Antimicrobial Resistance of Nosocomial Strain of Acinetobacter baumannii in Children’s Medical Center of Tehran: A 6-Year Prospective Study
-
Setareh Soroush
,
Mohammad Taghi Haghi-Ashtiani
,
Morovat Taheri-Kalani
,
Mohammad Emaneini
,
Marzieh Aligholi
,
Nourkhoda Sadeghifard
,
Iraj Pakzad
,
Mina Abedini
,
Masoud Yasemi
,
Hadi Paiman
Abstract
There are increasing reports of emergence of multiple drug resistant (MDR) Acinetobacter spp in the world; however there are a few reports in our country. 145 A. baumannii isolates from distinct wards and Children's Medical Center (CMC) in Tehran were studied in order to find the profile of antibiotic resistance among them. 40.6% (59/145) of A. baumannii isolates were identified as MDR. Overall susceptibility rates to cotrimoxazole, chloramphenicole and ciprofloxacin were 23.4%, 16.9% and 20.1%, respectively. Frequency susceptibility rates to amikacin, kanamycin, gentamycin and tobramycin decreased gradually from 81.2%, 50%, 50% and 62.5% in 2002 to 25%, 15.6%, 28.1% and 25% in 2007 respectively. Overall susceptibility rates to cephalosporines cephalotin, ceftazidime, cefteriaxon, ceftizoxime and cefixime were 9.3%, 14.7%, 16.2%, 15.9% and 18%, respectively. Susceptibility to carbapenems was assessed only in 2007. The susceptibility rates of Imipenem and meropenem were shown to be 50% and 46.8%, respectively. Our data indicates that MDR A. baumannii strains are spreading and carbapenem resistance is becoming more common in Iran. Our findings also highlight the importance of clinicians' access to updated susceptibility data regarding A. baumannii in developing countries such as Iran.
Manikal VM, Landman D, Saurina G, Oydna E, Lal H, Quale J. Endemic carbapenem-resistant Acinetobacter species in Brooklyn, New York: citywide prevalence, interinstitutional spread, and relation to antibiotic usage. Clin Infect Dis 2000;31(1):101-6.
El Shafie SS, Alishaq M, Leni Garcia M. Investigation of an outbreak of multidrug-resistant Acinetobacter baumannii in trauma intensive care unit. J Hosp Infect 2004;56(2):101-5.
Corbella X, Montero A, Pujol M, Domínguez MA, Ayats J, Argerich MJ, et al. Emergence and rapid spread of carbapenem resistance during a large and sustained hospital outbreak of multiresistant Acinetobacter baumannii. J Clin Microbiol 2000;38(11):4086-95.
Acar JF. Consequences of bacterial resistance to antibiotics in medical practice. Clin Infect Dis 1997;24 Suppl 1:S17-8.
Ayan M, Durmaz R, Aktas E, Durmaz B. Bacteriological, clinical and epidemiological characteristics of hospitalacquired Acinetobacter baumannii infection in a teaching hospital. J Hosp Infect 2003;54(1):39-45.
Bergogne-Berezin E, Towner KJ. Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin Microbiol Rev 1996;9(2):148-65.
Landman D, Quale JM, Mayorga D, Adedeji A, Vangala K, Ravishankar J, et al. Citywide clonal outbreak of multiresistant Acinetobacter baumannii and Pseudomonas aeruginosa in Brooklyn, NY: the preantibiotic era has returned. Arch Intern Med 2002;162(13):1515-20.
Yong D, Shin JH, Kim S, Lim Y, Yum JH, Lee K, et al. High prevalence of PER-1 extended-spectrum betalactamase- producing Acinetobacter spp. in Korea. Antimicrob Agents Chemother 2003;47(5):1749-51.
Livermore DM. The impact of carbapenemases on antimicrobial development and therapy. Curr Opin Investig Drugs 2002;3(2):218-24.
Murray BE, Moellering RC Jr. Aminoglycosidemodifying enzymes among clinical isolates of Acinetobacter calcoaceticus subsp. anitratus (Herellea vaginicola): explanation for high-level aminoglycoside resistance. Antimicrob Agents Chemother 1979;15(2):190-9.
Karlowsky JA, Draghi DC, Jones ME, Thornsberry C, Friedland IR, Sahm DF. Surveillance for antimicrobial susceptibility among clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii from hospitalized patients in the United States, 1998 to 2001. Antimicrob Agents Chemother 2003;47(5):1681-8.
Haghi-Ashteiani M, Sadeghifard N, Abedini M, Soroush S and M. Taheri-Kalani. Etiology and antibacterial resistance of bacterial urinary tract infections in children's medical center, Tehran, Iran. Acta Medica Iranica 2007;45(2):153-7.
Feizabadi MM, Fathollahzadeh B, Taherikalani M, Rasoolinejad M, Sadeghifard N, Aligholi M, et al. Antimicrobial susceptibility patterns and distribution of blaOXA genes among Acinetobacter spp. Isolated from patients at Tehran hospitals. Japan J Infect Dis 2008; 61(4):274-8.
Taherikalani M, Etemadi G, Geliani KN, Fatollahzadeh B, Soroush S, Feizabadi MM. Emergence of multi and pandrug resistance Acinetobacter baumannii carrying blaOXA- type -carbapenemase genes among burn patients in Tehran, Iran. Saudi Med J 2008;29(4):623-4.
Kalantari N,Taherikalani M, Parvaneh N, Mamishi S. Etiology and antimicrobial susceptibility of bacterial septic arthritis and osteomyelitis. Iran J Public Health 2007;36(3):27-32.
Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn Jr WC. Color Atlas and Textbook of Diagnostic Microbiology. 5th ed. Philadelphia: Lippincott-Raven Publishers; 1997. p. 253-320.
National Committee for Clinical Laboratory Standards (NCCLS). Performance Standards for Antimicrobial Susceptibility Testing: Ninth Informational Supplement M100-S14. Villanova PA: National Committee for Clinical Laboratory Standards, 2004.
Clinical Laboratory Standard Institute (CLSI). USER GUIDS NEO-SENSITABTM. Susceptibility testing, potency according to CLSI, 2006.
Buisson Y, Tran Van Nhieu G, Ginot L, Bouvet P, Schill H, Driot L, et al. Nosocomial outbreaks due to amikacinresistant tobramycin-sensitive Acinetobacter species: correlation with amikacin usage. J Hosp Infect 1990;15(1):83-93.
Luzzaro F, Mantengoli E, Perilli M, Lombardi G, Orlandi V, Orsatti A, et al. Dynamics of a nosocomial outbreak of multidrug-resistant Pseudomonas aeruginosa producing the PER-1 extended-spectrum beta-lactamase. J Clin Microbiol 2001;39(5):1865-70.
Kollef MH, Fraser VJ. Antibiotic resistance in the intensive care unit. Ann Intern Med 2001;134(4):298-314.
Tognim MC, Andrade SS, Silbert S, Gales AC, Jones RN, Sader HS. Resistance trends of Acinetobacter spp. in Latin America and characterization of international dissemination of multi-drug resistant strains: five-year report of the SENTRY Antimicrobial Surveillance Program. Int J Infect Dis 2004;8(5):284-91.
Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH, et al. The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee. JAMA 1995;274(8):639-44.
Hanberger H, Garcia-Rodriguez JA, Gobernado M, Goossens H, Nilsson LE, Struelens MJ. Antibiotic susceptibility among aerobic gram-negative bacilli in intensive care units in 5 European countries. French and Portuguese ICU Study Groups. JAMA 1999;281(1):67-71.
Schmitz FJ, Verhoef J, Fluit AC. Prevalence of aminoglycoside resistance in 20 European university hospitals participating in the European SENTRY Antimicrobial Surveillance Programme. Eur J Clin Microbiol Infect Dis 1999;18(6):414-21.
Higgins PG, Coleman K, Amyes SG. Bactericidal and bacteriostatic activity of gemifloxacin against Acinetobacter spp. in vitro. J Antimicrob Chemother 2000;45 Suppl 1:71-7.
Shi ZY, Liu PY, Lau Y, Lin Y, Hu BS, Shir J-M. Antimicrobial susceptibility of clinical isolates of Acinetobacter baumannii. Diagn Microbiol Infect Dis 1996;24(2):81-5.
Glupczynski Y, Delmée M, Goossens H, Struelens M. A multicentre survey of antimicrobial resistance in gramnegative isolates from Belgian intensive care units in 1994- 1995. Belgian Multicenter ICU Study Group. Acta Clin Belg 1998;53(1):28-38.
Ruiz J, Núñez ML, Pérez J, Simarro E, Martínez-Campos L, Gómez J. Evolution of resistance among clinical isolates of Acinetobacter over a 6-year period. Eur J Clin Microbiol Infect Dis 1999;18(4):292-5.
Gunseren F, Mamikoglu L, Ozturk S, Yucesoy M, Biberoglu K, Yulug N, et al. A surveillance study of antimicrobial resistance of gram-negative bacteria isolated from intensive care units in eight hospitals in Turkey. J Antimicrob Chemother 1999;43(3):373-8.
Jones ME, Draghi DC, Thornsberry C, Karlowsky JA, Sahm DF, Wenzel RP. Emerging resistance among bacterial pathogens in the intensive care unit: a European and North American Surveillance study (2000-2002). Ann Clin Microbiol Antimicrob 2004;3:14.
Corbella X, Montero A, Pujol M, Domínguez MA, Ayats J, Argerich MJ, et al. Emergence and rapid spread of carbapenem resistance during a large and sustained hospital outbreak of multiresistant Acinetobacter baumannii. J Clin Microbiol 2000;38(11):4086-95.
Manuel RJ, Shin GY, Farrag N, Holliman R. Endemic carbapenem-resistant Acinetobacter baumannii in a London hospital. J Antimicrob Chemother 2003;52(1):141-2.
Walther-Rasmussen J, Hoiby N. OXA-type carbapenemases. J Antimicrob Chemother 2006;57(3):373-83.
| Files | ||
| Issue | Vol 48, No 3 (2010) | |
| Section | Original Article(s) | |
| Keywords | ||
| Drug resistance multiple Acinetobacter baumannii cross infection | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
