“To Study the Molecular Characterization of Invasive CarbapenemResistant Acinetobacter baumannii with special reference to blaVIM genes in ICU patients at a Tertiary Care Centre, Uttar Pradesh, India”

Abstract

Introduction: Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important health problem for the treatment of infectious diseases. Carbapenems have historically been used as a last resort for treating MDR Gram-negative bacterial infections. There has been a recent surge in carbapenem resistance in A. baumannii. The majority of the carbapenem resistance mechanisms in A.
baumannii are due to enzymatic degradation by -lactamases. Aim And Objectives: To study the Molecular Characterization of Invasive CarbapenemResistant Acinetobacter baumannii with special reference to blaVIM gene in ICU patients at a Tertiary care centre, Uttar Pradesh. Material And Methods: This was a Cross sectional study carried out in the Department of Microbiology for a period of 1 year i.e, August 2022 to August 2023 at a tertiary care centre, Uttar pradesh. A total of 210 non-duplicate, consecutive, carbapenem-resistant isolates recovered from Acinetobacter species were included in this study. The isolates were obtained from the clinical  samples. The isolates were identified by the Standard biochemical tests and the Antimicrobial susceptibility testing was performed according to the CLSI guidelines 2022.
Results: In the present study a total of 926 clinical samples were collected out of which 210 Acinetobacter species were isolated. The maximum number of isolates were from the ETA samples with 132 (62.8%), 70 (33.3%) from blood and 8 (3.8%) from the tissue. The ratio of Males 124 (59%) was more as compared to that of the Females 86( 40%) with the maximum age of 31-40 being affected the most followed by 41-50 and least in the age group above 61 years of age. Antimicrobial susceptibility testing revealed that all the isolates were resistant to ceftazidime, cefepime, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, amikacin, netilmycin, tetracycline, tobramycin, levofloxacin and co-trimoxazole. In the present study it was also observed that 208 (98.5%) of the study isolates were susceptible to polymyxin B ( colistin). The Molecular characterization reveals that among 210 isolates tested for MBL, there were 11 isolates positive for the blaVIM gene (5.2%).
Conclusion: There should be continuous further research necessary to monitor the spread of carbapenem-resistant OXA-type lactamase genes from A. baumannii in hospital settings since they are becoming a significant cause of carbapenem resistance. . Effective infection control practises and strict guidelines for the use of antibiotics should be in place