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2013, Number 104

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Rev Enfer Infec Pediatr 2013; 26.27 (104)

Acinetobacter Baumanni and antimicrobial resistance in a second level hospital of Mexico City

Ramirez SMLP, Moreno PFJ, Aranza AJL, Varela RMA, Vélez CG, Salcedo RR, Fajardo LMM, Pastrana JE

Language: Spanish
References: 29
Page: 300-306
PDF size: 282.80 Kb.


ABSTRACT

Summary: Acinetobacter baumannii is a gram negative bacilii that has become a very important nosocomial pathogen due to its capacity to develop resistance to both commonly used and restricted antibiotics, as well as being able to colonize and infect patients and persist in medical care facilities environment thanks to its capacity to survive on inanimate surfaces such as mechanical ventilators, mattresses, catheters and walls by being able to process carbon from different sources and reproduce despite varying levels of ph, temperature and humidity.
Objectives: Describe A. baumannii’s resistance to different antibiotics used in patients admitted from January 1st 2011 to May the 30th 2012 in Hospital General de Zon No. 32 “Mario Madrazo Navarro” of Instituto Mexicano del Seguro Social (HGZ32).
Material and Methods: A transverse, prospective, observational study was conducted; it included 50 different A. baumanni strains obtained from admitted adult and pediatric patients, each strain belonging to a patient was then isolated for further study.All strains were identified according to the methodology of the VITEK 2 automated system with ID GN cards; sensitivity tests were conducted through AST N82 cards with automated reading.
Results: 50 strains of A. Baumanni were isolated; 45 out of the previous 50 were obtained from bronchial mucus, 3 from catheter insertion sites and 2 from hemo-cultures. Antimicrobial susceptibility reported 100% resistance to the following antibiotics: ampicilin, ceftriaxone, ceftazidime, cefepime, aztreonam, ciprofloxacine, moxifloxacine, levofloxacine and nitrofurantoin. 20% resistance to Imipenem, 22% resistance to Meropenem.
Aminoglycoside such as Amikacin reported 38% resistance, gentamicin 28%, Tobramicin 72%, TMP-SMZ 98% and Tigecycline 0%.
Conclusion: It’s necessary to consider that physicians must always have prevention in mind which is why it is of the utmost importance to enforce 4 basic measures to prevent spreading of multi-drug-resistant nosocomial pathogens, which are: Proper and regular handwashing, exhaustive cleansing of hospital instruments and devices, temporary isolation of infected patients and rational antibiotic administration.


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