In Vitro Efficacy of Tetracyclines Against Multi Drug Resistant Acinetobacter Baumannii Amongest Intensive Care Patients

Abstract

Objective: To determine the anti-microbial susceptibility and frequency of A.baumannii, especially focusing the efficacy of Doxycycline and Minocycline against multi drug resistant (MDR) and extremely drug resist ant (XDR) A.baumannii in a tertiary care hospital. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Study conducted at the department of Pathology, Armed Forces Institute of Cardiology/ National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi Pakistan, from Jan 2020 to Dec 2021. Methodology: Data was collected by non-probability consecutive sampling. Antimicrobial susceptibility was assessed for A.baumanni isolated from hospital setting. Results: A total of 6239 culture specimens were received from different wards of AFIC. Out of these 1439 (23%) yielded growth of different pathogens. Amongst 1439 positive cultures, 167 (11.6%) were A.baumannii. Multi drug resistant (MDR) A.baumannii were 9(5.4%), extremely drug resistant (XDR) 152(91%) and pan drug resistant (PDR) were 6(3.6%). Antibiotic susceptibility of A. baumannii revealed highest resistance for cephalosporins and carbapenems about 162(97%), ampicillin and beta lactamase inhibitor combinations about 157(94%), quinolones 152(91%), aminoglycosides 134(80%) and Trimethoprim+ sulfamethoxazole 131(78%). The least resistance observed from tetracyclines group of antibiotics which was 34(20%) from Minocycline and 54(32%) from Doxycycline. Conclusion: A high resistant pattern was observed for A.baumanni against cephalosporins, carbapenems, ampicillin, beta lactamase inhibitor combinations, quinolones, aminoglycosides and Trimethoprim + sulfamethoxazole. Comparatively tetracycline antimicrobials i.e., minocycline and doxycycline were found to be less resistant than others to manage MDR and XDR cases.