Antibiotic Sensitivity Pattern of Blood Isolates of Acinetobacter Species in a Tertiary Care Hospital: A Retrospective Analysis

Problem statement: Multi-drug resistant Acinetobacter bacterium is one of the major causes of sepsis in ICUs in tertiary care hospitals in India. In this report we describe the antibiotic sensitivity patterns of Acinetobacter species isolated from blood over a one year period at a tertiary care hospital. Approach: We retrospectively analyzed the sensitivity pattern of Acinetobacter species isolated from blood during the period 1/6/2010 to 31/5/2011. Isolation and identification were performed using the best alert system and VITEK2 respectively. Sensitivities were determined by Kirby Bauer disc diffusion and broth dilution using VITEK2 -AST cards. Results: The total number of Acinetobacter species isolated during the study period was 72, out of which 57 (79%) were A. baumanii, 7 (9.7%) were A. Iwofii and 3 (5.2%) were A. Junii. One each from A. calcoaceticus, A. ursingii and A. denitrificans were isolated. All of the baumanii isolates were sensitive to polymyxin B and 61.4% were sensitive to tigecycline. Only 25% of the isolates in baumanii group were sensitive to meropenem and imipenem. In the non-baumanii group however, 73% were sensitive to carbapenems. Conclusion: There is a very high incidence of resistance to most antibiotics, including carbapenems. All of the Acinetobacter isolates tested are sensitive to polymyxin B. Tigecycline is the only other drug with reasonable susceptibilities, but this drug is not recommended for primary bacteriemias. If Acinetobacter sepsis is suspected, empiric therapy with polymyxins, followed by de-escalation after sensitivity results are back, is advisable.