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Analysis of drug resistance in 1,861 strains of Acinetobacter baumannii
Hao Jin1, Fan Qiu2, Hong Jian Ji1
1Department of Clinical Laboratory, Yancheng Third People's Hospital, Yancheng, Jiangsu 224005, P.R. China.
Abstract:
Acinetobacter baumannii is an emerging human pathogen that causes hospital-acquired infections. The trend in increased antimicrobial resistance limits the choice of effective antimicrobial agents. The present study reports the resistance to Acinetobacter baumannii and analyzes the associations between antibiotic use and resistance rates at a general hospital between 2010 and 2014. A total of 1,861 isolates were obtained from clinical cultures, accounting for 10.33% of all detected bacteria (1,861/18,016). The strains were mainly from respiratory samples (1,628 isolates, 87.5%) and the intensive care unit (696 isolates, 37.4%). The resistance rates of Acinetobacter baumannii to the majority of antibiotics were >50%, particularly the resistance rate to cefoperazone/sulbactam increased from 47.37 in 2011 to 89.25% in 2014. However, the rates of imipenem and cilastatin sodium decreased from 81.03 to 69.44% due to the antibiotic policy. There were Pearson significant associations between the use of three antibiotics and resistance in Acinetobacter baumannii to this drug, piperacillin/tazobactam (r=0.976, P<0.01), gentamicin (r=0.870, P<0.01) and cefoxitin (r=0.741, P<0.05). Therefore, a combination of drugs should be adopted to treat Acinetobacter baumannii infections. Microbiology laboratory support and surveillance policies are essential to control the emergence of multidrug-resistance Acinetobacter baumannii.
Insights
Acinetobacter baumannii infections are rising, with high resistance to many antibiotics. Hospital antibiotic policies can reduce resistance, but combination drug therapy is crucial for treatment.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Acinetobacter baumannii is a significant cause of hospital-acquired infections.
- Increasing antimicrobial resistance complicates treatment options for Acinetobacter baumannii infections.
Purpose of the Study:
- To report Acinetobacter baumannii resistance rates.
- To analyze associations between antibiotic use and resistance.
- To evaluate trends between 2010 and 2014 in a general hospital.
Main Methods:
- Analysis of 1,861 Acinetobacter baumannii isolates from clinical cultures.
- Tracking resistance rates to various antibiotics over a five-year period.
- Statistical analysis of correlations between antibiotic usage and resistance.
Main Results:
- High resistance rates (>50%) observed for most antibiotics.
- Significant increase in cefoperazone/sulbactam resistance (47.37% to 89.25%).
- Decreased imipenem/cilastatin sodium resistance attributed to antibiotic policy.
- Significant positive correlations found between piperacillin/tazobactam, gentamicin, cefoxitin use and resistance.
Conclusions:
- Multidrug-resistant Acinetobacter baumannii poses a significant threat.
- Hospital antibiotic stewardship and surveillance are essential.
- Combination drug therapy is recommended for treating Acinetobacter baumannii infections.
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