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

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2018-07-02 eCollection Date: 2018-01-01 DOI:10.1155/2018/9129083

Tuhina Banerjee, Anwita Mishra, Arghya Das, Swati Sharma, Hiranmay Barman, Ghanshyam Yadav

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引用次数: 49

Abstract

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 bla_IMP (89%), bla_VIM (51%), bla_NDM-1 (34%), and bla_OXA-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.

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印度瓦拉纳西某三级医院重症监护病房多重耐药不动杆菌的高流行率和流行率

在重症监护病房(ICU)越来越多的不动杆菌与医疗保健相关感染(HCAI)的出现是令人担忧的。本研究是一项以实验室为基础的审计，旨在确定印度北部瓦拉纳西一家三级医院成人ICU中与HCAI相关的不动杆菌的流行情况，并特别参考了5年来的抗菌素耐药性和耐药性决定因素。对993例HCAI进行分析。根据药敏记录对分离株进行多重耐药和扩展耐药(MDR/XDR)鉴定。随机选取100株鲍曼不动杆菌(A. baumannii)，采用最低抑菌浓度(MIC)法检测其对亚胺培南、美罗培南和多粘菌素B的敏感性，采用多重PCR法检测A类和B类碳青霉烯酶的存在。同时对ICU环境进行主动监测。不动杆菌相关医院获得性肺炎(HAP)高发，对亚胺培南(blaimp(89%)、blaVIM(51%)、blaNDM-1(34%)和blaoxa -23样基因(93%)有显著耐药。这些耐亚胺培南不动杆菌在我院ICU已达到地方性流行水平，应采取针对性干预措施加以控制。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.