Emergence of multidrug resistant, extended-spectrum β-lactamase and metallo-β-lactamase strain of Acinetobacter baumannii in ICU ward of Kashan Beheshti Hospital during 2013-14

Acinetobacter baumannii (A .baumannii) is a nosocomial opportunistic pathogen especially in intensive care unit (ICU) patients with innate resistance to many antibiotics. The aims of this study were to determine the antibiotic resistance patterns, the frequency of extended-spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) enzymes among the A. baumannii isolated from tracheal tubes of hospitalized patients in ICU ward of Beheshti hospital (Kashan, Iran) during 2013-2014.
A descriptive cross-sectional study was performed on 40 isolates of A .baumannii. Antibiotic susceptibility test for seventeen antimicrobial agents was performed according to the CLSIs guidelines. ESBL and MBL producing isolates were confirmed by double-disk diffusion test. The presence of blaOXA51 gene was investigated using PCR.
All of A. baumannii isolates were resistant to Piperacillin, Piperacillin-Tazo­bactam, Ceftazidime, Cefepime, Cefotaxime, Ceftriaxone, Meropenem, Imipenem, Ciprofloxacin, Levofloxacin, and Trimethoprim-Sulfamethoxazole; 100% of the isolates were multi-drug resistant (MDR). Two (5%) and 26 (65%) strains were ESBL- and MBL-positive, respectively. All isolates were positive for blaOXA-51 gene.
The study emphasizes the high frequency of MDR in Kashan Shahid Beheshti hospital. Since the resistance genes are located on mobile elements, to prevent further spread of the infection, rapid identification of the mentioned strains is essential.