Prevalence of Multidrug-Resistant and Carbapenem-Resistant Acinetobacter baumannii among Clinical Specimens in Baghdad, Iraq

Abstract

Background: Acinetobacter baumannii is a healthcare associated pathogen with marked capacity to develop multidrug resistance and carbapenem resistance. Local resistance data are essential for empirical antimicrobial therapy. Objective: This study investigated antibiotic resistance profiles of A. baumannii isolated from clinical specimens, determined the prevalence of multidrug resistant and carbapenem resistant isolates, and assessed associations with gender and specimen type in Baghdad, Iraq. Materials and Methods: A total of 220 clinical specimens were collected from patients in Baghdad. Isolates were identified using standard microbiological methods and the VITEK 2 Compact system. Multidrug resistance was defined as resistance to at least one agent in three or more antimicrobial classes, while carbapenem resistance was defined as resistance to carbapenem antibiotics. Data were analyzed using SPSS, R, and PAST, and statistical significance was set at 0.05. Results: Thirty nine non duplicate A.baumannii isolates were recovered. Urine was the most common source, accounting for 51.3 percent of isolates, and females represented 59 percent of cases. The highest resistance rates were recorded against cefotaxime, at 76.9 percent, and ampicillin sulbactam, at 61.5 percent, while colistin remained most active antibiotic, with 5.1 percent resistance. Rates of multidrug resistance and carbapenem resistance were 69.2 percent and 23.1 percent, respectively. Resistance patterns were more associated with specimen type than with gender. Conclusion: Multidrug resistant and carbapenem resistant A. baumannii isolates are prevalent among specimens in Baghdad, especially urine specimens. Continuous antimicrobial resistance surveillance and evidence based empirical therapy are needed to improve treatment decisions and limit resistance dissemination.