Clonality of MDR/XDR Acinetobacter baumannii

Abstract

The rapid expansion of multi drug-resistant (MDR) and extremely drug-resistant (XDR) Acinetobacter baumannii over the last few decades is a rising health concern. This study evaluated the efficacy of last-line antibiotics against Acinetobacter baumannii isolates collected from Birdem Hospital, Dhaka, Bangladesh. Current study analyzed data from 50 confirmed A. baumannii isolates collected between October-November 2024. A. baumannii were cultured on selective media to isolate pure colonies at 44°C and the antibiograms for carbapenem drugs including colistin and others were determined by Vitek®2 along with traditional Kirby-Bauer disk diffusion method. Among the 50 isolates, 60% (30) were from female patients and 40% (20) from males. A significant number of samples (40%) were collected from ICU patients. Among the patients, 90% (45) were diabetic and 5% (5) were non-diabetic. Ventilator-associated pneumonia (38%) was the most common infection, followed by chronic kidney disease (32%) and acute kidney infection (26%). Out of the 50 isolates tested, 88% were identified as MDR, while 14% were classified as XDR. The prevalence of XDR and MDR A. baumannii strains were influenced by hyperglycemia. Also, the majority (44%) of the age group in this study was 51-70, which is a very vulnerable age group in terms of immune response. However, the second highest (34%) age group was 31-50 years which was alarming because it denoteed the severity of AMR among different age groups. The findings emphasized the urgent need for antimicrobial stewardship programs and alternative treatment strategies to combat MDR/XDR A. baumannii. Ongoing surveillance and research on resistance mechanisms are crucial for guiding clinical and policy decisions.