Submitted: 12 Jan 2017
Accepted: 14 Feb 2017
ePublished: 09 May 2017
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Avicenna J Clin Microbiol Infect. 2017;4(3): 45454.
doi: 10.5812/ajcmi.45454
  Abstract View: 545
  PDF Download: 316

Research Article

Increasing Trend of Imipenem-Resistance Among Acinetobacter baumannii Isolated From Hospital Acquired Pneumonia in Northeast of Iran

Azad Khaledi 1, Omid Elahifar 1, Hossein Vazini 2, Mohammad Yousef Alikhani 3, Afsane Bahrami 4, Davoud Esmaeili 5, Kiarash Ghazvini 1*

1 Antimicrobial Resistance Research Center, Avicenna Research Institute, Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
2 Nursing Department Basic Sciences Faculty, Hamedan Branch, Islamic Azad University, Hamedan, IR Iran
3 Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
4 Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
5 Applied Microbiology Research Ccenter, and Microbiology Department, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
Corresponding author: Kiarash Ghazvini, MD., PhD, Ghaem Hospital, Ahmad Abad Avenue, Mashhad 91735, IR Iran. Tel: +98-9151248938, Fax: +98-5138409612, Ghazvinik@mums.ac.ir


Background: Nosocomial infections due to high mortality and economic cost are one of the most important challenges that hospitals face with it. Reports show that hospital acquired pneumonia (HAP) is the second most common nosocomial infection in some countries such as the United States.

Objectives: The aim was to study the frequency and resistance pattern of Acinetobacter baumannii isolates against imipenem.

Methods: This cross-sectional study was conducted for 2 years on patients with nosocomial pneumonia caused by A. baumannii in 2 major university hospitals in Mashhad, Iran. After detection and identification, data regarding mortality, length of hospital stay, and treatment were collected. Furthermore, the pattern of antibiotic resistance was investigated in A. baumannii against imipenem.

Results: In this study, among 700 patients with nosocomial pneumonia, 364 and 336 of those were male and female, respectively. All of these received imipenem. Of the total patients, 317 cases (45%) were resistant to imipenem. 84% of these patients were cured and the remaining 16% expired (P value = 0.001). A. baumannii resistance to the imipenem in both hospitals had an increasing rate. The resistance rate in the Ghaem hospital increased 96.6% at the end of the period compared to beginning of study (P value = 0.004). Also, a similar increase (94.7%) was observed in the Imam Reza hospital (P value = 0.003).

Conclusions: According to our results, excessive use of imipenem has been caused by antibiotic resistance, for this, the appropriate selective choice of antibiotics should be considered. At first, other antibiotics such as new generations of cephalosporins should be chosen for empirical treatment of A. baumannii.

Keywords: Imipenem, Hospital Acquired Pneumonia, Acinetobacter baumannii
Copyright © 2017, Hamadan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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