospital in Dhaka

2015 ◽  
Vol 5 (2) ◽  
pp. 88-92 ◽  
Author(s):  
Afsana Begum ◽  
Md Shafiqul Bari ◽  
Fazle Rabbi Chowdhury ◽  
Naser Ahmed ◽  
KAR Sayeed
Keyword(s):  
Resistant Strain ◽  
Enteric Fever ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Epidemic Strain ◽  
Salmonella Spp ◽  
Cross Sectional ◽  
Paratyphi B

Background: Drug resistant Salmonella spp. continues to remain a health problem as last two decades have witnessed the emergence and spread of multidrug resistance against conventional anti-typhoid drugs. Multidrug resistant (MDR) typhoid is now a serious problem in many developing countries including Bangladesh.Objectives: To find out antimicrobial sensitivity and resistance patterns of different types of Salmonella spp. in patients with enteric fever and to find out the epidemiological strains (e.g. resistant strain, epidemic strain, MDR strain) in patients with enteric fever.Materials and Methods: This cross-sectional study was done during October 2009–November 2010 and January–December 2012 at United Hospital Limited, Dhaka. Laboratory reports of blood culture were collected from those patients who were investigated as suspected cases of enteric fever. Both the indoor and outdoor patients were enrolled in the study. Salmonella species resistant to one or more of the first line drugs were divided into resistant strain, epidemic strain and multi-drug resistant strain.Results: During the period October 2009–November 2010, total 210 subjects were enrolled. Among the participants, 122 were male and 88 were female. S. typhi were found in 133 samples whereas 76 were S. paratyphi A and only 1 S. paratyphi B. Sensitivity was found 77% for ampicillin, 91.4% for cotrimoxazole, 78.6% for chloramphenicol, 87.6% for ciprofloxacin, 96.6% for cefixime, 98% for ceftriaxone and only 22.1% for azithromycin (77.9% resistant). Total 91 (43.3%) cases were found having resistant strain, 6 (2.8%) epidemic strain and 8 (3.8%) MDR strain Salmonella spp. The sensitivity of azithromycin was analyzed among different categories of strains and revealed that 52.7% showed resistance in resistant strain, 100% in epidemic strain and 87.5% in MDR strain. During the period between January–December 2012, total 139 subjects were enrolled. Among the participants 68 were male and 71 were female with a ratio of 1:1.04. S. typhi were found in 84 cases whereas 55 were S. paratyphi A and no S. paratyphi B. Sensitivity was found 62.7% for ampicillin, 82% for cotrimoxazole, 83% for chloramphenicol, 45.2% for azithromycin, 95% for ciprofloxacin, 99.3% for cefixime and 100% for ceftriaxone. Total 55 (39.6%) cases were found having resistant strain, 3 (2.1%) epidemic strain and 17 (12.2%) MDR strain Salmonella spp. Against azithromycin 67.3% showed resistance in resistant strain, 33.3% in epidemic strain and 29.4% in MDR strain.Conclusion: The policy of empirical treatment of enteric fever needs to be rationalized and newer generation antibiotics should be restricted only for multi-resistant cases of enteric fever.J Enam Med Col 2015; 5(2): 88-92

scholarly journals Gaps in Knowledge About SARS-CoV-2 & COVID-19 Among University Students Are Associated With Negative Attitudes Toward People With COVID-19: A Cross-Sectional Study in Cyprus

2021 ◽  
Vol 9 ◽  
Author(s):  
Nicos Middleton ◽  
Constantinos Tsioutis ◽  
Ourania Kolokotroni ◽  
Alexandros Heraclides ◽  
Panagiotis Theodosis-Nobelos ◽  
...  
Keyword(s):  
University Students ◽  
Doctoral Students ◽  
Positive Attitude ◽  
Online Survey ◽  
Social Activity ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Cross Sectional ◽  
Negative Attitudes

University students represent a highly active group in terms of their social activity in the community and in the propagation of information on social media. We aimed to map the knowledge, attitudes, and perceptions of University students in Cyprus about severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and Coronavirus disease 2019 (COVID-19) to guide targeted future measures and information campaigns. We used a cross-sectional online survey targeting all students in conventional, not distance-learning, programs in five major universities in the Republic of Cyprus. Students were invited to participate through the respective Studies and Student Welfare Office of each institution. The survey was made available in English and Greek on REDCap. Participation was voluntary and anonymous. The questionnaire was developed based on a consensus to cover the main factual information directed by official channels toward the general public in Cyprus at the time of the survey. In addition to sociodemographic information (N = 8), the self-administered questionnaire consisted of 19 questions, assessing the knowledge regarding the characteristics of SARS-CoV-2 and COVID-19, infection prevention and control measures (N = 10), perceptions related to COVID-19, for instance, whether strict travel measures are necessary (N = 4), and attitudes toward a hypothetical person infected (N = 2). Furthermore, participants were asked to provide their own assessment of their knowledge about COVID-19 and specifically with regard to the main symptoms and ways of transmission (N = 3). The number of students who completed the survey was 3,641 (41% studying Health/Life Sciences). Amongst them, 68.8% responded correctly to at least 60% of knowledge-related questions. Misconceptions were identified in 30%. Only 29.1% expressed a positive attitude toward a hypothetical person with COVID-19 without projecting judgment (9.2%) or blame (38%). Odds of expressing a positive attitude increased by 18% (95% CI 13–24%; p < 0.001) per unit increase in knowledge. Postgraduate level education was predictive of better knowledge (odds ratio (OR) 1.81; 95% CI 1.34–2.46; p < 0.001 among doctoral students] and positive attitude [OR 1.35; 95% CI 1.01–1.80; p = 0.04). In this study, we show that specific knowledge gaps and misconceptions exist among University students about SARS-CoV-2 and COVID-19 and their prevalence is associated with negative attitudes toward people with COVID-19. Our findings highlight the integrated nature of knowledge and attitude and suggest that improvements to the former could contribute to improvements in the latter.

scholarly journals Experience of Menopause and Menopausal Transition among Middle aged Women Attending A Periurban Hospital

2017 ◽  
Vol 31 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Saria Tasnim ◽  
Md Abidul Haque ◽  
Summyia Nazmeen
Keyword(s):  
Significant Proportion ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Menopausal Symptoms ◽  
Menopausal Transition ◽  
Middle Aged ◽  
Health Seeking ◽  
Cross Sectional ◽  
Hot Flush ◽  
Night Sweats

Objective (s): The objective was to explore frequency of menopause related symptoms among middle aged women and their perception about menopause,Materials and Methods: This was a cross sectional study carried during March to May 2013 among women aged 45-60 years at the out patient Department of Obstetrics and Gynaecology of a tertiary hospital using structured questionnaire. Information was sought regarding menstrual pattern, self reported menopausal symptoms and attitude towards menopausal transition. Data analysis was done using SPSS version 16.Results: Total 106 women were interviewed, The mean age of the respondents was 50.3± 53 years, and 58.5% were post menopausal and 41.5% in menopausal transition. More than half (59.4%) were illiterate, 32% were working. Common menopausal symptoms were insomnia 51.8%, body ache 44.3% and feeling sad 31.3%. Hot flush and night sweats were reported by 50% and 33% respectively. Half of them regard menopause as normal and health seeking for menopausal problems was 42.5%.Conclusion: A significant proportion of women were suffering from vasomotor and psychosomatic symptoms but most of them did not seek treatment. To ensure quality of life health needs of middle aged women should be identified and their views towards menopause incorporated in formulating services for themBangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 10-15

scholarly journals Acinetobacter species meningitis in children: a case series from Karachi, Pakistan

2011 ◽  
Vol 5 (11) ◽  
pp. 809-814 ◽  
Author(s):  
Ali Faisal Saleem ◽  
Muhammad Shafaat Shah ◽  
Abdul Sattar Shaikh ◽  
Fatima Mir ◽  
Anita K M Zaidi
Keyword(s):  
Antimicrobial Agents ◽  
Medical Center ◽  
External Ventricular Drain ◽  
Tertiary Care ◽  
Case Series ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Resistant Isolate ◽  
Acinetobacter Species ◽  
Tertiary Care Medical Center

Introduction: Multidrug-resistant strains of Acinetobacter pose a serious therapeutic dilemma in hospital practice, particularly when they cause meningitis, as the few antimicrobial agents to which these isolates are susceptible have poor central nervous system (CNS) penetration.  Methodology: We retrospectively reviewed the clinical course and outcome of eight consecutive cases of meningitis due to Acinetobacter spp. in children ages 15 years or less, seen in a tertiary care medical center in Karachi, Pakistan. Results: Of the eight cases of Acinetobacter meningitis, isolates from five patients were pan-resistant, and two were multidrug-resistant. A neurosurgical procedure was performed in five of eight patients followed by external ventricular drain insertion prior to the development of infection. Seven received intravenous (IV) polymyxin (mean; 12.8 days), while 5/8 also received intrathecal (IT) polymyxin (mean; 12.0 days). The mean length of hospitalization was 38.7 ± 19 days. All patients achieved cerebrospinal fluid (CSF) culture negativity by the end of treatment (mean; 5.4 days). Two patients died: one with pan-resistant Acinetobacter, and the second with a multi-drug resistant isolate. Conclusion: Post-neurosurgical multidrug-resistant and pan-resistant Acinetobacter meningitis can be successfully treated if appropriate antimicrobial therapy is instituted early. The role of IT polymyxin B administration alone versus combination therapy (IV and IT) needs further study.  

Phenotypic detection of extended-spectrum beta-lactamase in multidrug-resistant acinetobacter baumannii isolated in Fauji Foundation Hospital Rawalpindi

2021 ◽  
pp. 1-12
Author(s):  
Asim Ali Shah ◽  
Yasir Ali ◽  
Ayesha Maqbool ◽  
Shahid Ahmad Abbasi ◽  
Admin
Keyword(s):  
Acinetobacter Baumannii ◽  
Sampling Technique ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Multiple Drugs

Abstract Objective: To evaluate the phenotypic detection of extended-spectrum beta-lactamase in multidrug-resistant acinetobacter baumannii. Methods: The cross-sectional study was conducted at the Department of Microbiology, Fauji Foundation Hospital, Rawalpindi, Pakistan, from August 2018 to April 2019, after the ethical approval from the Institutional Review Committee. Consecutive Non- probability sampling technique was used, and comprised clinical specimens, including pus, blood, sputum, urine, tracheal tubes and canula double lumen, which were processed using standard protocols. Colonies of acinetobacter baumannii were identified by gram staining and Analytical Profile Index-20E kit. Combination disc method was used for the identification of extended-spectrum beta-lactamse. Clinical and Laboratory Standards Institute guidelines were used for antimicrobial susceptibility. Data was analysed using SPSS 22 and Sample size was calculated by using earlier study with 5 % margin of error and 95 % confidence level. Results: Of the 78 isolates, 58(74.4%) related to females and 20(25.6%) to males. There was no extended-spectrum beta-lactamse producer. Imipenem, meropenem, cefotaxime, ampicillin and ceftazidime showed 100% resistance, while colistin and polymyxin B were sensitive to all strains. The incidence rate was high in samples isolated from tracheal tubes 47(60.3%), followed by pus 21(26.9%). Age was not found to be a significant factor (p>0.05).   Conclusion: Acinetobacter baumannii showed a high resistance to multiple drugs and was not confined to any specific age group. Colistin and polymyxin B were found to be better choices. Continuous...

scholarly journals Psychological distress during the COVID-19 pandemic in Ethiopia: an online cross-sectional study to identify the need for equal attention of intervention

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Argaw Ambelu ◽  
Zewdie Birhanu ◽  
Yimenu Yitayih ◽  
Yohannes Kebede ◽  
Mohammed Mecha ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Cross Sectional ◽  
High Psychological Distress ◽  
Prevention And Control Measures ◽  
Middle Aged Adults ◽  
And Control

Abstract Background The COVID-19 pandemic led individuals to suffer from different levels of mental health problems such as psychological distress, anxiety, depression, denial, panic, and fear. This study aimed at determining the prevalence of psychological distress and associated factors among the Ethiopian population during the COVID-19 pandemic. Methods A cross-sectional study was performed through an online survey using different online platforms. The questionnaire was created through Google Form and the survey link was administered by e-mail, LinkedIn, Telegram, and Facebook. Educated Ethiopian population who have access to the internet were invited to participate through an online survey and addressed to 929 respondents. The study participants completed the survey anonymously without any personal identifier. The psychological distress was assessed using the Kessler 10-item tool to measure psychological distress. Data were analyzed using SPSS and logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. A generalized additive model was also employed to identify additional predictors using R. Results The prevalence of high psychological distress among the study population was 236 (25.5%). Of all respondents, 421 (45.1%) had low psychological distress, 274 (29.4%) had moderate psychological distress, 164 (17.6%) had high psychological distress, and 72 (7.3%) had very high psychological distress. Psychological distress increased with being at young and middle-aged adults, getting information from social media, and not correctly practicing infection prevention and control measures to prevent COVID-19 infection. Respondents with high perceived severity had increased psychological distress. On the contrary, those with the highest score of perceived response efficacy had low distress. Conclusion Prevalence of psychological distress was substantial. The need for intervention of psychological distress inline with the prevention of COVID-19 is critically essential. The intervention target groups are those whose information sources are from social media, young and middle-aged adults, and those who do not correctly practice infection prevention and control measures against COVID-19 infection.

scholarly journals Delivery of Seasonal Malaria Chemoprevention With Enhanced Infection Prevention and Control Measures During the COVID-19 Pandemic in Nigeria, Burkina Faso and Chad: A Cross-sectional Study

2021 ◽  
Author(s):  
Charlotte Ward ◽  
Abimbola Phillips ◽  
Olusola Oresanya ◽  
Gloria Olisenekwu ◽  
Ekundayo Arogunade ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Burkina Faso ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Cross Sectional ◽  
Prevention And Control Measures ◽  
And Control

Abstract IntroductionSeasonal malaria chemoprevention (SMC) is a WHO-recommended intervention for children aged 3-59 months living in areas of high malaria transmission to provide protection against malaria during the rainy season. Operational guidelines were developed, based on WHO guidance, to support countries to mitigate the risk of coronavirus disease 2019 (COVID-19) transmission within communities and among community distributors when delivering SMC.MethodsA cross-sectional study to determine adherence to infection prevention and control measures during two distribution cycles of SMC in Nigeria, Chad and Burkina Faso. Community distributors were observed receiving equipment and delivering SMC. Adherence across six domains was calculated as the proportion of indications in which the community distributor performed the correct action. Focus group discussions were conducted with community distributors to understand their perceptions of the infection prevention and control measures and barriers and facilitators to adherence.ResultsWe observed community distributors in Nigeria (n=259), Burkina Faso (n=252) and Chad (n=266) receiving infection prevention and control equipment and delivering SMC. Adherence to infection prevention and control indications varied. In all three countries, adherence to mask use was the highest (ranging from 73.3% in Nigeria to 86.9% in Burkina Faso). Adherence to hand hygiene for at least 30 seconds was low (ranging from 3.6% in Nigeria to 10.3% in Burkina Faso) but increased substantially when excluding the length of time spent hand washing (ranging from 36.7% in Nigeria to 61.4% in Burkina Faso). Adherence to safe distancing in the compound ranged from 5.4% in Chad to 16.4% in Nigeria. In Burkina Faso and Chad, where disinfection wipes widely available compliance with disinfection of blister packs for SMC was low (17.4% in Burkina Faso and 16.9% in Chad). Community distributors generally found the infection prevention and control measures acceptable, however there were barriers to optimal hand hygiene practices, cultural norms made social distancing difficult to adhere to and caregivers needed assistance to administer the first dose of SMC.ConclusionAdherence to infection prevention and control measures for SMC delivery during the COVID-19 pandemic varied across domains of infection prevention and control, but was largely insufficient, particularly for hand hygiene and safe distancing. Improvements in provision of equipment, early awareness raising and adaptations to make infection prevention and control measures more feasible to implement could increase adherence.

scholarly journals SARS-CoV-2 infection and transmission in school settings during the second wave in Berlin, Germany: a cross-sectional study

2021 ◽  
Author(s):  
Stefanie Theuring ◽  
Marlene Thielecke ◽  
Welmoed van Loon ◽  
Franziska Hommes ◽  
Claudia Hülso ◽  
...  
Keyword(s):  
School Attendance ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Infection Prevalence ◽  
Igg Antibodies ◽  
School Students ◽  
Cross Sectional ◽  
Modelling Studies ◽  
Household Members

AbstractBackgroundSchool attendance during the SARS-CoV-2 pandemic is intensely debated. Modelling studies suggest that school closures contribute to community transmission reduction. However, data among school-attending students and staff are scarce. In November 2020, we examined SARS-CoV-2 infections and seroreactivity in 24 randomly selected school classes and connected households in Berlin, Germany.MethodsStudents and school staff were examined, oro-nasopharyngeal swabs and blood samples collected, and SARS-CoV-2 infection and IgG antibodies detected by RT-PCR and ELISA. Household members performed self-swabs. Individual and institutional infection prevention and control measures were assessed. Classes with SARS-CoV-2 infection and connected household members were re-tested after one week.Findings1119 participants were examined, including 177 primary and 175 secondary school students, 142 staff, and 625 household members. Participants reported mainly cold symptoms (19·4%). SARS-CoV-2 infection occurred in eight of 24 classes affecting each 1-2 individuals. Infection prevalence was 2·7% (95%CI; 1·2-5·0%; 9/338), 1·4% (0·2-5·1%; 2/140), and 2·3% (1·3-3·8%; 14/611) among students, staff and household members, respectively, including quarantined persons. Six of nine infected students were asymptomatic. Prevalence increased with inconsistent facemask use in school, way to school on foot, and case-contacts outside school. IgG antibodies were detected in 2·0% (0·8-4·1%; 7/347), 1·4% (0·2-5·0%; 2/141) and 1·4% (0·6-2·7%; 8/576), respectively. For three of nine households with infection(s) detected at cross-sectional assessment, origin in school seemed possible. After one week, no school-related, secondary infections appeared in affected classes; the attack rate in connected households was 1·1%.InterpretationThese data suggest that school attendance under preventive measures is feasible, provided their rigorous implementation. In balancing threats and benefits of open versus closed schools during the pandemic, parents and society need to consider possible spill-overs into their households. Deeper insight is needed into the infection risks due to being a schoolchild as compared to attending school.FundingSenate of Berlin.

scholarly journals Study of genetic diversity, biofilm formation, and detection of Carbapenemase, MBL, ESBL, and tetracycline resistance genes in multidrug-resistant Acinetobacter baumannii isolated from burn wound infections in Iran

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Reza Ranjbar ◽  
Abbas Farahani
Keyword(s):  
Antimicrobial Resistance ◽  
Acinetobacter Baumannii ◽  
Biofilm Formation ◽  
Antimicrobial Agents ◽  
Tetracycline Resistance ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Wound Infections ◽  
Burn Wound ◽  
Cross Sectional

Abstract Background Antimicrobial resistance in multidrug-resistant Acinetobacter baumannii (MDR-AB) isolated from burn wound infections is a major concern in intensive care or burns units worldwide, and molecular studies are considered critical strategies for control of MDR-AB outbreaks in this regard. Thus, in this study, antibiotic resistance, biofilm-forming ability, molecular epidemiology of MDR A. baumannii strains recovered from patients with burns were investigated in three major hospital centers of Iran. Methods In this cross-sectional research, 163 non-repetitive A. baumannii strains were tested for susceptibility to antimicrobial agents. Polymerase chain reaction (PCR) was performed to characterize ambler classes A, B, and D β-lactamases, ISAba1 and integrons, biofilm formation was also investigated. Clonal relatedness was analyzed using Pulsed-Field Gel Electrophoresis (PFGE). Results Among 163 A. baumannii strains collected, 94.5% of them were Carbapenem-Non-Susceptible A. baumannii (CNSAB) and also 90.1 and 52.2% of them were Metallo-β-Lactamases (MBL) and Extended-Spectrum β-Lactamases (ESBL) producing isolates, respectively. Colistin and polymyxin B exhibited excellent activity against CNSAB strains. High prevalence of blaOXA − 23-like (85.1%), blaVIM (60.5%), blaPER − 1 (42.3%), tetB (67.8%), and Class 1 integrons (65.6%) were identified in CNSAB strains. ISAba1 element was associated with 42 (25.8%) and 129 (98.5%) of blaOXA-51-like and blaOXA-23-like genes, respectively. 6 clusters with the ability to form strong biofilms were found to be dominant and endemic in our entire areas. Conclusions Results of the present study show that antimicrobial resistance in CNSAB isolates from burn wound infections in monitored hospitals in Iran is multifactorial, and also findings of the study suggested that local antibiotic prescription policies should be regularly reviewed, and efficient infection control measures should be observed. Therefore, further strengthening of surveillance of antimicrobial resistance is urgently needed in these regions.

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