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Emergence of carbapenem-resistant Acinetobacter baumannii in hospitals in Pakistan
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
2014 (English)In: Journal of Medical Microbiology, ISSN 0022-2615, Vol. 63, no 1, 50-55 p.Article in journal (Refereed) Published
Abstract [en]

The emergence of pan-resistance in bacterial pathogens poses a threat to human health. Carbapenem-resistant Acinetobacter baumannii has emerged as a serious challenge, causing nosocomial infection and community-acquired outbreaks in hospitals globally, including in Pakistan. We collected 90 Acinetobacter isolates from patients with secondary or nosocomial infections from different hospitals in Pakistan and screened for carbapenem-resistant strains. Of the 90 isolates, 59 were resistant to carbapenems. Among oxacillinase -encoding genes, blaOXA-51-like was common in all isolates, including in combination with blaOXA-23-like in 14 isolates; however, blaOXA-24-like and blaOXA-58-like were completely absent. Among metallo-β-lactamase-encoding genes, only blaNDM-1 was found in one isolate, while the other three genes, blaIMP, blaVIM and blaSIM, were completely absent. None of the isolates was found to harbour the blaCTX-M gene. The isolates were also tested for susceptibilities to a panel of different antibiotics belonging to several classes. Of all the drugs tested, tigecycline was the most effective with 80 % sensitivity amongst isolates, followed by colistin with 50 % sensitivity. Three categories of resistance were found in these isolates: extreme drug resistance in 26, pan-drug resistance in 19 and multidrug resistance in 87 isolates. The isolates exhibited a high resistance to cephalosporins, trimethoprim-sulfamethoxazole and β-lactam antibiotics, followed by tetracycline and β-lactam/β-lactam inhibitor combination, fluoroquinolone and aminoglycosides. The results show a prominent level of antibiotic-resistance phenotypes in A. baumannii and strongly suggest the need for full-scale national surveillance of carbapenem-resistant A. baumannii with particular emphasis on the newly identified NDM-1 (New Delhi metallo-β-lactamase-1).

Place, publisher, year, edition, pages
2014. Vol. 63, no 1, 50-55 p.
National Category
Microbiology in the medical area Infectious Medicine
URN: urn:nbn:se:uu:diva-221850DOI: 10.1099/jmm.0.063925-0ISI: 000338478100007PubMedID: 24085817OAI: oai:DiVA.org:uu-221850DiVA: diva2:710170

Journal of medical microbiology, eISSN: 1473-5644

Available from: 2014-04-04 Created: 2014-04-04 Last updated: 2014-08-11Bibliographically approved

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