The Prevalence and Pattern of Acinetobacter Antibiotic Resistance in the Patients Admitted to Imam Reza Hospital in Kermanshah, Iran (2016 - 2018)

M. Shirvani, M. Zamanian, A. Janbakhsh, B. Sayad, S. Vaziri, Zeinab Mohseni Afshar, R. Miladi, S. Khazaei, F. Mansouri, M. Afsharian, Mitra Tarlan
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Abstract

Background: Acinetobacter is a gram-negative coccobacillus, which is widespread in nature and causes several nosocomial infections, such as pneumonia, meningitis, endocarditis, skin and soft tissue infections, conjunctivitis, and bacteremia. Acinetobacter has also demonstrated resistance against multiple antimicrobial agents. Objectives: The present study aimed to investigate the antibiotic resistance pattern of the isolated Acinetobacter strains from the patients admitted to various wards of Imam Reza hospital in Kermanshah, Iran. Methods: This descriptive, cross-sectional study was performed on 726 patients with positive Acinetobacter cultures at Imam Reza hospital during 2016 - 2018. Bacterial isolates were identified using laboratory tests and based on the CLSI protocol, and the standard disc-diffusion method was used assess antibiotic susceptibility. Data analysis was performed in SPSS version 20. Results: Most of the Acinetobacter-positive cases were isolated from the intensive care units (75.88%) and sputum (73.3%) and urine samples (10.1%). In addition, the highest and lowest resistance rate of the isolates was observed against ceftriaxone (96.6%) and ampicillin-sulbactam (58.7%), respectively. Conclusions: According to the results, the bacterial isolates were multiple-drug resistant and showed resistance to ciprofloxacin, ceftazidime, cotrimoxazole, ceftriaxone, cefepime, gentamicin, imipenem, ampicillin, ampicillin-sulbactam, and amikacin. The high resistance to imipenem is rather alarming as it is considered the 'last resort' in the treatment of the infections caused by gram-negative bacteria. Therefore, monitoring programs are recommended to prevent the misuse of this drug in hospitals.
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2016 - 2018年伊朗克尔曼沙阿伊玛目礼萨医院住院患者不动杆菌耐药情况及模式分析
背景:不动杆菌是一种革兰氏阴性球芽孢杆菌,广泛存在于自然界中,可引起多种医院感染,如肺炎、脑膜炎、心内膜炎、皮肤和软组织感染、结膜炎和菌血症。不动杆菌也显示出对多种抗菌剂的耐药性。目的:本研究旨在调查伊朗克尔曼沙阿伊玛目礼萨医院各病房住院患者分离的不动杆菌菌株的抗生素耐药模式。方法:对2016 - 2018年伊玛目礼萨医院726例不动杆菌培养阳性患者进行描述性横断面研究。采用实验室试验和CLSI方案鉴定分离的细菌,并采用标准的圆盘扩散法评估抗生素敏感性。数据分析采用SPSS version 20。结果:大多数不动杆菌阳性病例来自重症监护病房(75.88%)、痰液(73.3%)和尿液(10.1%)。对头孢曲松(96.6%)和氨苄西林-舒巴坦(58.7%)的耐药率最高、最低。结论:分离出的细菌多重耐药,对环丙沙星、头孢他啶、复方新诺明、头孢曲松、头孢吡肟、庆大霉素、亚胺培南、氨苄西林、氨苄西林-舒巴坦、阿米卡星耐药。对亚胺培南的高耐药性相当令人担忧,因为它被认为是治疗革兰氏阴性菌引起的感染的“最后手段”。因此,建议制定监测方案,以防止医院滥用该药。
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