A STUDY OF MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII- A SUSCEPTIBILITY PATTERN AND POSSIBLE RISK FACTORS IN A TERTIARY CARE HOSPITAL OF CHHATTISGARH
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 36
Abstract
BACKGROUND The resistance of Acinetobacter varies widely geographically and between various units of the same hospital at various time points. The variations in Acinetobacter resistance demands a periodic surveillance of these pathogens to achieve appropriate selection of therapy. Due to unpredictable multidrug resistance patterns of clinical strains of Acinetobacter baumannii, it is important to know the prevalent susceptibility profiles as well as various risk factors associated with multidrug resistance. The aim of this study is to determine the proportion of Acinetobacter infections, susceptibility patterns and the possible risk factors for the multidrug resistance. MATERIALS AND METHODS This study was conducted in a tertiary care hospital over a period of 18 months. Acinetobacter species were isolated from a range of clinical samples (ICU, wards, outpatient departments) received in Department of Microbiology. The antibiotic susceptibility was determined by the standard disc diffusion method. RESULTS Out of total 1581 positive samples, 4.7% were found to be Acinetobacter. The most predominant species was Acinetobacter baumannii complex (72.8%). Samples showed the maximum resistance to piperacillin (49%), ceftazidime (48%), amikacin (46%), cefepime (41%), ciprofloxacin (27%), imipenem and netilmicin (33%). Antibiotic resistance was higher in the samples from Intensive Care Units (ICUs) of the hospital. Statistical analysis showed the following risk factors for Multidrug Resistance (MDR) A.baumannii infection: the occurrence of ischaemic heart disease patients (OR= 2.12, p-value 0.04), mechanical ventilation (OR= 2.84, p-value= 0.001) and usage of home-based antimicrobial treatment (OR= 2.47, p-value= 0.02). CONCLUSION This study clearly documents a high prevalence rate of infections as well as antibiotic resistance. The occurrence of multidrug resistant infections was associated with the risk factors, which can be prevented or treated early.
Authors and Affiliations
Nikita Sherwani, Rekha Barapatre, Arvind Neral, Rachana Singh, Neeta Gade
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