Acinetobacter infections in intensive care unit patients at Al-Azhar University Hospitals in Assiut

Background: The increasing occurrence of Acinetobacter infections in intensive care units and among patients with weakened or compromised immune systems is a major concern for clinicians around the world. This is primarily due to the bacteria's remarkable capacity to develop resistance to various antibiotic classes, which significantly restricts the range of available treatment options. Objectives: Examine the patterns of healthcare-related infections and the resistance profiles of Acinetobacter species in the Intensive Care Units at Al-Azhar University Hospitals in Assiut. Methods: samples collected from 200 ICU patients with infections underwent direct microscopic examination and cultured on blood and MacConkey agar plates. The VITEK 2 automated microbiology system was utilized to perform species-level identification of Gram-negative bacilli that are oxidase-negative. The susceptibility profiles were evaluated using the Modified Kirby-Bauer disc diffusion technique. Results: Among 200 patients with infections, 9% (n=18) were identified as being infected with Acinetobacter species. This bacterium accounted for 13.8% of lower respiratory tract infections (LRTIs), 8.3% of wound infections, and 2.6% of urinary tract infections (UTIs). The most common species detected was Acinetobacter baumannii, making up 61.1% of the cases. Significant factors associated with Acinetobacter infections included extended ICU stays (p=0.03) and chronic obstructive pulmonary disease (COPD) (p=0.005). The most effective antibiotics were imipenem (83.3%), followed by ofloxacin (16.7%) and amikacin (5.6%). Notably, 55.5% (10 out of 18 isolates) were categorized as multidrug-resistant (MDR) Acinetobacter isolates. Conclusion: The rise in infections caused by Acinetobacter has posed a substantial challenge to healthcare systems. Patients who undergo invasive procedures, have extended ICU stays, or suffer from various underlying conditions are more susceptible to these infections. Successfully eliminating Acinetobacter spp. necessitates strict adherence to effective infection control measures and judicious use of antibiotics.