Abstract
Objective: Acinetobacter baumannii has emerged as a major nosocomial pathogen due to its remarkable ability to develop resistance to multiple antibiotics including carbapenems. The objective of this study was to assess the carbapenem resistance and detect carbapenem-resistant genes in clinical isolates of A. baumannii.
Methods: A cross-sectional study was conducted in Shahid Gangalal National Heart Centre, Kathmandu during February to September 2024. A total of 42 A. baumannii were isolated from different clinical specimens and identified. Antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method and carbapenemase production was assessed using modified carbapenem inactivation method and EDTA-carbapenem inactivation method. Carbapenem-resistant genes were detected through polymerase chain reaction. Among 1607 samples tested, 349 were culture positive for bacteria.
Results: The prevalence of A. baumannii was 12% (42/349). Among the 42 A. baumannii isolates, 88.1% were resistant to carbapenems. Metallo-β-lactamase production was observed in 35.7% and multidrug resistance in 83.3% isolates. Resistance rates were highest against cefotaxime, cefepime and carbapenems. The blaOXA-23 gene was detected in 69.1% of the isolates, blaNDM-1 in 66.7%, and blaVIM in 14.3%, but none of the isolates harbored the blaIMP. Co-occurrence of blaOXA-23 and blaNDM-1 genes was detected in 20 (47.6%) isolates, blaOXA-23, blaNDM-1 and blaVIM in 4 (9.5%) isolates, and blaNDM-1 and blaVIM in 1 (2.4%) isolate.
Conclusion: This study showed a high burden of carbapenems resistant and multi-drug resistant A. baumannii, likely contributed by the co-occurrence of carbapenem resistant genes. These findings provide valuable insights for clinical management and infection control of A. baumannii.
Keywords: Carbapenem resistance, MDR, Gene co-existence, Acinetobacter baumannii
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