High rates of extensively drug-resistant Acinetobacter baumannii in a Peruvian hospital 2013-2019
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Rodrigo Samuel Barrientos-Yong1, Bryan Andrei Hinojosa-Salas1, Percy Genaro Salas-Ponce1,2
1Escuela de Medicina, 187071Universidad Científica del Sur, Lima, Perú.
Abstract:
Multidrug-resistant (MDR) Acinetobacter baumannii has become a major concern of hospital care. The objective of the study was to evaluate the evolution of antimicrobial resistance of A. baumannii in a Peruvian hospital from 2013 to 2019. A total of 993 A. baumannii clinical isolates were recovered. Antimicrobial resistance levels were extremely high, except for colistin. Among the remaining antibacterial agents, ampicillin plus sulbactam (AMS) was the most active (71.4% of resistance), with resistance levels to the remaining agents ranging from 75.9% to amikacin to 99.2% to ertapenem. The presence of significant differences was observed in extensively drug-resistant (XDR) A. baumannii according to samples origin. No association was observed between MDR or XDR isolates and seasonality. An impressive rate of XDR A. baumannii isolates was found, including a growing number of only-colistin-susceptible isolates highlighting the urgent need for new therapeutic alternatives.
Insights
Multidrug-resistant Acinetobacter baumannii shows high resistance to antibiotics, except colistin. The study highlights an urgent need for new treatments due to increasing extensively drug-resistant strains.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Multidrug-resistant (MDR) Acinetobacter baumannii is a significant hospital-acquired infection.
- Rising antimicrobial resistance necessitates continuous surveillance and understanding of resistance patterns.
Purpose of the Study:
- To analyze the antimicrobial resistance trends of Acinetobacter baumannii in a Peruvian hospital from 2013 to 2019.
- To identify the prevalence of extensively drug-resistant (XDR) Acinetobacter baumannii and its characteristics.
Main Methods:
- Retrospective analysis of 993 Acinetobacter baumannii clinical isolates.
- Antimicrobial susceptibility testing for various agents.
- Statistical analysis to assess resistance patterns, XDR prevalence, and associations with sample origin and seasonality.
Main Results:
- Extremely high resistance rates were observed for most tested antibiotics, with colistin remaining highly effective.
- Ampicillin plus sulbactam (AMS) showed the lowest resistance (71.4%), while resistance to amikacin was 75.9% and to ertapenem was 99.2%.
- Significant variations in XDR Acinetobacter baumannii were noted based on sample origin, with no link to seasonality. A growing proportion of isolates were only susceptible to colistin.
Conclusions:
- Acinetobacter baumannii exhibits alarming levels of antimicrobial resistance in the Peruvian hospital setting.
- The increasing prevalence of XDR strains, particularly those only susceptible to colistin, underscores the critical need for novel therapeutic strategies.
- Continuous monitoring of resistance patterns is essential for effective infection control and treatment of Acinetobacter baumannii.
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