Antibiotic resistance pattern and prevalence of multi-drug and extensive resistant Acinetobacter baumannii isolates from clinical specimens after Military Operations western Iraq

Abstract

The main objective of this paper is to investigate the multi-drug resistance among A. baumannii isolates that are isolated from clinical specimens in Ramadi Teaching Hospital, after Military Operations western Iraq. The total number of patients who were culture positive was eighty-eight out of two hundred and thirteen (88%), during the period from April 2011 to June 2012. Thirty-one A. baumannii clinical isolates were selected. IPM-EDTA-disk synergy test was used for phenotypic expression of MBL producing A. baumannii and minimal inhibitory concentration (MIC) of antimicrobial susceptibility test by Vitek2 system for antibiotic resistance pattern and prevalence of multi-drug resistant A. baumannii. Twentyeight out of thirty-one isolates (90.32%) of A. baumannii were determined MBL producers by using IPM-EDTA-disk synergy test (positive), while twenty-seven out of thirty-one isolates (87%) were resistance to Imipenem by MICs obtained by VITEK-2. Results reported that all isolates (31 isolates/100%) of A. baumannii were Multi-drug resistant (MDR), while 27 isolates (87%) were Extensively Drug-Resistant (XDR) and ten isolates (32.25%) were Pan Drug-Resistant (PDR). Antibiotic resistance pattern showed all isolates exhibited a high rate of resistance (100%) to Ampicillin, Cefazolin, Cefoxitin, Nitrofurantoin, and Trimethoprim/sulfamethoxazole. Most isolates (96.7%) were resistance to Piperacillin/Tazobactam. Resistance to anther antibiotics varied among isolates of A. baumannii, were (93.5%) for Ceftriaxone and Cefepime, (90.3%) for Ampicillin/Sulbactam, (87%) for Imipenem and meropenem, (80.6%) for Gentamicin, (71%) for Ceftazidime, (67.7%) for Amikacin and Ciprofloxacin and (64.5%) for Tobramycin. Furthermore, the lowest resistance was to Levofloxacin (9.6%), while 58% of isolates (18/31) were sensitive to Levofloxacin