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New Delhi metallo-β-lactamase-producing Acinetobacter isolates among late-onset VAP patients: multidrug-resistant

Asmaa M Elbrolosy1, Azza Z Labeeb1, Dina M Hassan2

  • 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt, asmaaelbrolosy@yahoo.com.

Infection and Drug Resistance
|February 28, 2019
PubMed
Abstract

Insights

New Delhi metallo-β-lactamase (MβL) producing Acinetobacter is a significant threat in ventilator-associated pneumonia (VAP). This study found a high prevalence of blaNDM-1 in VAP patients, with risk factors including prolonged ventilation and prior antibiotic exposure.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acinetobacter species are increasingly implicated in late-onset ventilator-associated pneumonia (VAP).
  • The emergence of carbapenem resistance in Acinetobacter poses a significant clinical challenge.

Purpose of the Study:

  • Determine the prevalence of New Delhi metallo-β-lactamase (MβL) (blaNDM-1)-producing Acinetobacter in VAP patients.
  • Investigate risk factors for acquiring blaNDM-1-producing Acinetobacter infections.
  • Correlate antimicrobial resistance patterns with therapeutic efficacy and clinical outcomes.

Main Methods:

  • Collected 64 Acinetobacter isolates from VAP patients.
  • Performed antimicrobial susceptibility testing, modified Hodge test (MHT), and combined disk tests (CDT) for MβL detection.
  • Utilized PCR to confirm the presence of the blaNDM-1 gene and analyzed risk factors and treatment outcomes.

Main Results:

  • 42 (65.6%) of 64 Acinetobacter isolates were blaNDM-1 positive.
  • Combined disk tests showed higher sensitivity (92.86%) and specificity (83.33%) for MβL detection compared to MHT.
  • Colistin exhibited high susceptibility (85.7%); combined carbapenem-colistin therapy improved clinical response.
  • Mortality was 46.8%, with 64.3% of deaths linked to blaNDM-1 positive isolates.
  • Prolonged mechanical ventilation, longer hospital/ICU stays, and prior antibiotic use were key risk factors for carbapenem resistance.

Conclusions:

  • The high prevalence of blaNDM-1-producing Acinetobacter in VAP patients highlights a significant global health threat.
  • Effective antimicrobial stewardship and infection control are crucial to combat the spread of carbapenem-resistant Acinetobacter.
Keywords:
Acinetobacter spp.blaNDM-1late-onset ventilator-associated pneumonia

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