High Prevalence and Endemicity of Multidrug Resistant Acinetobacter spp. in Intensive Care Unit of a Tertiary Care Hospital, Varanasi, India

Tuhina Banerjee; Anwita Mishra; Arghya Das; Swati Sharma; Hiranmay Barman; Ghanshyam Yadav

doi:10.1155/2018/9129083

High Prevalence and Endemicity of Multidrug Resistant Acinetobacter spp. in Intensive Care Unit of a Tertiary Care Hospital, Varanasi, India

J Pathog. 2018 Jul 2:2018:9129083. doi: 10.1155/2018/9129083. eCollection 2018.

Authors

Tuhina Banerjee¹, Anwita Mishra¹, Arghya Das¹, Swati Sharma¹, Hiranmay Barman², Ghanshyam Yadav²

Affiliations

¹ Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
² Department of Anaesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.

Abstract

The increasing emergence of Acinetobacter spp. with healthcare associated infections (HCAI) in intensive care units (ICU) is alarming. This study was a laboratory-based audit to determine the prevalence of Acinetobacter spp. associated with HCAI in the adult ICU of a tertiary care hospital in Varanasi, north India, with special reference to antimicrobial resistance and resistance determinants over a period of 5 years. A total of 993 cases of HCAI were analyzed. Isolates were characterized as multidrug resistance and extended drug resistance (MDR/XDR) based on antimicrobial susceptibility records. Few (100) randomly selected isolates of Acinetobacter baumannii (A. baumannii) were tested for imipenem, meropenem, and polymyxin B susceptibility by minimum inhibitory concentration (MIC) and for the presence of class A and B carbapenemases by multiplex PCR. Active surveillance of ICU environment was also performed. High prevalence of Acinetobacter related hospital acquired pneumonia (HAP) with significant resistance to imipenem (p<0.05) and 88.02% MDR and 61.97% XDR was detected along with persistence in the ICU environment. The isolates harbored bla_IMP (89%), bla_VIM (51%), bla_NDM-1 (34%), and bla_OXA-23-like (93%) genes. Specific interventional measures should be adopted to control these imipenem resistant Acinetobacter spp. which have attained the level of endemicity in our ICU setup.