Antibacterial Resistance Pattern of Acinetobacter baumannii in Burn Patients in Northeast of Iran

Background: Globally, Acinetobacter spp., most commonly, Acinetobacter baumannii, are one of the most common Gram-negative nosocomial infections, especially in Intensive Care Units (ICUs) and burn wards. Because of the pathogens’ ability to survive for a long time, the eradication of the pathogen from these wards remains a great concern. Simultaneously, the remarkable increase in antibacterial resistance among A. baumannii strains in recent years has raised a great deal of concern. Objectives: The study assessed the prevalence and antibacterial resistance pattern of A. baumannii in the only academic-affiliated burn center in northeastern Iran in 2012-2014. Methods: In this cross-sectional study, 5,080 samples from patients admitted to two burnt wards and one burn ICU were included. The samples were from different sources including wound tissue, blood, bronchial secretion, and urine. The antibacterial resistance pattern was determined using relevant antibiotics based on the Clinical and Laboratory Standards Institut (CLSI) instructions. Results: Acinetobacter spp. were found in 39% of the acquired cultures (1,985 out of 5,080) and 51.9% of bacterial positive cultures (1985 out of 3823). The resistance rate of Acinetobacter spp. against antibiotics varied from 0.9% for colistin to 100% for piperacillin-tazobactam. All Acinetobacter spp. were multidrug-resistant (MDR) due to considerable resistance to fluoroquinolones (95%), cephalosporins (93% 98%), penicillins (97%), carbapenems (94% 95%), and beta-lactamase inhibitors (87% 100%). Conclusions: Given that infections are a major cause of mortality in burn wards, the high prevalence of MDR isolates of Acinetobacter spp. in this burn center suggests that local antibiotic prescription policies should be revised and infection control strategies should be improved. Also, antibiotic cycling and restrict infection control strategies should be implemented in high-risk wards such as burn units.