Study of Efflux Pump Genes (Ade A, Ade C Genes) in Acinetobacter Baumannii Isolated from Patients in National Liver Institute

Background: Acinetobacter baumannii is an opportunistic pathogen that has emerged as a major cause of hospital-acquired infections, particularly in intensive care units. It is known for its remarkable ability to survive in harsh environmental conditions and its resistance to a wide range of antibiotics, making it a significant threat to public health. Objectives: To study the relation of efflux pump genes (AdeA, AdeC) with the antibiotic resistant acinetobacter. Methodology: Bacteriological Samples were collected from 50 patients admitted to the National Liver Institute (NLI)with signs of infection, these samples were cultured on blood and MacConkey agar, identification of Acinetobacter was done by microscopy, colonies and biochemical tests and species was identified by using GN-ID cards from the VITEK-2 system. Antibiotic susceptibility testing was performed using VITEK2 AST-N73 cards, while the presence of AdeA and AdeC efflux pump genes was detected through Multiplex-PCR analysis. Results: Co- expression of the AdeA and AdeC efflux pump genes was detected in 68% of the bacterial isolates, a prevalence notably higher than the individual expression rates of AdeA (10%) and AdeC (4%). In contrast, 18% of isolates exhibited no detectable expression of either gene, A statistically significant correlation was observed between meropenem resistance and the presence of the AdeA gene. Similarly, a significant association was identified between levofloxacin resistance and the presence of the AdeC gene. Moreover, a significant difference in the distribution of AdeA and AdeC gene expression was observed between multidrug-resistant (MDR) isolates and nonMDR isolates. Conclusion: The presence of efflux pump genes AdeA and AdeC is strongly associated with high levels of antibiotic resistance in Acinetobacter spp., particularly among isolates obtained from intensive care unit (ICU) settings. Recommendation: Continuous surveillance of antimicrobial resistance patterns is important to guide the appropriate and effective use of antibiotics.