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Microbiology Society, Journal of Medical Microbiology, 1(63), p. 50-55, 2014

DOI: 10.1099/jmm.0.063925-0

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Emergence of carbapenem-resistant Acinetobacter baumannii in hospitals in Pakistan

Journal article published in 2014 by Badrul Hasan, Khalida Perveen ORCID, Björn Olsen, Rabaab Zahra
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

The emergence of pan-resistance in bacterial pathogens poses a threat to human health. Carbapenem-resistant Acinetobacter baumannii has emerged as a serious challenge, causing nosocomial infection and community-acquired outbreaks in hospitals globally, including in Pakistan. We collected 90 Acinetobacter isolates from patients with secondary or nosocomial infections from different hospitals in Pakistan and screened for carbapenem-resistant strains. Of the 90 isolates, 59 were resistant to carbapenems. Among oxacillinase -encoding genes, bla OXA-51-like was common in all isolates, including in combination with bla OXA-23-like in 14 isolates; however, bla OXA-24-like and bla OXA-58-like were completely absent. Among metallo-β-lactamase-encoding genes, only bla NDM-1 was found in one isolate, while the other three genes, bla IMP, bla VIM and bla SIM, were completely absent. None of the isolates was found to harbour the bla CTX-M gene. The isolates were also tested for susceptibilities to a panel of different antibiotics belonging to several classes. Of all the drugs tested, tigecycline was the most effective with 80 % sensitivity amongst isolates, followed by colistin with 50 % sensitivity. Three categories of resistance were found in these isolates: extreme drug resistance in 26, pan-drug resistance in 19 and multidrug resistance in 87 isolates. The isolates exhibited a high resistance to cephalosporins, trimethoprim–sulfamethoxazole and β-lactam antibiotics, followed by tetracycline and β-lactam/β-lactam inhibitor combination, fluoroquinolone and aminoglycosides. The results show a prominent level of antibiotic-resistance phenotypes in A. baumannii and strongly suggest the need for full-scale national surveillance of carbapenem-resistant A. baumannii with particular emphasis on the newly identified NDM-1 (New Delhi metallo-β-lactamase-1).