Minimum Inhibitory Concentration of Tigecycline on Acinetobacter in Burn Patients
Bisekha Jaiswal1, Laxmi Timalsina1, Sushmita Karki1
1Department of Medical Microbiology, Nobel college, Sinamangal, Kathmandu, Nepal.
Background:
Burn infection is a major cause of morbidity and mortality in spite of significant improvements in burn care and treatment. Pseudomonas aeruginosa, Acinetobacter spp., Staphylococcus aureus etc. are the commonest isolates in which rapid development of resistance to multiple drugs limits the therapeutic options for infections by Acinetobacter species. Hence, this study was done to find the occurrence of Acinetobacter and to determine the minimum inhibitory concentration of tigecycline against Acinetobacter isolates.
Methods:
This cross-sectional study was conducted in Phect-Nepal Hospital, Kirtipur, Nepal from September to December 2018. Total 205 samples were included for the isolation and identification of Acinetobacter and further minimum inhibitory concentration of isolates were done following the standard laboratory protocol. Collected data were analyzed by SPSS version 23.0.
Results:
Among 155 culture positive samples, 27 isolates were Acinetobacter spp. Antimicrobial Susceptibility Test revealed that 24 isolates were resistant to ceftriaxone and ceftazidime, but all isolates were susceptible to polymyxin B. For tigecycline, 19 isolates were resistant through dis diffusion test while 20 isolates cross the Minimum Inhibitory Concentration value from E test. The reliability of the E-test and disc diffusion was 0.920, which represent strong agreement between E- test and dis diffusion test.
Conclusions:
Tigecycline resistance is presenting as serious problem to the management of infection caused by Acinetobacter species. Therefore, minimum inhibitory concentration for the detection of resistance should be included in routine laboratory diagnosis.
Insights
Tigecycline resistance is a growing concern for Acinetobacter infections. Minimum inhibitory concentration testing is crucial for accurate resistance detection in Acinetobacter species.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Burn infections pose significant morbidity and mortality risks.
- Acinetobacter species infections are challenging due to rapid multi-drug resistance.
- Limited therapeutic options necessitate understanding resistance patterns.
Purpose of the Study:
- To determine the prevalence of Acinetobacter species in clinical samples.
- To evaluate the minimum inhibitory concentration (MIC) of tigecycline against Acinetobacter isolates.
- To assess tigecycline resistance in Acinetobacter species.
Main Methods:
- Cross-sectional study conducted at Phect-Nepal Hospital.
- Isolation and identification of Acinetobacter from 205 samples.
- Minimum Inhibitory Concentration (MIC) determination using E-test and disc diffusion.
Main Results:
- Acinetobacter species identified in 27 out of 155 culture-positive samples.
- High resistance observed against ceftriaxone and ceftazidime; complete susceptibility to polymyxin B.
- Tigecycline resistance detected in 19 isolates by disc diffusion and 20 by E-test, showing strong agreement (0.920 reliability).
Conclusions:
- Tigecycline resistance is a significant challenge in managing Acinetobacter infections.
- Routine laboratory diagnosis should incorporate MIC testing for tigecycline resistance detection.
- Effective treatment strategies require ongoing monitoring of antimicrobial susceptibility.
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