Prevalence of extremely drug resistant (xdr) acinetobacter baumannii at a northeast brazilian emergency hospital

Acinetobacter baumannii is an opportunistic pathogen that causes healthcare-associated infections, especially in intensive care units (ICUs). This study aimed to analyze the epidemiological and resistance profile of 106 patients hospitalized at an emergency hospital from Teresina, Piauí, Brazil, as well as, to investigate the resistance profile of A. baumannii strains isolated from these patients. To determine the occurrence of resistance mediated by efflux pump mechanism, minimum inhibitory concentration values of different antibiotics were determined in the presence or absence of carbonylcyanidem-chlorophenylhydrazone, a known efflux pump inhibitor. Many of the patients with healthcare-associeted infections (HAI) caused by A. baumannii in analizeted hospital were male (69%), aged20-60 years old (56.6%), with respiratory tract infections (77.3%). A high percentage of extremely drug resistant (XDR) strains (81.1%) was verified among A. baumannii clinicalisolates, with greater prevalence of resistance to gentamicin (98.0%), ceftriaxone (94.3%), ceftazidime (92.0%), ciprofloxacin(90.5%) and levofloxacin (90.5%). On the other hand, all strains were sensitive to colistin. Resistance mediated by efflux pump was verified for ceftazidime (26.4%), amikacin (16.0%) and ciprofloxacin (8.5%). These results point to a need for implementing preventive measures aiming to reduce the prevalence of multidrug-resistant A. baumannii strains in hospital environments.