The prevalence of antibiotic-resistant Acinetobacter baumannii infections among the Iranian ICU patients

Keikha, Masoud; Karbalaei, Mohsen; Rahimi, Farid; Talebi Bezmin Abadi, Amin

The prevalence of antibiotic-resistant Acinetobacter baumannii infections among the Iranian ICU patients

Date

2023

Authors

Keikha, Masoud

Karbalaei, Mohsen

Rahimi, Farid

Talebi Bezmin Abadi, Amin

Abstract

Background: Global emergence of multidrug-resistant Acinetobacter baumannii is a significant challenge for hospitals, especially the ICUs. We aimed to assess the prevalence of resistance and resistance patterns of A. baumannii among patients admitted to Iranian ICUs. Methods: We systematically searched the major databases including the ISI Web of Science, PubMed, Scopus, Embase, Google Scholar, and local Iranian resources to collect all the relevant reports, published up to December 2021, on antibiotic-resistant A. baumannii cases among Iranian ICU patients. We assessed the prevalence of the resistance to certain antibiotics using event rates, corresponding to 95% confidence intervals by using the Comprehensive Meta-Analysis (Biostat V2.2) software. Results: The pooled prevalence of resistance to antibiotics was as follows: imipenem 85.9% (95% CI: 79.1–90.8), meropenem 88% (95% CI: 80.6–92.8), ceftriaxone 93.5% (95% CI: 85.2–97.3), ciprofloxacin 92.2% (95% CI: 86.7–95.6), gentamicin 81.8% (95% CI: 75.8–86.6), ceftazidime 92.2% (95% CI: 86.8–95.5), cefotaxime 93% (95% CI: 86.5–96.4), cefepime 91.9% (95% CI: 87–95.1), ampicillin-sulbactam 78.3% (95% CI: 67.1–86.4), amikacin 74.4% (95% CI: 68.3–79.6), netilmicin 40% (95% CI: 31.6–49), tobramycin 63.7% (95% CI: 53.1–73.1), tetracycline 76.3% (95% CI: 65.7–84.4), TMP-SXT 88.1% (95% CI: 79.7–93.4), rifampin 98.1% (95% CI: 94.9–99.3), polymyxin B 13.3% (95% CI: 7.3–23.3), and colistin 12.7% (95% CI: 4–34). Our results show that the prevalence of multidrug-resistant, extensively drug-resistant, metallo-β-lactamase-producing bacteria, and extended-spectrum β-lactamase-producing bacteria were ≈88.7, 72.8, 84.8, and 24.2%, respectively. Conclusion: Resistance of A. baumannii isolates to antibiotics among ICU patients in Iranian hospitals was higher than the reported international statistics, highlighting the need for comprehensive monitoring and infection-control procedures to reduce the spread of the drug-resistant A. baumannii in ICUs.