Determination of Colistin and Tigecycline Resistance Profile of Acinetobacter Baumannii Strains from Different Clinical Samples in a Territory Hospital in Turkey
Abstract
Material and Methods: For this study, 1,265 clinical samples (a samples from each patient) were obtained from various clinics, between; January 2015/December 2018. Identification was conducted by VITEK® 2 compact (bioMerieux, USA) and conventional biochemical tests. Antibiotic susceptibility tests were performed by VITEK 2, and the results of colistin and tigecycline were confirmed by E test and the broth microdilution method.
Results: A. baumannii strains (1,265) were most frequently isolated from tracheal aspirate, sputum and blood samples. At the same time, strains were obtained from intensive care units (70.4%) as well as other clinics (29.6%). The rates of colistin and tigecycline-resistant strains were determined using VITEK 2, E test and the broth microdilution methods as: 3.0%, 5.7%, 9.0% and 21.7%, 24.5%, 33.0%, respectively.
Conclusion: The determination of appropriate antibioticis are important for empirical treatment. Colistin and tigecycline have become prominent as an important, alternative agent in the treatment of A. baumannii-related infections. The results of this study show that colistin and tigecycline resistance rates in intensive care units have been increasing gradually over the years. Monitoring of resistance patterns of nonfermentative bacteria, isolated from intensive care units, is important for the immediate initiation of appropriate empirical treatment. In-vitro studies with A. baumannii strains should also be supported by clinical trials.
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Atik TK, Atik B, Kilinç O, Bektöre B, Duran H, Selek BM, et al. Epidemiological evaluation of an Acinetobacter baumannii outbreak observed at an intensive care unit. Saudi Med J 2018;39:767–72.
Grandesso S, Sapino B, Amici G, Mazzucato S, Solinas M, Gion M. Are E-test and Vitek 2 good choices for tigecycline susceptibility testing when comparing BMD for MDR and XDR Acinetobacter baumannii? New Microbiol 2014;37:503-8.
Zhao SY, Jiang DY, Xu PC, Zhang YK, Shi HF, Cao HL, et al. An investigation of drug-resistant Acinetobacter baumannii infections in a comprehensive hospital of East China. Annals of clinical microbiology and antimicrobials 2015;14:7
Turk HD, Kus H, Arslan U, Tuncer I. In vitro synergistic activity of sulbactam in combination with imipenem, meropenem and cefoperazone against carbapenem resistant Acinetobacter baumannii isolates. Bull Microbiol 2014;48:311-5.
Goic Barisic I, Tonkic M. The review of carbapenem resistance in clinical isolates of Acinetobacter baumannii. Acta Med Croatica 2009;63:285-96.
Eser OK, Ergin A, Tunçkanat F, Hasçelik G. In vitro activity of tigecycline as a therapeutic option against multidrug-resistant Acinetobacter spp. New Microbiol 2008;31:535-42.
Bouchillon SK, Iredell JR, Barkham T, Lee K, Dowzicky MJ. Comparative in vitro activity of tigecycline and other antimicrobials against gram-negative and gram-positive organisms collected from the Asia-Pacific Rim as part of the tigecycline evaluation and surveillance trial (TEST). Int J Antimicrob Agents 2009;33:130-6.
Li J, Nation RL, Milne RW, Turnidge JD, Coulthard K. Evaluation of colistin as an agent gainst multi-resistant gram-negative bacteria. Int J Antimicrob Agents 2005;25:11-25.
Li J, Nation RL, Turnidge JD, Milne RW, Coulthard K, Rayner CR, et al. Colistin: the re-emerging antibiotic for multidrugresistant gram negative bacterial infections. Lancet Infect Dis 2006;6:589-601.
Falagas ME, Karageorgopoulos DE. Pan-drug resistance (PDR), extensive-drug resistance (XDR), and multi-drug resistance (MDR) among gram-negative bacilli: need for international harmonization in terminology. Clin Infect Dis 2008;46: 1121-2.
The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters [homepage on the Internet]. Växjö: EUCAST; 2015 [cited 2019 May 9]. Available from: http://www.eucast.org/ fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_ tables/v_5.0_Breakpoint_Table_01.pdf
United States Food and Drug Administration. Breakpoint tables for interpretation of MICs and zone diameter [homepage on the Internet]. Silver Spring: USFDA; 2017 [cited 2019 May 9]. Available from: https://www.fda.gov/Drugs/Development ApprovalProcess/DevelopmentResources/ucm587585m
Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008; 21:538-82.
Odewale G, Adefioye OJ, Ojo J, Adewumi FA, Olowe OA. Multidrug resistance of Acinetobacter baumannii in Ladoke Akıntola Universıty Teaching Hospital, Osogbo, Nigeria. Eur J Microbiol Immunol 2016;6:238-43.
Sivaranjani V, Umadevi S, Srirangaraj S, Kali A, Seetha KS. Multi-drug resistant Acinetobacter species from various clinical samples in a tertiary care hospital from South India. Australas Med J 2013;6:697-700.
Biglari S, Hanafiah A, Ramli R, Rahman MM, Khaithir TMN. Clinico-epidemiological nature and antibiotic susceptibility profile of Acinetobacter species. Pak J Med Sci 2013;29:469.
Ferdous J, Murshed M, Shahnaz S, Duza SS, Siddique PR. Isolation of Acinetobacter species and their antimicrobial resistance pattern in a tertiary care hospital in Dhaka, Bangladesh. Bangladesh J Med Microbiol 2016;10:18-21.
Kwon SH, Ahn HL, Han OY, La HO. Efficacy and safety profile comparison of colistin and tigecycline on the extensively drug resistant Acinetobacter baumannii. Biol Pharm Bull 2014;37: 340-6.
Henwood CJ, Gatward T, Warner M, James D, Stockdale MW, Spence RP, et al. Antibiotic resistance among clinical isolates of Acinetobacter in the UK, and in vitro evaluation of tigecycline (GAR– 936). J Antimicrob Chemother 2002;49:479–87.
Abdulzahra AT, Khalil MAF, Elkhatib WF. First report of colistin resistance among carbapenem resistant Acinetobacter baumannii isolates recovered from hospitalized patients in Egypt. New Microbes New Infect 2018;26:53-8.
Elabd FM, Mohamed SZ. AlAyed MSZ, Asaad AM, Alsareii SA, Qureshi MA, et al. Molecular characterization ofoxacillinases among carbapenem resistant Acinetobacter baumannii nosocomial isolates in a Saudihospital. J Infect Public Health 2015;8: 242-7.
Rossi F, Girardello R, Cury AP, DiGioia TS, Almeida JN, Duarte AJ. Emergence of colistin resistance in the largest university hospital complex of Sao Paulo, Brazil, over five years. Braz J Infect Dis 2017;21:98-101.
Asif A, Cheema KH, Ashraf Z, Malik M, Imran F. Colistin resistance among gram-negative non fermentors isolated from patients at a tertiary care referral burn center. Pak J Pathol 2018;29:4-7.
Waites KB, Duffy LB, Dowzicky MJ. Antimicrobial susceptibility among pathogens collected from hospitalized patients in the United States and in vitro activity of tigecycline, a new glycylcycline antimicrobial. Antimicrob Agents Chemother 2006; 50:3479-84.
Alhaddad MS, AlBarjas AK, Alhammar LE, AlRashed AS, Badger Emeka LI. Molecular characterization and antibiotic susceptibility pattern of Acinetobacter baumannii isolated in intensive care unit patients in Al-Hassa, Kingdom of Saudi Arabia. Int J Appl Basic Med Res 2018;8:19-23.
Zarkotou O, Pournaras S, Altouvas G, Pitiriga V, Tziraki M, Mamali V, et al. Comparative evaluation of tigecycline susceptibility testing methods for expanded-spectrum cephalosporin and carbapenem-resistant gram-negative pathogens. J Clin Microbiol 2012;50:3747-50.
Bakthavatchalam YD, Veeraraghavan B, Shankar A, Thukaram B, Krishnan DN. Evaluation of colistin and polymyxin B susceptibility testing methods in Klebsiella pneumoniae and Acinetobacter baumannii. J Infect Dev Ctries 2018;12:504-7.
Arroyo LA, Curiel AG, Ibanez MEB, Llanos AC, Ruiz M, Pachon J, et al. Reliability of the E-test method for detection of colistin resistance in clinical isolates of Acinetobacter baumannii. J Clin Microbiol 2005;43:903-5.
Deng M, Zhu MH, Li JJ, Bi S, Sheng ZK, Hu FS, et al. Molecular epidemiology and mechanisms of tigecycline resistance in clinical isolates of Acinetobacter baumannii from a Chinese University Hospital. Antimicrob Agents Chemother 2014;58:297-13.
Casal M, Rodríguez F, Johnson B, Garduno E, Tubau F, Lejarazu OR, et al. Influence of testing methodology on the tigecycline activity profile against presumably tigecycline-nonsusceptible Acinetobacter spp. J Antimicrob Chemother 2009; 64:69-72.
Dafopoulou K, Zarkotou O, Dimitroulia E, Hadjichristodoulou C, Gennimata V, Pournaras S, Tsakris A. Comparative evaluation of colistin susceptibility testing methods among carbapenemnonsusceptible Klebsiella pneumoniae and Acinetobacter baumannii clinical isolates. Antimicrob Agents Chemother 2015; 59:4625-30.
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