Prevalence of ESBL, MBL and Amp C Producing XDR Acinetobacter Isolates from Lower Respiratory Tract Specimens
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 10
Abstract
Introduction: Acinetobacter baumannii has become a red alert pathogen in ICU as a result of their profundity in developing multidrug (MDR) and extreme drug resistance (XDR). The problem is further worsened by the emergence of resistant enzymes like ESBL, MBL and Amp C which are not detected by routinely used laboratory susceptibility testing. As there is lack of therapeutic options against such strains, knowledge of prevalence of such strains and resistance mechanism and antimicrobial susceptibility pattern will help in framing institutional antibiotic policy and better management of patients. Study aimed to know the prevalence of XDR A. baumannii and the rate of ESBL, MBL and Amp C enzymes production in them. Method and Materials: The study was prospective observational study. Transtracheal or bronchoscopic aspirates collected aseptically from 335 patients were processed by semi-quantitative method on the blood agar and Mac-Conkey agar. Isolates were identified up to the species level with BD Phoenix automated system. The susceptibility testing of all the A. baumannii isolates was done against 22 drugs belonging to nine different categories by automated system as well as by Kirby bauer’s method. All the strains were further tested for ESBL, MBL and Amp C production. Results: A. baumannii was the commonest isolate 88 (36.82%) with high MDR (100%) and XDR 76(86.33%) frequency. All the XDR were 100% resistant to cephalosporins, tetracycline, doxycycline, gentamycin, netilmicin and ticarcillin/clavulinic acid. About 25 (32.8%) XDR strains were resistant to all the carbapenems and eight (10.52%) were susceptible only to colistin and polymyxin B. ESBL, MBL and Amp C production in XDR strains was seen in 25 (32.9%), 28 (36.8%) and 45 (59.21%) strains respectively. The 8 isolates which were sensitive only to colistin and polymyxin B produced ESBL, MBL and AmP C in 100% strains. Conclusion: there is high prevalence of XDR Acinetobacter isolates from ICU patients. The production of resistant enzymes like ESBL, MBL and Amp C is also on a rise. Our data will help in framing Institutional antibiotic policy.
Authors and Affiliations
Nidhi Goel, Parul Punia, Uma Chaudhary
Keywords
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