Assessment of the antimicrobial sensitivity of Acinetobacter baumannii collected from the environment of neonatal ward of a rural hospital of Bangladesh

Abstract

Background: Healthcare associated infection caused by multi drug resistant Acinetobacter baumannii is not only becoming increasingly prevalent in hospital settings but also becoming a huge challenge for the healthcare system globally. It has already made space on the priority pathogen list by WHO for addressing growing global resistance to antimicrobial medicines (World Health Organization: WHO, 2017). Since it can survive under a wide range of environmental conditions for a prolonged period of time, it can cause outbreaks of nosocomial infection in healthcare settings. Objective: The objective of this study is to investigate the prevalence and assess the antimicrobial sensitivity of Acinetobacter baumannii collected from the environment of the neonatal ward of a rural healthcare facility of Bangladesh. Method: A total of 100 environmental samples were collected from different sites of the neonatal ward of the Zahid Memorial Children's Hospital of Faridpur district using proper protocol. After collection, these samples were transferred to the laboratory for proper identification and antimicrobial susceptibility testing which was done through Vitek-2 machine according to manufacturer’s guideline. Result: Among these 100 environmental samples, 31 Acinetobacter baumannii were isolated and 26% of these strains were multidrug resistant (MDR) and 10% were extremely drug resistant (XDR) bacteria. The antimicrobial susceptibility was determined based on minimum inhibitory concentration value according to the CLSI (Clinical and Laboratory Standards Institute) guideline and natural resistance across 14 different antimicrobial agents such as Piperacillin/Tazobactam, Ceftriaxone, Ceftazidime, Cefoperazone/Sulbactam, Cefepime, Imipenem, Meropenem, Amikacin, Gentamicin, Colistin, Ciprofloxacin, Levofloxacin, Minocycline, Trimethoprim/Sulfamethoxazole. Moreover, the presence of 13% carbapenem resistant Acinetobacter baumannii (CRAB) isolate is of great concern since according to CDC, the threat level of CRAB is urgent and requires immediate action (Carbapenem-resistant Acinetobacter | A.R. & Patient Safety Portal, n.d.). Conclusion: The presence of multi-drug resistant and extremely drug resistant strains of A. baumannii in hospital environments is concerning and poses a grave danger to the residing patients. To gain critical information of these resistant strains, further study should be done including whole genome sequencing (WGS) and genetic analysis for the control of nosocomial A. baumannii infection.