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CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2013; 03(04): 007-009
DOI: 10.1055/s-0040-1703693
Original Article

SYSTEMATIC REVIEW OF URINARY TRACT INFECTION CAUSED BY ACINETOBACTER SPECIES AMONG HOSPITALISED PATIENTS

Sanjeev H.
1   Assistant Professor, Department of Microbiology, K S Hegde Medical Academy, Nitte University, Deralakatte, Mangalore - 575 018, India
,
Swathi N.
2   Post Graduate, Department of Microbiology, K S Hegde Medical Academy, Nitte University, Deralakatte, Mangalore - 575 018, India
,
Asha Pai
1   Assistant Professor, Department of Microbiology, K S Hegde Medical Academy, Nitte University, Deralakatte, Mangalore - 575 018, India
,
Rekha R.
3   Professor, Department of Microbiology, K S Hegde Medical Academy, Nitte University, Deralakatte, Mangalore - 575 018, India
,
Vimal K.
4   Professor & HOD, Department of Microbiology, K S Hegde Medical Academy, Nitte University, Deralakatte, Mangalore - 575 018, India
,
Ganesh H. R.
5   Tutor, Department of Microbiology, K S Hegde Medical Academy, Nitte University, Deralakatte, Mangalore - 575 018, India
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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


Publication History

Article published online:
26 April 2020

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  • References

  • 1 Prashanth K, Badrinath S. Nosocomial infections due to Acinetobacter species: Clinical findings, risk factors and prognostic factors. Indian J Med Microbiol 2006; 24:39-44.
  • 2 Deep A, Singhi S. Nosocomial infections in PICU. Pediar Today 2004; 783-92.
  • 3 Sinha M, Srinivasa H. Mechanisms of resistance to carbapenams in Meropenem resistant Acinetobacter isolates from clinical samples. Indian J Med Microbiol 2007; 25:121-125.
  • 4 Berogue-Berezin E, Towner KJ. Acinetobacter species as nosocomial pathogen:Microbiological, clinical and epidemiological. Clin Microbiol Rev 1996; 9:365-366.
  • 5 Vinodkumar CS, Neelagund F. Acinetobacter septicemia in neonates. Indian J Med Microbiol 2004; 22:71.
  • 6 Manikal VM, Landman D, Saurma G, Oydna E, Lal H, Quale J. Endemic carbapenam-resistant Acinetobacter species in Brooklyn, New York: Citywide prevalence, inter-institutional spread and relation to antibiotic usage. Clin Infect Dis 2000; 31:101-106.
  • 7 Bou G, Cervero G, Dominguez MA, Quereda C, Martinez-Beltran J. Characterization of a nosocomial outbreak caused by a multiresistant Acinetobacter baumanii strain with a carbapene-hydrolysing enzyme: High level carbapenem resistance in A.baumanii is nit due solely to the presence of beta-lactamase. J Clin Microbiol 2000; 38:3299-3305.
  • 8 Corbella X, Montero A, Pujol M, Dominguez MA, Ayats J, Argerich MJ et. Emergence and rapid spread of carbapenam-resistance during a large and sustained hospital outbreak og multiresistant Acinetobacter baumanii. J Clin Microbiol 2000; 38:4086-4095.
  • 9 Quale J, Bratu S, Landman D, Heddurshetti R. Molecular epidemiology and mechanism of Carbapenam-resistance in Acinetobacter baumanii endemic in New York city. Clin Infect Dis 2003; 37:214-220.
  • 10 Forster DH, Daschner FD. Acinetobacter species as nosocomial pathogens. Eur J Clin Microbiological Infect Dis 1998; 17:73-77.
  • 11 Peleg AY, Seifert H, Paterson DL. Acinetobacter baumanii:Emergence of a successful pathogen. Clin Microbiol Rev 2008; 21:538-582.
  • 12 Yang HY, Lee HJ, Suh JT, Lee KM. Outbreaks of Imipenem resistant Acinetobacter baumanii producing OXA-23 B-lactamase in a tertiary care hospital in Korea. Yonsei Med J 2009; 50:764-770.
  • 13 Feizabadi MM, Fathollahzadeh B, Taherikalani M, Rasoolinejad M, Sadeghifard N, Aligholi M et al. Antimicrobial susceptibility patterns and distribution of blaOXA genes among Acinetobacter species isolated from patients at Tehran hospital. Jpn J Infect Dis 2008; 61:274-278.
  • 14 Sofianou DC, Constandinidis TC, Yannacou M, Anastasiou H, Sofianos E. Analysis of risk factors for ventilator-associated pneumonia in a multidisciplinary intensive care unit. Eur J Clin Microbiol Infect Dis 2000; 19:460-463.