Evaluation of antibiotic resistance changes in Acinetobacter baumannii in the era of COVID-19 in Northern Iran

Abstract

Background and objectives: During the coronavirus pandemic, the overuse of antibiotics to reduce coinfections and mortality may be contributing to the rise of antimicrobial resistance. In this study, we aim to investigate the antibiotic resistance changes of Acinetobacter baumannii post-COVID-19 pandemic in Northern Iran.

Materials and methods: The current study is a cross-sectional study. Between 2022 and 2023, 2190 clinical samples were collected from patients with healthcare-associated infections (HAIs) at four hospitals in Sari, which served as corona centers after the COVID-19 pandemic. Antimicrobial sensitivity was determined using standard broth macro-dilution, and resistance genes were detected using multiplex PCR.

Results: Based on the results co-amoxiclav had a resistance rate of 100%, while piperacillin/tazobactam showed the least resistance rate of 29.82%. In terms of GM MIC values, colistin was the most potent against multi-drug resistant isolates. The frequency of bla _OXA-51 , ampC, aphA6, and bla _NDM genes were 100%, 99.12%, 90.35%, and 69.30% respectively.

Conclusion: Our study revealed high multi-drug resistance rates. Piperacillin/tazobactam recommended for treating multi-drug resistant Acinetobacter baumannii infections in Northern Iran.

Keywords: Acinetobacter baumannii; COVID-19; Drug resistance; Healthcare associated infections; Multiplex polymerase chain reaction.

Fig. 1.

Antimicrobial susceptibility of MDR A. baumannii strains based on broth macro dilution technique.

Fig. 2.

The results of multiplex PCR in MDR A. baumannii isolates. (A): Negative control, (B): Ladder (100–3000 bp), (C): Positive control containing; AmpC (824 bp), bla _NDM (135 bp), and bla _OXA-51-like (410 bp), and aphA6 (631 bp) genes, (D, E, F): The samples from MDR A. baumannii.