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. 2018 Jul 2:2018:9129083.
doi: 10.1155/2018/9129083. eCollection 2018.

High Prevalence and Endemicity of Multidrug Resistant Acinetobacter spp. in Intensive Care Unit of a Tertiary Care Hospital, Varanasi, India

Tuhina Banerjee  1 , Anwita Mishra  1 , Arghya Das  1 , Swati Sharma  1 , Hiranmay Barman  2 , Ghanshyam Yadav  2
Affiliations

High Prevalence and Endemicity of Multidrug Resistant Acinetobacter spp. in Intensive Care Unit of a Tertiary Care Hospital, Varanasi, India

Tuhina Banerjee et al. J Pathog. .

Abstract

The increasing emergence of Acinetobacter spp. with healthcare associated infections (HCAI) in intensive care units (ICU) is alarming. This study was a laboratory-based audit to determine the prevalence of Acinetobacter spp. associated with HCAI in the adult ICU of a tertiary care hospital in Varanasi, north India, with special reference to antimicrobial resistance and resistance determinants over a period of 5 years. A total of 993 cases of HCAI were analyzed. Isolates were characterized as multidrug resistance and extended drug resistance (MDR/XDR) based on antimicrobial susceptibility records. Few (100) randomly selected isolates of Acinetobacter baumannii (A. baumannii) were tested for imipenem, meropenem, and polymyxin B susceptibility by minimum inhibitory concentration (MIC) and for the presence of class A and B carbapenemases by multiplex PCR. Active surveillance of ICU environment was also performed. High prevalence of Acinetobacter related hospital acquired pneumonia (HAP) with significant resistance to imipenem (p<0.05) and 88.02% MDR and 61.97% XDR was detected along with persistence in the ICU environment. The isolates harbored blaIMP (89%), blaVIM (51%), blaNDM-1 (34%), and blaOXA-23-like (93%) genes. Specific interventional measures should be adopted to control these imipenem resistant Acinetobacter spp. which have attained the level of endemicity in our ICU setup.

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Figures

Figure 1
Figure 1
Prevalence of Acinetobacter spp. and imipenem resistance in the study period.
Figure 2
Figure 2
Amplification of blaOXA-51 and blaOXA-23 by multiplex PCR.
Figure 3
Figure 3
Amplification of class B carbapenemase genes by multiplex PCR.
See this image and copyright information in PMC

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