Abstract
Introduction:Acinetobacter species have emerged as important nosocomial pathogens and have been known to cause different kinds of opportunistic infections. Acinetobacter species cause a wide variety of illness in debilitated and hospitalized patients especially in intensive care units (ICU). Because of frequent resistance to aminoglycoside's, fluoroquinolone's, ureidopenicillin's and third generation cephalosporin's, carbapenem are important agents in managing Acinetobacter infections.
Material and Methods: A systematic retrospective analysis was performed on culture positive urinary tract infections among hospitalized patients between January 2010-December 2012. Significant isolates of Acinetobacter species were included in the study and was further analyzed for antimicrobial susceptibility, associated risk factors, underlying debility and co-morbid conditions.
Results:Among the 2240 culture positive samples, Acinetobacter species was isolated from 46 patients with UTI. Tigecyline was found to be the antibiotic with highest susceptibility (91%) followed by Imipenem(69.5%), Meropenem (67.3%) and Gatilfoxacin (63%). The six patients who expired had disseminated infection with highly resistant strains of Acinetobacter species. Mechanical ventilation was the predominant risk factor for severe and disseminated infection.
Conclusion:Acinetobacter infections are associated with high morbidity and mortality. Multidrug resistant Acinetobacter are common in hospitals, especially in ICU's. A feasible hospital antibiotic policy and strict adherence to it, rigorous surveillance and good hospital infection control programme is needed to control the increasing incidence of highly resistant Acinetobacter infections.
Keywords
Acinetobacter species - Mechanical ventilation - Nosocomial infections - carbapenems