Prashant Mule*, Niranjan Patil and Seema Gaikwad
Consultant Microbiologist, Department of Microbiology and Molecular Microbiology, Metropolis Healthcare Ltd, Mumbai, India
*Corresponding Author:Prashant Mule, Consultant Microbiologist, Department of Microbiology and Molecular Microbiology, Metropolis Healthcare Ltd, Mumbai, India.
Received: May 31, 2018; Published: July 17, 2018
Citation: Prashant Mule.,et al. “Urinary Tract Infections by Multidrug Resistant Acinetobacter species- A Retrospective Analysis”. Acta Scientific Microbiology 1.8 (2018).
Background: : Acinetobacter species have emerged as important cause of nosocomial infections like pneumonia and urinary tract infections. Acinetobacter species are known to be highly resistant to commonly used antimicrobial agents. Since Acinetobacter species are ubiquitous and have tremendous colonizing capacity, it is difficult to explain the role of Acinetobacter acquisition in the ICU and medical wards. The objective of this study was to determine the frequency of urinary tract infection (UTI) caused by different Acinetobacter species in hospitalized patients and in the community and to analyze their antimicrobial susceptibility pattern
Materials and Methods: : This is a retrospective analysis from January 2016 to December 2017. Urine samples collected in appropriate sterile manner were screened for polymorphonuclear leucocytes and bacteria by routine microscopic examination. This was followed by plating on MacConkey’s agar and Blood agar. Isolated Acinetobacter strains which are oxidase negative and non-lactose fermenters from MacConkey’s agar were identified with Matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) to confirm the identification. Antibiotic susceptibility was performed by Vitek CompactTM 2 (Biomeuriux, France) as per CLSI standards establishing MIC (Minimum Inhibitory Concentration).
Results: : Of the 429 isolates of Acinetobacterspecies from urinary tract, Acinetobacter baumannii complex (78%) found to be the most common species followed by Acinetobacter junii (10%) and Acinetobacter baumannii (8%). Of the 334 (78%) isolates of Acinetobacter baumannii complex from urinary tract, 73 (21.85%) isolates were resistant with doripenem, 62 (18.56%) with imipenem and 59 (17.66%) were resistant with meropenem with MIC values >= 8 µg/ml. The rest of the isolates like Acinetobacter junii, Acinetobacter johnsonii, and Acinetobacter lwoffii are found to be more sensitive with carbapenems with lower MIC values.
Discussion: : The treatment of multidrug-resistant bacteria in hospitalized patients continues to be a challenge for the clinician’s in routine practice. Acinetobacter baumannii complex has proven to be an important pathogen in health care associated infections with significant mortality and morbidity. The drug resistant nature of the pathogen and its unpredictable susceptibility patterns make empirical and therapeutic decisions even more difficult
Conclusion: : A. baumannii is an important opportunistic agent of nosocomial UTI, especially in patients with longer hospitalization,antibiotic exposure, urinary catheterization and decreased immunity. High antimicrobial resistance and patient co-morbidities limit therapeutic choices. Hence, alternative therapeutic options are urgently needed to treat a patient with A. baumannii infection.
Keywords: Nosocomial Infections; Acinetobacter baumannii Complex; MALDI-TOF MS; Urinary Catheterization
Copyright: © 2018 Prashant Mule.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.