Antibiotic resistance pattern of Acinetobacter species in Kuwait hospitals

Abstract number: P1712

Al-Sweih N., Al-Hubail M., Rotimi V.

Objective: As high and increasing resistance of Acinetobacter spp to many potential therapeutic agents limit the choice of appropriate therapy, this study was carried out to determine the resistance pattern of strains causing clinically proven infections and those associated with mere colonisation.

Methods: A total of 250 consecutive isolates were collected from infected and colonised patients in 8 major hospitals in Kuwait. They were identified by VITEK-2 and their susceptibility to 18 antibiotics determined by Etest method. Susceptibility and resistance were assessed according to the recommended criteria of the CLSI and FDA for tigecycline. Metallo-b-lactamase (MBL) production was detected by the MBL Etest method.

Results: Resistance to many of the tested antibiotics were very high, in particular to amikacin (82.8%), gentamicin (68.4%), cefepime (69.6%), ciprofloxacin (73.2%) and piperacillin-tazobactam (71.2%). It is note-worthy that, in this study, resistance to tigecycline was as high as 13.6%. Similarly, of clinical importance were the resistance rates of 25.2, 37.3 and 12% to imipenem, meropenem and colistin, respectively. The overall prevalence of MBL was 37.2%. Both MIC50 and MIC90 of amikacin, cefotaxime, ceftazidime, cefepime and piperacillin-tazobactam were each 256 ug/ml, while MIC50 and MIC90 of imipenem, meropenem, tigecycline and colistin were 1.5 and 32, 3 and 32, 0.38 and 3, 1 and 3, respectively. Interestingly, only 36% of MBL-positive strains were from infected patients, with the highest rate (48.3%) from Mubarak hospital followed by 44.9% from Al-Jahra hospital.

Conclusion: Multi-resistant Acinetobacter spp is highly prevalent in our hospitals and has reached an alarming level which justifies continuous surveillance and stringent infection control measures to control its spread.