American Journal of Microbiological Research
ISSN (Print): 2328-4129 ISSN (Online): 2328-4137 Website: http://www.sciepub.com/journal/ajmr Editor-in-chief: Apply for this position
Open Access
Journal Browser
Go
American Journal of Microbiological Research. 2015, 3(2), 76-79
DOI: 10.12691/ajmr-3-2-6
Open AccessArticle

Prevalence and Resistance Profile of Acinetobacter baumannii Clinical Isolates from a Private Hospital in Khartoum, Sudan

Muntasir I. Omer1, , Samia A. Gumaa2, Abdullatif A. Hassan1, Khaled H. Idris1, Osama A. Ali3, Mustafa M. Osman1, Mahmmoud S. Saleh1, Nagla A. Mohamed1 and Mustafa M. Khaled1

1Department of Medical Microbiology Laboratory at RCIH

2Professor of Microbiology, Head of Microbiology Department at Royal Care International Hospital (RCIH) Khartoum, Sudan

3Department of Medical Microbiology Laboratory at Royal Care International Hospital (RCIH), Khartoum, Sudan

Pub. Date: March 24, 2015

Cite this paper:
Muntasir I. Omer, Samia A. Gumaa, Abdullatif A. Hassan, Khaled H. Idris, Osama A. Ali, Mustafa M. Osman, Mahmmoud S. Saleh, Nagla A. Mohamed and Mustafa M. Khaled. Prevalence and Resistance Profile of Acinetobacter baumannii Clinical Isolates from a Private Hospital in Khartoum, Sudan. American Journal of Microbiological Research. 2015; 3(2):76-79. doi: 10.12691/ajmr-3-2-6

Abstract

Introduction: Acinetobacter baumannii is an important cause of nosocomial infections worldwide. It is difficult to control, and the infections caused by it are difficult to treat, because it is multidrug resistant. Objectives: This retrospective study was conducted to determine the prevalence and antibiotic resistance pattern of A. baumannii at Royal Care International Hospital, Khartoum, Sudan over a 37 month period. Methodology: Antimicrobial susceptibility testing of the isolates was performed by the disk diffusion method as recommended by Clinical Laboratory and Standards Institute CLSI [1]. Result: Non duplicate 275 A. baumannii were isolated out of a total 2899 pathogenic Gram negative isolates (9.5% prevalence). The most frequently isolated A. baumannii was from ICU patients (72%) followed by inpatients (24%) and outpatients (4%). The greatest number of isolates were recovered from sputum (61%) followed by wound (19%). The Resistance rates were higher than most of the internationally reported levels. Cephalosporins, aminoglycoside, aztreonam, fluoroquinolones and carbapenems are becoming practically ineffective, where the colistin elicited the highest susceptibility levels. Conclusion: This report shows for the first time (to our knowledge) the prevalence and resistance profile of A. baumannii in Sudan. The prevalence will help to conduct better infection control policy, and an update the local antibiogram will improve the knowledge of antimicrobial resistance patterns in our region.

Keywords:
Acinetobacter baumannii antibiogram RCIH

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Wayne, PA: Clinical and Laboratory Standards Institute; 2011. CLSI. Performance standards for antimicrobial susceptibility testing. 20th Informational Supplement. CLSI document M100-S21. Schreckenberger PC, Daneshvar MI, Weyant RS, Hollis DG. Acinetobacter, Achromobacter, Chryseobacterium, Moraxella, and other nonfermentative gram-negative rods. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH, editors. Manual of Clinical Microbiology. Washington, DC: ASM Press, 2007; 8: 770-779.
 
[2]  Fournier, P. E., D. Vallenet, V. Barbe, S. Audic, H. Ogata, L. Poirelet al., Comparative genomics of multidrug resistance in Acinetobacter baumannii. PLOS Genet. 2006; 10: 2-7.
 
[3]  Eveillard M, Soltner C, Kempf M, Saint-Andre J P, Lemarie C, Randrianarivelo C. et al,.The virulence variability of different Acinetobacter baumannii strains in experimental pneumonia. J Infect. 2010; 60 (2): 154-61.
 
[4]  Howard A, O'Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: an emerging opportunistic pathogen. Virulence, 2012; 1: 3 (3): 243-50.
 
[5]  Kraniotaki E, Manganelli R, Platsouka E, Grossato A, Paniara O, Palù G. Molecular investigation of an outbreak of multidrug-resistant Acinetobacter baumannii, with char-acterisation of class 1 integrons. Int J Antimicrob Agents. 2006; 28: 193-9.
 
[6]  Song JY, Kee SY, Hwang IS, Seo YB, Jeong HW, Kim WJ. et al., In vitro activities of carbapenem/sulbactam combination, colistin, colistin/rifampicin combination and tigecycline against carbapenem-resistant Acinetobacter baumannii. J Antimicrob Chemother. 2007; 60 (2): 317-22.
 
[7]  Rello J. Acinetobacter baumannii infections in the ICU: customization is the key. Chest1999; 115: 1226-1229.
 
[8]  Rice, LB. Federal funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. J Infect Dis. 2008; 197 (8): 1079-81.
 
[9]  Drummond, Katie. Pentagon to Troop-Killing Superbugs: Resistance Is Futile. Wired.com. Condé Nast. Retrieved 8 April 2013.
 
[10]  Manchanda V, Sanchaita S, and Singh NP. Multidrug Resistant Acinetobacter. J Glob Infect Dis.: 2010; 2 (3): 291-304.
 
[11]  Cisneros JM, Rodriguez-Bano J. Nosocomial bacteremia due to Acinetobacter baumannii: epidemiology, clinical features and treatment. Clin. Microbiol. Infect: 2002; 8: 687-69.
 
[12]  Shakibaie MR, Adeli S, Salehi MH. Antibiotic resistance patterns and extended-spectrum β-lactamase production among Acinetobacter spp. isolated from an intensive care Unit of a hospital in Kerman, Iran. Antimicrob Resist Infect Control: 2012; 1: 1-8.
 
[13]  Patwardhan RB, Dhakephalkar PK, Niphadkar KB, Chopade BA.A study on nosocomial pathogens in ICU with special reference to multiresistant Acinetobacter baumannii harboring multiple plasmids. Indian J Med Res: 2008; 128: 178-187.
 
[14]  AbdAllah S et al., Nosocomial infections and their risk factors at Mubarak Al-Kabeer hospital, Kuwait. Medical Journal of Cairo University, 2009, 78: 123-131.
 
[15]  Al Johani SM1, Akhter J, Balkhy H, El-Saed A, Younan M, Memish Z. Prevalence of antimicrobial resistance among gram-negative isolates in an adult intensive care unit at a tertiary care center in Saudi Arabia. Ann Saudi Med.: 2010; 30: 364-369.
 
[16]  Forbes BA, Sahm DF, Weissfeld AS. Bloodstream infections. In: Wilson L, editor. Bailey and Scott's Diagnostic Microbiology, 12 th ed. St Louis: The Mosby Company; 2007; 778-97.
 
[17]  Jaggi, Namita; Sissodia, Pushpa; Sharma, Lalit, Acinetobacter baumannii isolates in a tertiary care hospital: J Microbiol Infect Dis: 2012; 2 (2) p 57.
 
[18]  H. Siau, KY Yuen, SSY Wong. The epidemiology of Acinetobacter infections in Hongkong, J Med Microbiol 1996; 44: 340-347.
 
[19]  Endo S., Yano H., Hirakata Y., Arai K., Kanamori H., Ogawa M.,et al. Molecular epidemiology of carbapenem-non-susceptible Acinetobacter baumannii in Japan. J. Antimicrob. Chemother: 2012; 67 (7): 1623-1626.
 
[20]  Villers D, Espaze E, Coste-Burel M, Giauffret F, Ninin E, Nicolas F. et al,. Nosocomial Acinetobacter baumannii infections: Microbiological and clinical epidemiology. Ann Intern Med 1998; 129: 182-189.
 
[21]  Dijkshoorn, L, Nemec, A, Seifert, H. An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol.: 2007; 12: 939-51.
 
[22]  Seifert H, Dolzani L, Bressan R, Van Der RT, van Strijen B, Stefanik D, Heersma H, et al,. Standardization and interlaboratory reproducibility assessment of pulsed-field gel electrophoresis-generated fingerprints of Acinetobacter baumannii. J ClinMicrobiol 2005; 43 (43) 28-35.
 
[23]  Wilks M, Wilson A, Warwick S, Price E, Kennedy D, Ely A, et al,. Control of an outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus colonization and infection in an intensive care unit (ICU) without closing the ICU or placing patients in isolation. Inf Control HospEpidemiol, 2006; 27: 654-8.
 
[24]  Munoz-Price LS, Weinstein RA. Current concept: Acinetobacter Infection. N EnglJ Med 2008; 358: 1271-81.
 
[25]  Glow RH.,Moellering RC, Kunz LJ. Infections with Acinetobacter calcoaceticus (Herelleavaginicola): Medicine (Baltimore): 1977; 56: 79-97.
 
[26]  Evans BA, Hamoud, A, Towner S.A, Khan S.A, Amyes S.G. High prevalence of unrelated multidrug-resistant Acinetobacter baumannii isolates in Pakistani military hospitals. Int J Antimicrob Agents: 2011; 37: 580-581.
 
[27]  Dent L, Dana R M, Siddharth P. Multi-drug resistant Acinetobacter baumannii: a descriptive study in a city hospital. BMC Infectious Diseases: 2010; 10: 196-204.
 
[28]  Rit K, Saha R. Multidrug-resistant Acinetobacter infection and their susceptibility patterns in a tertiary care hospital. Niger Med J.: 2012; 53: 126-8.
 
[29]  Marchaim D, Chopra T, Pogue JM, Perez F, Hujer AM, Rudin S, et al,. Outbreak of colistin-resistant, carbapenem-resistant Klebsiella pneumoniae in metropolitan Detroit, Michigan. Antimicrob. Agents Chemother: 2011; 55 (2): 593-599.
 
[30]  Mammina C, Bonura C, Di Bernardo F, Aleo A, Fasciana T, Sodano C.et al,. Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, Euro Surveill: 2011; 17 (33): 20-48.
 
[31]  Lesho E, Yoon EJ, McGann P, Snesrud E, Kwak Y, Milillo M, et al. Emergence of colistin-resistance in extremely drug-resistant Acinetobacter baumannii containing a novel pmrCAB operon during colistin therapy of wound infections. J. Infect. Dis.: 2013; 208 (7): 1142-1151.
 
[32]  Lean SS, Suhaili Z, Ismail S, Rahman NI, Othman N, Abdullah FH, et al,. Prevalence and Genetic Characterization of Carbapenem-and Polymyxin-Resistant Acinetobacter baumannii Isolated from a Tertiary Hospital in Terengganu, Malaysia. ISRN Microbiology Vol 2014 (2014), Article ID 953417, 9.