High Prevalence and Endemicity of Multidrug Resistant Acinetobacter spp. in Intensive Care Unit of a Tertiary Care Hospital, Varanasi, India

Abstract EN

The increasing emergence of Acinetobacter spp.

with healthcare associated infections (HCAI) in intensive care units (ICU) is alarming.

This study was a laboratory-based audit to determine the prevalence of Acinetobacter spp.

associated with HCAI in the adult ICU of a tertiary care hospital in Varanasi, north India, with special reference to antimicrobial resistance and resistance determinants over a period of 5 years.

A total of 993 cases of HCAI were analyzed.

Isolates were characterized as multidrug resistance and extended drug resistance (MDR/XDR) based on antimicrobial susceptibility records.

Few (100) randomly selected isolates of Acinetobacter baumannii (A.

baumannii) were tested for imipenem, meropenem, and polymyxin B susceptibility by minimum inhibitory concentration (MIC) and for the presence of class A and B carbapenemases by multiplex PCR.

Active surveillance of ICU environment was also performed.

High prevalence of Acinetobacter related hospital acquired pneumonia (HAP) with significant resistance to imipenem (p<0.05) and 88.02% MDR and 61.97% XDR was detected along with persistence in the ICU environment.

The isolates harbored blaIMP (89%), blaVIM (51%), blaNDM-1 (34%), and blaOXA-23-like (93%) genes.

Specific interventional measures should be adopted to control these imipenem resistant Acinetobacter spp.

which have attained the level of endemicity in our ICU setup.