The Frequency of Multidrug-Resistance and Extensively Drug-Resistant Acinetobacter Baumannii in West of Iran
Author(s): Reza Hatami Moghadam, Amir Houshang Alvandi, Neda Akbari, Parvaneh Jafari, Ramin Abiri
Abstract
Acinetobacter baumannii is an opportunistic bacterial pathogen that can cause a variety of hospital-acquired infections, especially in the intensive care units (ICUs) and burn wards. Reportedly, one of the current globally health concerns is the prevalence of multidrug resistant and extensively drug-resistant A. baumannii (MDR-AB, and XDR-AB). Antibiotic resistance and in-hospital survival nature of this bacterium can be attributed to its biofilm formation ability. The present study aimed to assess the antibiotic resistance pattern and the prevalence of pgaD and abaI genes in A. baumannii isolated from the clinical settings in Kermanshah, Iran. Fifty isolates of A. baumannii were collected from the hospitals in Kermanshah during April 2016 to September 2017, which were identified according to API-20E system. Then, the antibiotic susceptibility test was performed for 14 antibiotics using disc diffusion method and minimum inhibitory concentration (MIC) based on microplate method for imipenem. The pgaD and abaI genes were analyzed by PCR technique. The study bacterial isolates were from burn wound samples collected from ICU and burn wards of Imam Reza and Imam Khomeini hospitals in Kermanshah. The findings showed that 50 isolates of A. baumannii were highly resistant to erythromycin, Ofloxacin, Ceftazidime, Tobramycin, Ticarcillin-clavulanate, Ceftriaxone and Azithromycin (>70%) and Cefepime, Piperacillintazobactam, Ampicillin/sulbactam and Amikacin (>50%) and sensitive to Colistin and Tigecycline. In addition, 80% of isolates were resistant to imipenem. The frequency of MDR-AB and MDR-AB strains was 84% and 48% respectively. The abaI and pga genes were found respectively in 18% and 58% of isolates. High prevalence of MDRAB isolates in Kermanshah represents the spread of resistant genes among the bacteria. The antibiotic resistance rate among A. baumannii isolates from hospitalized patients of burn and ICU wards is a warning for the region and failure to control appropriately can cause severe problems in the future.
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