Antimicrobial Multi-Resistance of Acinetobacter baumanii Isolated from Clinical Specimens in Douala (Cameroon)

摘要

Bacteria of the genus Acinetobacter are non-fermentative gram-negative bacilli, often considered as ubiquitous and frequently found in the environment. This work aimed to study the susceptibility of Acinetobacter baumannii isolated at the General Hospital of Douala. This bacterium, which is greatly involved in human pathology, demonstrated high innate and acquired resistance to multiple antibiotics classes. This was a descriptive and retrospective study over a period of ten years (2005-2014), covering all the isolates of Acinetobacter baumannii from in and out patients. Samples were analyzed in the bacteriology laboratory at the General Hospital of Douala. Data collection was made by extraction of the results of all susceptibility of Acinetobacter baumannii, carried out from 2005 to 2014, registered in the memory of the mini API system; this automated machine identifies and measures the susceptibility of all the bacterial strains. A total of 266 strains were isolated from suppurations, urine, urinary catheters, and all other specimens received by the laboratory during the study period. These strains obtained from samples collected from all services of the hospital and ambulatory patients. The resistance rates noted were: 67.29 % for ticarcillin, 64.28 % ticarcillin + clavulanic acid, 68.33 % for piperacillin, 56.97 piperacillin + tazobactam, 58.27 % ceftazidime, 58.01 % cefepime, 21.05 % imipenem, 33.46 % colistin, 52.63 % gentamicin, 48.49 % tobramycin, 24.43 % amikacin, 53.40 % netilmicin, 50% for ciprofloxacin and levofloxacin, 51.05 % ofloxacin. The prevalence of multi-resistant strains was 43.18 %, mostly seen in patients hospitalized in the Burns unit. Only imipenem and Amikacin showed good activity on these strains with 78.95 % and 75.57 % of susceptibility respectively. This study showed the low activity of penicillin even in combination with beta lactamases inhibitors, as well as the cephalosporins on strains of Acinetobacter baumannii. Therapeutic support of infections due to this pathogen is highly problematic in General hospital of Douala. However, imipenem and amikacin, and to a lesser extent colistin remains effective treatment choices.