The Antibiotic Resistance Rates in Multidrug Resistant Acinetobacter Isolates from Microbiological Culture Samples of Adult Patients in Turkey: A Retrospective Study

Abstract

Objective: Acinetobacter species lead to extremely serious infections, particularly in hospitalized patients, and in patients with impaired host defense. The high rates of resistance against several antibiotics detected in recent years have created serious issues in treatments of different diseases. We aimed to examine antibiotic resistance profiles of Acinetobacter species isolated from patients who are treated as outpatients in polyclinics or hospitalized in services or intensive care units (ICU), against various antimicrobial therapies. Materials and Methods: Antibiotic resistance of Acinetobacter strains isolated from 533 clinical samples collected between 2017-2021 years in Bandırma State Hospital Clinical Microbiology Laboratory were evaluated retrospectively. The identification of isolates and antibiotic susceptibility tests were performed by BD Phoenix (Becton Dickinson, USA) automated system. Results: Most of Acinetobacter strains were isolated from respiratory secretions (32.5%) and from urine (24.4%). Of species, 63.8% were Acinetobacter baumannii, 34.9% Acinetobacter baumannii complex, 1.1% other Acinetobacter spp., 0.2% Acinetobacter lwoffii. Resistance rates to antibiotics were found as following: ciprofloxacin 91.1%, meropenem 91.3%, imipenem 89.2%, gentamicin 82.5%, trimethoprim-sulfamethaxasol 78.6%, amikacin 66.3% (highest in 2020), aztreonam 99.0% (significantly decreased in 2020), ceftriaxone 100%, ampicillin 100%, amoxicillin-clavulanate 100%, ertapenemicin 100%, cefuroxime 100%, netilmicin 62.5%, nitrofurantion 100%, colistin 4.7% and levofloxacin 87.1%. The samples collected from patients hospitalized in service and ICU were found more resistant against Ciprofloxacin, Levofloxacin, Meropenem, Imipenem, Trimethoprim/Sulfamethoxazole, Gentamicin and Amikacin (P<0.0001). Conclusion: Colistin resistance against Acinetobacter infections was observed to be low, hence colistin could be utilized in treatments. Infection control measures have to be taken in services and ICU, and rational antibiotic use policies should be applied so as to prevent the spread of infection