Department of Microbiology, IMS & SUM Hospital, Bhubaneswar, Odisha, India.
Department of Virology, RMRC (ICMR), Bhubaneswar, Odisha, India.
Mol Biol Rep. 2024 Feb 24;51(1):357. doi: 10.1007/s11033-023-08982-5.
Acinetobacter baumanii (AB) is a bacterium of concern in the hospital setup due to its ability to thrive in unfavorable conditions and the rapid emergence of antibiotic resistance. Carbapenem resistance in this organism is disheartening, further clouded by the emergence of colistin resistance.
The present prospective study aims to note the epidemiology, molecular profile, and clinical outcome of patients with colistin resistance AB infections in a multispecialty tertiary care setup in Odisha, Eastern India.
All AB strains received from March 2021 to February 2022, identified by Vitek2 (Biomerieux) and confirmed by oxa-51 genes, were included. Carbapenem and colistin resistance were identified as per CLSI guidelines. Known mutations for blaOXA-23-like, blaIMP, blaVIM, blaKP, lpxA, lpxC, pmrA, pmrB, and plasmid mediated mcr (mcr1-5) were screened by conventional PCR techniques. The clinical outcome was noted retrospectively from case sheets. Data was entered in MS Excel and tabulated using SPSS software.
In the study period, 350 AB were obtained, of which 317(90.5%) were carbapenem resistant (CRAB). Among the CRAB isolates, 19 (5.9%) were colistin resistant (ABCoR). The most valuable antibiotics in the study were tigecycline (65.4% in ABCoI; 31.6% in ABCoR) and minocycline (44.3% in CI; 36.8% in CR). There was a significant difference in mortality among ABCoI and ABCoR infections. bla OXA was the predominant carbapenem resistance genotype, while pmrA was the predominant colistin resistant genotype. There were no plasmid mediated mcr genes detected in the present study.
鲍曼不动杆菌（AB）是一种在医院环境中值得关注的细菌，因为它能够在不利条件下生存，并且抗生素耐药性迅速出现。该菌对碳青霉烯类药物的耐药性令人沮丧，而多粘菌素耐药性的出现更是雪上加霜。
本前瞻性研究旨在记录印度东部奥里萨邦一家多专科三级保健机构中耐多粘菌素鲍曼不动杆菌感染患者的流行病学、分子特征和临床结局。
纳入 2021 年 3 月至 2022 年 2 月期间从 Vitek2（生物梅里埃）鉴定并通过 oxa-51 基因确认的所有 AB 株。根据 CLSI 指南鉴定碳青霉烯类和多粘菌素类耐药。通过常规 PCR 技术筛选 blaOXA-23-like、blaIMP、blaVIM、blaKP、lpxA、lpxC、pmrA、pmrB 和质粒介导的 mcr（mcr1-5）的已知突变。从病历中回顾性记录临床结局。数据输入 MS Excel 并使用 SPSS 软件进行制表。
在研究期间，共获得 350 株 AB，其中 317 株（90.5%）为碳青霉烯类耐药（CRAB）。在 CRAB 分离株中，有 19 株（5.9%）为多粘菌素耐药（ABCoR）。研究中最有价值的抗生素是替加环素（ABCoI 中 65.4%；ABCoR 中 31.6%）和米诺环素（CI 中 44.3%；CR 中 36.8%）。ABCoI 和 ABCoR 感染的死亡率有显著差异。bla OXA 是主要的碳青霉烯类耐药基因型，而 pmrA 是主要的多粘菌素耐药基因型。本研究未检测到质粒介导的 mcr 基因。
