Acinetobacter baumannii bloodstream infections in a tertiary hospital: Antimicrobial resistance surveillance

Abstract

Nosocomial bacteremia caused by Acinetobacter baumannii is of increasing concern in critically ill patients. there is a world-wide increase in the emergence of multidrug-resistant (MDR) A. baumannii to antimicrobials. therefore we conducted this study to evaluate the resistance pattern of A. baumannii in patients with bacteremia. this is a retrospective study conducted in a tertiary hospital in Saudi Arabia. During the period from April 2006 till April 2010, data for A. baumannii isolated from blood were collected. Multidrug resistant A. baumannii was defined as resistance to three or more classes of antibiotics. We found 191 isolates of A. baumannii from blood. the majority of cases were reported in surgical ICU (40.8%). the highest resistance rates to antimicrobials were reported for cefepime (73.8%) and piperacillin / tazobactam (72.3%), followed by ciprofloxacin (68%), and gentamicin (66%). Resistance rates were also high to imipenem (61.3%) and meropenem (60.7%). low rates of resistance to colistin (0.5%) and to tigecycline (3.9%) were observed. MDR was observed in 132 (69%) of the A. baumannii isolates and 104 (78.8%) of these MDR strains showed sensitivity only to colistin and tigecycline. Bacteremia due to A. baumannii was the highest in surgical ICU. the emergence of MDR A. baumannii is increasing and the resistance rates to carbapenems are alarming. Urgent measures are in need to slow the development of MDR AB. We recommend encouraging clinicians for strict adherence to infection control Antibiotic resistance of A. baumannii in blood Al -Mously et al. policies, enhancement of ongoing antimicrobial stewardship program and restrictive use of recommended antibiotics according to susceptibility testing and local guidelines. In-house surveillance is needed for the detection of resistance rates particularly MDR A. baumannii.