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Int. J. Environ. Res. Public Health 2018, 15(1), 153; https://doi.org/10.3390/ijerph15010153

High Proportions of Multidrug-Resistant Acinetobacter spp. Isolates in a District in Western India: A Four-Year Antibiotic Susceptibility Study of Clinical Isolates

1
Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden
2
Bac-Test Laboratory, College Road, Nashik 422005, Maharashtra, India
3
Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain 456006, India
Contributed equally.
*
Author to whom correspondence should be addressed.
Received: 9 December 2017 / Revised: 12 January 2018 / Accepted: 17 January 2018 / Published: 19 January 2018
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
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Abstract

The purpose of the study was to determine the proportions of multidrug-resistant (MDR) Acinetobacter spp. isolates from the district of Nashik in Western India during the period from 2011–2014. Antibacterial susceptibility testing of isolates from inpatients and outpatients was performed using Kirby–Bauer disc diffusion method to determine inhibitory zone diameters. Proportions of non-susceptible isolates were calculated from the antibacterial susceptibility data. MDR was defined as an isolate being non-susceptible to at least one antibacterial agent in at least three antibacterial categories. The change in proportions of MDR isolates; extended-spectrum β-lactamase (ESBL)-producing isolates; and non-susceptible isolates to specific antibacterial categories over calendar time was investigated by logistic regression. The proportions of MDR and ESBL-producing isolates ranged from 89.4% to 95.9% and from 87.9% to 94.0%; respectively. The proportions of non-susceptible isolates to aminoglycosides; carbapenems; antipseudomonal penicillins/β-lactamase inhibitors; cephalosporins; folate pathway inhibitors; or penicillins/β-lactamase inhibitors exceeded 77.5%. Proportions of fluoroquinolone and tetracycline non-susceptible isolates ranged from 65.3% to 83.3% and from 71.3% to 75.9%; respectively. No changes in trends were observed over time; except for a decreasing trend in fluoroquinolone non-susceptible isolates (OR = 0.75 (95% CI, 0.62–0.91)). Significantly higher proportions of non-susceptible; MDR and ESBL-producing isolates were found among isolates from the respiratory system compared to isolates from all other specimen types (p < 0.05). High proportions of MDR Acinetobacter spp. isolates were observed in the period from 2011–2014. Antimicrobial stewardship programmes are needed to prevent the emergence and spread of antibiotic resistance. View Full-Text
Keywords: Acinetobacter; India; multidrug resistance; antibiotic resistance; antibacterial susceptibility testing Acinetobacter; India; multidrug resistance; antibiotic resistance; antibacterial susceptibility testing
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Odsbu, I.; Khedkar, S.; Khedkar, U.; Nerkar, S.S.; Tamhankar, A.J.; Stålsby Lundborg, C. High Proportions of Multidrug-Resistant Acinetobacter spp. Isolates in a District in Western India: A Four-Year Antibiotic Susceptibility Study of Clinical Isolates. Int. J. Environ. Res. Public Health 2018, 15, 153.

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