Hospital-Acquired Infection by Carbapenem-Resistant Acinetobacter Species in ICUs in Assiut, Egypt

Document Type : New and original researches in the field of Microbiology.

Authors

1 Microbiology and Immunology Department, Faculty of Medicine, Assiut University

2 Microbiology and Immunology Department, Faculty of Pharmacy, Assiut University

3 Microbiology and Immunology department, Assiut university

4 Medical Microbiology and Immunology , Faculty of Medicine, Assiut University,

Abstract

Background: The genus Acinetobacter is one of the main fears of hospital-acquired infection (HAI) wide-reaching mostly in ICUs. Objectives: This study aimed to identify the incidence of carbapenem-resistant Acinetobacter (CRA) HAI in Assiut University Hospitals ICU and determine their antimicrobial susceptibility profile. Methodology: The study included 1204 clinical samples from 928 patients with HAI and 625 environmental samples. Carbapenemase production was detected phenotypically by MIC determination using imipenem, meropenem and doripenem E-test, modified Hodge test, combined disc test and double disc synergy test (DDST). OXA genes (blaOXA-51, blaOXA-23, blaOXA-24, and blaOXA-58) and MβL genes (blaSIM-1, blaVIM, and blaIMP-1) were investigated genotypically by PCR. Results: Out of total 60 Acinetobacter isolates, 55 (91.7%) were extensively drug-resistant (XDR) and 5 (8.3%) were multi-drug resistant (MDR). 93.3% of Acinetobacter isolates were resistant to imipenem and meropenem, and 90% were resistant to doripenem. The prevalence of bla genes in isolates were blaOXA-51 (93.3%), blaOXA-23 (68.3%), blaOXA-24 (23.3%), blaOXA-58 (10%), blaSIM-1 (46.7%), and blaVIM (8.3%). blaIMP-1 was not detected in any isolate. Conclusion: CRA infections were considerable in our ICUs. The high prevalence of XDR Acinetobacter spp. observed in our study was very alarming and requires critical intervention.

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