Antibiotic Resistance Pattern and Prevalence of blaOXA-51, blaNDM, blaVIM, blaPER, blaVEB, blaCTX, tetA and tetB Genes in Acinetobacter baumannii Isolated from Clinical Specimens of Hospitals in Tabriz city, Iran

Background: Nowadays, the resistance of pathogenic bacteria to antibiotics has become a global problem. Acinetobacter baumannii is an important opportunistic nosocomial pathogen. Acinetobacter baumannii plays a significant role in antibiotic resistance. Objectives: The purpose of this study was to investigate the prevalence of the blaOXA-51, blaNDM, blaVIM, blaPER, blaVEB, blaCTX-M, tetA and tetB genes and antibiotic resistance pattern of A. baumannii isolated from hospitals in Tabriz city, Iran. Methods: This study was descriptive cross-sectional research, performed on 129 isolates of Acinetobacter from different clinical specimens. The Isolates were identified using standard laboratory methods and culture in selective mediums. The antibiotic resistance pattern of isolates was also determined by the Kirby-Bauer disk diffusion susceptibility test. Phenotypic and genotypic detection of blaOXA-51, blaNDM, blaVIM, blaPER, blaVEB, blaCTX-M, tetA and tetB genes in the isolates was carried out by a combined disk test (CDT) and polymerase chain reaction (PCR), respectively. Results: The highest resistance of isolates was determined to cefotaxime (100%) and ceftazidime (100%). The results of CDT showed that 14 (12.96%) isolates could produce extended-spectrum Beta-lactamases (ESBLs). However, the PCR results blaOXA-51, blaNDM, blaVIM, blaPER, blaVEB, blaCTX-M, tetA and tetB genes showed that these genes were in 100%, 18.51%, 16.66%, 32.40%, 16.66%, 31.48%, 32.40% and 21.29% of isolates, respectively. Conclusions: Due to the high prevalence of antimicrobial resistance in strains, rapid and timely detection of antibiotic-resistant A. baumannii strains is necessary for the selection of an appropriate therapeutic approach and prevention of their prevalence.

Emerging antibiotic resistance pattern of urinary tract infection (UTI) due to Escherichia Coli (E.Coli).

Objective: To determine the emerging antibiotic resistance pattern of adult patients of MDR UTI cases caused by E.Coli. Study Design: Retrospective Data. Setting: Departments of Medicine and Obstetrics & Gynecology, Madinah Teaching Hospital / University Medical and Dental College, Faisalabad. Period: August 2016 to Sep 2018. Material & Methods: This retrospective study included 187 patients meeting the operational definition of multi-drug resistance cases of urinary tract infection caused by E. coli. All cases either male or female of age above 15 years with positive reports of urine culture and sensitivity for E.coli were included in the study. Along with the demographic variables urine WBC’s, results of urine culture and sensitivity were noted. Antibiotic sensitivity pattern of all the E.coli resistant UTI cases was analyzed. After identification of the microbe, antimicrobial sensitivity was accessed using Kirby–Bauer disc diffusion method on the Mueller–Hinton agar. The antimicrobial susceptibility test was performed against E. coli strains by using the following antibiotics: Piperacilin, Amoxicilin-Calvulanic, Pipmedic Acid, Cefipime, Ceftrixone, Cefuroxime, Cefoperazone-sulbactam, Ceftazidime, Cephradine, Ciprofloxacin, Ofloxacin, Levofloxacin, ofloxacin, Nitrofurantoin, Amikacin, Tombramycin, Gentamicin, Linezolid, Doxycycline, Sulphamethoxazole, Imipenem, Meropenem, Aztreonam in order to obtain an antibiogram. Results: In our data, 66.8% (n=125) were MDR UTI, and more than half of these cases were 63.2% (n=79) were females. Among the total 187 cases, 97.3% patients were resistant to most of the beta-lactam antibiotics, 95.7% were resistant to most of the quinolones and 68.4% were resistant to most of the aminoglycosides. Conclusion: This increasing antibiotic resistance is very alarming and steps should be taken to reduce the misuse of antibiotics. Studies should be done to control the risk factors leading to E. coli UTI. By following proper pharmacological guidelines, principles to use antibiotics and manage outpatient cases of UTIs, the incidence of MDR UTI can be controlled.