Doxycycline sensitivity in multidrug resistant Acinetobacter baumanii isolates from blood
Keywords:
Acinetobacter, blood, doxycycline, multidrugs resistance
Abstract
Background: Acinetobacter species has become a leading cause of blood stream infection in health care setting. Acinetobacter species possess a wide array of β-lactamases that hydrolyze and confer resistance to penicillins, cephalosporins and carbepenems. Doxycycline, a semisynthetic tetracycline, has effective antibacterial effect on multidrug resistant Acinetobacter species.Methods: Total numbers of 13,880 samples were received in 5 years for blood culture in brain heart infusion broth. Antimicrobial susceptibility testing was done on Mueller Hinton’s agar by Kirby Bauer Disc diffusion method as per the Clinical and Laboratory Standards Institute (CLSI) guidelines for the following antimicrobials: cefotaxime 30µg, ceftriaxone 30µg, cefoperazone 75µg, cefipime 30µg, cefoperazone+sulbactum 75/75 µg, gentamicin 10µg, amikacin 30µg, netilmicin 30µg, tobramycin 10µg ,ciprofloxacin 5µg, piperacillin+tazobactum 100/10 µg , Imipenem 10µg and doxycycline 30µg. Isolates resistant to atleast three drugs belonging to three different groups were considered to be multidrug resistant (MDR).Results: One hundred and fifty one isolates were identified as Acinetobacter baumanii. Majority of the isolates 101(66.88%) were from the patients between 0-10 years of age. 45% of the isolates were found to be multidrug resistant. Barring imipenem, doxycycline was found to have the best spectrum of activity with just 48.34% (73 isolates) resistanceConclusion: Rational and appropriate use of antimicrobial agents is of paramount importance to minimize the risk of resistant organism. Doxycycline can be used as an effective therapeutic agent in multidrug resistant Acinetobacter baumanii.References
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2. Ayan M, Durmaz R, Aktas E, Durmaz B. Bacteriological, clinical and epidemiological characteristics of hospital-acquired Acinetobacter baumannii infection in a teaching hospital. J Hosp Infect. 2003; 54: 39 –45.
3. Raffaele Z, Maria G, Federica T, Maria T, Athanassios T. Carbapenem resistance in Acinetobacter baumannii: the molecular epidemic features of an emerging problem in health care facilities. J Infect Dev Countries 2009; 3:335-41.
4. John SE, Milena G, Chao Q, Michael M, Michael JP, Marc HS..Impact of Carbapenem Resistance and Receipt of Active Antimicrobial Therapy on Clinical Outcomes of Bloodstream Infections.Antimicrob Agents Chemother. 2011;55: 4844–9.
5. Anton YP, Harald S, and David LP. Acinetobacter baumannii: Emergence of a Successful Pathogen. Clinical microbiology reviews 2008,21:538–82.
6. Sunenshine RH, Wright MO, Maragakis LL, Harris AD, Song X, Hebden J, et al. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis 2007;13:97–103.
7. Vila, J, Marcos A, Marco F, Abdalla S, Vergara Y, Reig J. In vitro antimicrobial production of β-lactamases, aminoglycoside modifying enzymes, and chloramphenicol acetyltransferase by and susceptibility of clinical isolates of Acinetobacter baumannii. Antimicrobial Agents and Chemotherapy 1993; 37:138–41.
8. Collee JG, Fraser AG, Marmion BP, Simmons A. Mackey and McCartney practical Medical Microbiology. In: Collee JG, Miles RS, Watt B, ed: Tests for the identification of Bacteria. 14th ed. New Delhi, India: Elsevier, 2006: 131-49.
9. Clinical and Laboratory Standards Institute 2003. Performance standards for antimicrobial susceptibility testing: Eighteenth informational supplement: Approved standards M100-S18. Clinical and Laboratory Standards Institute, Baltimore, USA.2008
10. Manchanda V, Sanchaita S, Singh NP. Multidrug resistant Acinetobacter. Symposium on infectious agents in a multidrug resistant globe 2010; 2: 291-304.
11. Rizvi M, Fatima N, Rashid M, et al. Extended spectrum AmpC and metallo-beta-lactamases in Serratia and Citrobacter spp. in a disc approximation assay. J Infect Dev Ctries. 2009;3:285-94.
12. Kuo SC, Chang SC, Wang HY, Lai JF, Chen PC, Shiau YR. Emergence of extensively drug-resistant Acinetobacter baumannii complex over 10 years: Nationwide data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program. BMC Infectious Diseases 2012;12:200
13. Rasha AN, Attalah MF. Molecular Epidemiology of Nosocomial Acinetobacter baumannii Isolates. Nature and Science. 2012;10:76-82
14. Patwardhan RB, Dhakephalkar PK, Niphadkar KB, Chopade BA. A study on nosocomial pathogens in ICU with special reference to multiresistant Acinetobacter baumannii harbouring multiple plasmids. Indian J Med Res. 2008;128:178-87.
15. Maleki MH, Sekawi Z, Suroush S, Jalilan FA, Asadollahi K, Mohammadi E, et al. Phenotypic and genotypic characteristics of tetracycline resistant Acinetobacter baumannii isolates from nosocomial infections at Tehran hospitals. Iran J Basic Med Sci. 2014; 17:21-6.
16. Peter A L. Safety and Efficacy of Doxycycline. Clinical Medicine: Therapeutics 2009: 1; 1069 –72 .
17. Kogawa AC, Salgado HRN. Doxycycline hyclate: a review of properties, applications and analytical methods. International journal of life science and pharma research. 2012; 2: 11 -25.
Published
2014-07-20
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