The multidrug resistant profile of Acinetobacter spp.isolated from clinical samples in a tertiary care hospital from western Rajasthan, India

Background: Acinetobacter species are aerobic Gram-negative coccobacilli, which have emerged as significant nosocomial pathogen and are responsible for intermittent hospital outbreaks. Acinetobacter species are the second most common isolated non-fermenters in human specimens after Pseudomonas spp. and emerged as multidrug resistant superbug in nosocomial infections. This study was conducted to isolate Acinetobacter species from various clinical samples by conventional and automated method (Siemen Microscan WalkAway) identification protocol and to determine the antibiotic susceptibility pattern of these isolates. Methods and materials: This is a retrospective observational study conducted in tertiary care hospital from January 2013 to May 2019. Acinetobacter species were isolated & identified by standard bacteriological methods from various clinical samples like pus, wound swab, urine, blood, sputum, BAL, tracheal aspirates, CSF & other body fluids received in Department of Microbiology for culture isolation. Antibiotic susceptibility profile was determined by Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: Out of 42,575 clinical samples processed, Acinetobacter spp. was isolated in 439 (1.03%); pyogenic infection (41.66%) was the most common source followed by respiratory tract infections (33.75%), UTI (15.31%), blood stream infections (7.20%) and CSF (2.02%). Acinetobacter species was isolated predominately from male patients and among age group of 61–70 years. Most Acinetobacter species clinical isolates were isolated from ICU, followed by trauma ward, inpatients and OPD patient. Acinetobacter baumannii was the commonest species isolated followed by Acinetobacter lwoffii. Maximum drug resistance was seen in gentamycin 62.64%, followed by piperacillin-tazobactam 62.18%, amikacin 56.94%, cefepime 55.58% and imipenem 53.3%. while less resistance was observed in colistin, polymyxin B, ampicillin-sulbactam (0.91%). Conclusion: Due to emergence of unpredictable multidrug resistance patterns of clinical strains of Acinetobacter, it is imperative to know the institutional prevalent susceptibility profiles so that local antibiotic policy can be made to start empirical antibiotic therapy.