National clinical bacteriology and mycology reference laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
The Global One Health Initiative, The Ohio State University, Columbus, OH, United States of America.
PLoS One. 2021 Apr 29;16(4):e0250896. doi: 10.1371/journal.pone.0250896. eCollection 2021.
Acinetobacter species have been a leading cause of nosocomial infections, causing significant morbidity and mortality over the entire world including Ethiopia. The most important features of A. baumannii are its ability to persist in the hospital environment and rapidly develop resistance to a wide variety of antibiotics. This study aimed to determine trend of antimicrobial resistance in Acinetobacter species over a five years period.
A retrospective data regarding occurrence and antimicrobial resistance of Acinetobacter species recovered from clinical specimens referred to the national reference laboratory was extracted from microbiology laboratory data source covering a time range from 2014 to 2018. Socio-demographic characteristics and laboratory record data was analyzed using SPSS 20.
A total of 102 strains of Acinetobacter species were analyzed from various clinical specimens. Majority of them were from pus (33.3%) followed by blood (23.5%), urine (15.6%) and body fluid (11.7%). Significant ascending trends of antimicrobial resistance was shown for meropenem (12.5% to 60.7%), ceftazidime (82.1% to 100%), ciprofloxacin (59.4% to 74.4%), ceftriaxone (87.1% to 98.6%), cefepime (80.0% to 93.3%) and pipracillin- tazobactam (67.8% to 96.3%). However, there was descending trend of antimicrobial resistance for tobramycin (56.5% to 42.8%), amikacin (42.1% to 31.4%) and trimethoprim-sulfamethoxazole (79.0 to 68.2%). The overall rate of carbapenem non-susceptible and multidrug resistance rates in Acinetobacter species were 56.7% and 71.6%.respectively.
A five year antimicrobial resistance trend analysis of Acinetobacter species showed increasing MDR and resistance to high potent antimicrobial agents posing therapeutic challenge in our Hospitals and health care settings. Continuous surveillance and appropriate infection prevention and control strategies need to be strengthened to circumvent the spread of multidrug resistant pathogens in health care facilities.
不动杆菌属已成为医院感染的主要原因，在包括埃塞俄比亚在内的全球范围内造成了大量的发病率和死亡率。鲍曼不动杆菌最重要的特征是其能够在医院环境中持续存在，并迅速对各种抗生素产生耐药性。本研究旨在确定五年期间不动杆菌属对抗菌药物的耐药趋势。
从 2014 年至 2018 年的微生物实验室数据来源中提取了国家参考实验室收到的临床标本中分离出的不动杆菌属发生情况和抗菌药物耐药性的回顾性数据。使用 SPSS 20 分析社会人口统计学特征和实验室记录数据。
从各种临床标本中分析了总共 102 株不动杆菌属。其中大多数来自脓液（33.3%），其次是血液（23.5%）、尿液（15.6%）和体液（11.7%）。美罗培南（12.5%至 60.7%）、头孢他啶（82.1%至 100%）、环丙沙星（59.4%至 74.4%）、头孢曲松（87.1%至 98.6%）、头孢吡肟（80.0%至 93.3%）和哌拉西林他唑巴坦（67.8%至 96.3%）的抗菌药物耐药性呈显著上升趋势。然而，庆大霉素（56.5%至 42.8%）、阿米卡星（42.1%至 31.4%）和复方磺胺甲噁唑（79.0%至 68.2%）的抗菌药物耐药性呈下降趋势。不动杆菌属的碳青霉烯类药物非敏感性和多重耐药率分别为 56.7%和 71.6%。
五年的不动杆菌属抗菌药物耐药趋势分析表明，MDR 和对高效抗菌药物的耐药性增加，给我们的医院和医疗保健环境带来了治疗挑战。需要加强持续监测和适当的感染预防和控制策略，以避免在医疗机构中传播多药耐药病原体。
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