Dash Muktikesh, Padhi Sanghamitra, Pattnaik Swetlana, Mohanty Indrani, Misra Pooja
Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India.
Avicenna J Med. 2013 Oct;3(4):97-102. doi: 10.4103/2231-0770.120501.
For the past two decades, Acinetobacter spp. have emerged as an important pathogen globally in various infections.
This study was conducted to determine the frequency, risk factors, and antibiotic resistance pattern of Acinetobacter spp. from various clinical samples.
This retrospective, hospital record-based, cross-sectional study included a total of 8749 clinical samples collected from patients at a tertiary care hospital in Odisha, India from July 2010 to December 2012. The samples were processed and identified by standard protocol. The Acinetobacter isolates were tested for antibiotic resistance by Kirby-Bauer disk diffusion method [according to the Clinical and Laboratory Standards Institute (CLSI) guidelines].
From 8749 clinical samples, 4589 (52.5%) yielded significant growth and only 137 (3%, 137/4589) Acinetobacter spp. were isolated. Maximum (56.9%) isolates were obtained from pus/swab, followed by blood (13.1%) and urine (12.4%). Elderly age, being inpatients, longer duration of stay in the hospital, associated co-morbidity, and invasive procedure were found to be significant risk factors in the setup investigated (P is less than 0.05). Out of 137 isolates, 75 (54.7%) were resistant to more than three classes of antibiotics (multidrug resistant) and 8 (5.8%) were resistant to all commonly used antibiotics (pan-drug resistant). Majority of the isolates were sensitive to imipenem, meropenem, and piperacillin/tazobactam, and showed resistance rates of 19%, 22%, and 23%, respectively. All eight pan-drug resistant isolates were 100% sensitive to colistin.
This hospital-based epidemiological data will help to implement better infection control strategies and improve the knowledge of antibiotic resistance patterns in our region.
在过去二十年中，不动杆菌属已成为全球各种感染中的重要病原体。
本研究旨在确定来自各种临床样本的不动杆菌属的频率、危险因素和抗生素耐药模式。
这项基于医院记录的回顾性横断面研究共纳入了2010年7月至2012年12月期间在印度奥里萨邦一家三级护理医院从患者身上采集的8749份临床样本。样本按照标准方案进行处理和鉴定。采用 Kirby-Bauer 纸片扩散法[根据临床和实验室标准协会（CLSI）指南]对不动杆菌分离株进行抗生素耐药性检测。
在8749份临床样本中，4589份（52.5%）有显著生长，仅分离出137株（3%，137/4589）不动杆菌属。分离株最多（56.9%）来自脓液/拭子，其次是血液（13.1%）和尿液（12.4%）。在所研究的环境中，老年、住院患者、住院时间较长、合并症以及侵入性操作被发现是显著的危险因素（P小于0.05）。在137株分离株中，75株（54.7%）对三类以上抗生素耐药（多重耐药），8株（5.8%）对所有常用抗生素耐药（泛耐药）。大多数分离株对亚胺培南、美罗培南和哌拉西林/他唑巴坦敏感，耐药率分别为19%、22%和23%。所有八株泛耐药分离株对黏菌素100%敏感。
这些基于医院的流行病学数据将有助于实施更好的感染控制策略，并提高我们地区对抗生素耐药模式的认识。
