Al Bshabshe Ali, Joseph Martin R P, Al Hussein Ali, Haimour Waleed, Hamid Mohamed E
Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Department of Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Asian Pac J Trop Med. 2016 Sep;9(9):903-908. doi: 10.1016/j.apjtm.2016.07.016. Epub 2016 Jul 26.
To identify and to determine the antimicrobial susceptibility of Acinetobacter baumannii (A. baumannii) clinical isolates from ICU at Aseer Central Hospital.
The study was conducted in the Intensive Care Unit, Aseer Central Hospital, Saudi Arabia over 13 months period (2014-2015). Acinetobacter species (n = 105) were isolated from various clinical samples. Isolates were identified using selected phenotypic criteria and confirmed using the Vitek 2 automated system. This system was used to determine the susceptibilities of 21 antimicrobial agents. Patients, isolates and drug data were analyzed using the SPSS statistical software package to determine some epidemiological and microbiological patterns.
Of the 105 stains, A. baumannii accounted for 49 (46.67%), A. baumannii complex, 19 (18.09%), A. baumannii/haemolyticus 32 (30.47), Acinetobacter haemolyticus 4 (3.81%), Acinetobater lwoffii 1 (0.95%) and unidentified Acinetobater species 2 (1.3%). Of the 105 Acinetobacter strains, 103 (98.1%) were found multidrug resistant (MDR). A. baumannii strain were 100% sensitive to colistin and 74.5% to trimethoprim + sulfamethoxazole. The remaining 19 antimicrobial agents revealed low or no sensitivities: amikacin 16.3%; ampicillin 7.7%; ceftazidime, 7.3%. Distribution of similar sensitivities was shown by other Acinetobacter species. Mean number of isolates from males and females indicates no statistical variation (P = 0.867) whereas age groups showed significant differences (P = 0.008) as it is clear from the high percentage of infected individuals more than 60 years followed by those aged 20-29 years old (19.05%). Upper respiratory tract (30.48%), lower respiratory tract (47.65%) and subcutaneous tissue (9.5%) were the main sources of Acinetobacter spp. but mean numbers of isolates from these specimens indicate no discrepancy between specimens (P = 0.731).
Acinetobacter species including A. baumannii were found MDR (98.1%) according to the current Acinetobacter spp. antimicrobial categorization. Approximately half of these strains were A. baumannii. All Acinetobacter species were 100% sensitive to colistin and to some extent to trimethoprim + sulfamethoxazole (74.5%). ICU-acquired pneumonia among patients over 60 years of age who spend prolong times at artificial ventilations made up the majority of the cases.
鉴定并确定阿西尔中心医院重症监护病房鲍曼不动杆菌临床分离株的抗菌药敏情况。
本研究在沙特阿拉伯阿西尔中心医院重症监护病房进行，为期13个月（2014 - 2015年）。从各种临床样本中分离出不动杆菌属菌种（n = 105）。使用选定的表型标准进行分离株鉴定，并通过Vitek 2自动化系统进行确认。该系统用于确定21种抗菌药物的药敏情况。使用SPSS统计软件包对患者、分离株和药物数据进行分析，以确定一些流行病学和微生物学模式。
在105株菌株中，鲍曼不动杆菌占49株（46.67%），鲍曼不动杆菌复合群占19株（18.09%），鲍曼不动杆菌/溶血不动杆菌占32株（30.47%），溶血不动杆菌占4株（3.81%），洛菲不动杆菌占1株（0.95%），未鉴定的不动杆菌属菌种占2株（1.3%）。在105株不动杆菌菌株中，发现103株（98.1%）具有多重耐药性（MDR）。鲍曼不动杆菌菌株对黏菌素的敏感性为100%，对甲氧苄啶+磺胺甲恶唑的敏感性为74.5%。其余19种抗菌药物显示出低敏感性或无敏感性：阿米卡星为16.3%；氨苄西林为7.7%；头孢他啶为7.3%。其他不动杆菌属菌种也表现出类似的敏感性分布。男性和女性分离株的平均数量无统计学差异（P = ），而年龄组显示出显著差异（P = 0.008），因为60岁以上感染个体的比例很高，其次是20 - 29岁的个体（19.05%）。上呼吸道（30.48%）、下呼吸道（47.65%）和皮下组织（9.5%）是不动杆菌属菌种的主要来源，但这些标本的分离株平均数量在标本之间无差异（P = 0.731）。
根据当前不动杆菌属菌种的抗菌分类，包括鲍曼不动杆菌在内的不动杆菌属菌种具有多重耐药性（98.1%）。这些菌株中约一半是鲍曼不动杆菌。所有不动杆菌属菌种对黏菌素均100%敏感，对甲氧苄啶+磺胺甲恶唑在一定程度上敏感（74.5%）。60岁以上长时间接受人工通气的患者中，重症监护病房获得性肺炎占大多数病例。
