Acinetobacter - A Hard to Treat Resilient ICU Pathogen

Objective: To isolate Acinetobacter sp and identify MDR (multidrug resistant) and XDR (extensively drug resistant) isolates from intensive care unit in a tertiary care hospital, Lahore. Methodology: This cross-sectional research was performed retrospectively in a tertiary care hospital, Lahore from January 2022-December 2022. It consisted of 435 specimens from ICU patients processed for culture and sensitivity in microbiology section of Pathology Laboratory, SMCH. The specimens included blood, pus, urine, cerebrospinal fluid, and other body cavity fluids, sputum, bronchial aspirates, wound swabs, ETT, etc. The specimens were cultured on Blood agar (Oxoid UK) and Mac Conkey agar (Oxoid UK) but CLED agar (Oxoid UK) was used for urine.  After overnight incubation at 37°C, Acinetobacter sp were identified by morphology and biochemical reactions using Analytical profile index (API) 20 NE (Biomerieux, France). Results: One hundred and seventy-five cases revealed Gram negative bacteria (GNB) and 31 (17.71%) of the GNB were Acinetobacter sp. Fifteen isolates of Acinetobacter sp were obtained from respiratory secretions,7 from pus, 6 from urine, 2 from ETT, and 1 isolate from blood sample. A total of 31 isolates were obtained. Thirteen (41.9%) Acinetobacter isolates were MDR and 9 (29.0%) turned out to be XDR. The remaining 9 isolates exhibited satisfactory susceptibility. Conclusion: Acinetobacter sp. is responsible for a significant bulk of drug resistant ICU associated infections and is increasingly developing resistance as evident by 41.9% MDR and 29.0% XDR isolates.