Biofilm-producing Acinetobacter baumannii in Asia: mapping the clinical burden and antimicrobial resistance through...

Acinetobacter baumannii, an evolving pathogen that has become a drug-resistant strain in the last two decades, causes a high rate of infections in health-care settings. Most nosocomial infections were caused by biofilm-forming A. baumannii, which enables it to survive and proliferate under hostile conditions, including high concentrations of antibiotics. They confer resistance to antibiotics and facilitate the spread of drug-resistance genes among strains. For alternative preventive measures, patterns of A. baumannii are required, which are still in their infancy, especially in Asia. Thus, the current systematic review and meta-analysis were conducted to evaluate the Asian prevalence of biofilm-forming A. baumannii in clinical isolates. Data extraction was performed by searching various electronic databases and was collected in Microsoft Excel. The extracted data were exported to STATA version 12 for further statistical analysis. The pooled prevalence of biofilm-forming A. baumannii was evaluated using random effects with DerSimonian-Laird. Sensitivity analysis was performed to assess the impact of individual reports on the pooled prevalence. A funnel plot was used to assess publication bias, and in addition to confirm, Egger's statistical test was employed. The prevalence of biofilm-forming A. baumannii in Asia was 67% (95% CI = 58.50, 75.31). A significant heterogeneity was observed among studies with an I² of 98.8%. The prevalence of strong, moderate and weak biofilm-forming A. baumannii was 20.37% (95% CI = 19.31, 21.43), 30.28% (95% CI = 29.17, 31.40) and 0%. The highest prevalence of biofilm-forming A. baumannii clinical isolates was reported for China (99.04%; 95% CI = 97.2, 100.9). The prevalent gene linked to biofilm-forming A. baumannii clinical isolates was the ompA gene (65.38%). The increased biofilm-forming burden of A. baumannii in healthcare settings indicates the need for routine patient screening and the prevention of emerging multidrug resistant A. baumannii. Moreover, these outcomes suggested the design of a novel prevention program by public-health policymakers to control the looming drug-resistant A. baumannii strain.