Vol 11, Special issue 2, 2018 Online - 2455-3891 Print - 0974-2441 PREVALENCE AND DRUG RESISTANCE IN ACINETOBACTER SP. ISOLATED FROM INTENSIVE CARE UNITS PATIENTS IN PUNJAB, INDIA TANVIR KAUR 1 *, CHAYANIKA PUTATUNDA 2 , AROMA OBEROI 3 , ASHISH VYAS 1 , GAURAV KUMAR 1 1 Department of Microbiology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara - 144 402, Punjab, India. 2 Department of Microbiology, DAV University, Jalandhar - 144 012, Punjab, India. 3 Department of Microbiology, Christian Medical College and Hospital, Ludhiana - 141 008, Punjab, India. Email: tanvirkaur132@gmail.com Received: 05 April 2018, Revised and Accepted: 11 July 2018 ABSTRACT Objective: This study was designed to study the prevalence and antibiotic susceptibility patterns of Acinetobacter sp. as isolated from patients lodged in intensive care units (ICUs) of a tertiary care hospital, Ludhiana, Punjab, India. Methods: The clinical samples were simultaneously streaked on Blood agar and MacConkey agar. The identification of the bacterial isolates was carried out with the aid of Gram stain, motility test and along with a combination of other commonly employed biochemical tests. The antimicrobial susceptibility testing (AST) of all the bacterial isolates was carried out on Muller-Hinton agar through Kirby-Bauer disc diffusion method. Results: Acinetobacter sp. formed a fair allowance contributing at 42% among all ICU culture positive samples. The respiratory tract samples had a major share at 63.15% for all samples attributed to be positive for Acinetobacter sp. nosocomial etiology. The antibiotic sensitivity pattern portrayed that more than 95% of Acinetobacter sp. isolates were multiple drug resistant (MDR) whereas >50% Acinetobacter sp. showed extensive drug resistant (XDR). The last resort for such Acinetobacter sp. nosocomial infections is left to colistin and polymyxin B. Conclusion: Acinetobacter sp. is a highly prevalent microorganism among ICU patients of Ludhiana, Punjab, India, while its potential to acquire resistance toward commonly used antibiotics represents it as a grave threat to the health-care industry, therefore signifying the need for its regular monitoring in the health-care setups. Keywords: Acinetobacter sp., Intensive care units, Nosocomial infections, Drug resistance. INTRODUCTION Acinetobacter sp. is being credited as an omnipresent, Gram-negative coccobacilli, belonging to the family Moraxellaceae [1]. The bacteria are saprophytic, non-fastidious, rigidly aerobic, non-motile and known to exhibit pleomorphism. They form a part of the normal resident flora of the skin, respiratory, and intestinal tract [2]. Acinetobacters are oxidase negative organisms with an affirmation for catalase test. The genus includes 34 species of which 25 have valid names while the other 9 are named after their genomic group of which Acinetobacter baumannii is frequently ascribed in human infections [1]. The members of Acinetobacter sp. are extensively prevalent in soil, water, humans, and animals [3]. They have extraordinary ability to grow at a wide range of temperatures and pH, to survive on moist and dry surfaces, tolerate exposure to various commonly used disinfectants thereby allowing some Acinetobacter species (A. baumannii, A. iwoffii, and A. haemolyticus) to thrive well in hospital environment too [3]. The Acinetobacter sp. is found to be the second most common Gram-negative pathogen isolated from clinical samples after Pseudomonas aeruginosa [4]. The prevalence of A. baumannii is highly seen among debilitated or immunocompromised patients especially those who have experienced greater than 90 days of hospital stay [5]. A. baumannii is attributed to cause nosocomial or hospital-acquired infections (HAIs), particularly in patients those who have been lodged in intensive care units (ICUs) on account of having a breach in their immunity by one means or the other. The risk factors in ICUs include presence of indwelling urinary catheters, central venous lines, ventilator or other intubations, exposure to broad-spectrum antibiotics, immunosuppression in lieu of any underlying disease as diabetes mellitus, and HIV, peritoneal dialysis, neurosurgical interventions, or any other surgical procedures [6-9]. The most common HAIs caused by A. baumannii include bacteremia, genital and urinary tract infections (UTIs), iatrogenic or secondary meningitis, and infective endocarditis along with wound and burn infections [10]. The European ICU surveillance data (2009) showed that Acinetobacter sp. was credited at 11.9–21.8% times in ICU acquired infections [1]. The highlighting problem with Acinetobacter infections is its capability to acquire high-grade innate resistance against all commonly used antibiotics (multiple drug resistance [MDR]) with a stupendous overall mortality rate of 26–68% [11-13]. The MDR ability of Acinetobacter sp. can be explained on account of its ability to portray different mechanisms as synthesis of β-lactamases and other antibiotic modifying enzymes, overexpression of efflux pumps, loss of porin channels across the cellular membranes, target mutations along with mutations in ribosomes or lipopolysaccharide structure [14]. The lack of standard identification techniques makes identification of Acinetobacter sp. a cumbersome task. The studies done to depict the status and gravity of Acinetobacter infections all over the world shows a grim picture. With respect to the Indian subcontinent, the studies done in context with Acinetobacter sp. exhibits it as one of the most frequent and commonly isolated pathogens especially prevalent in ICUs of tertiary care hospitals which are otherwise considered as “Mecca of recovery.” The antibiotic susceptibility tests thoroughly decipher the MDR nature of the Acinetobacters along with their inborn ability to depict high-grade resistance even to the last resort antibiotics as carbapenems and colistin. Hence, this study was designed to have an © 2018 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2018.v11s2.28590 Research Article Recent Trends in Biomedical Sciences-2018 (RTBS-2018)