ISOLATION OF ACINETOBACTER

SPECIES FROM PUS SAMPLES IN A

TERTIARY CARE HOSPITAL

DR. B. BHAVANI

INTRODUCTION
Acinetobacter

species
are
Gram
Negative
coccobacilli causing various nosocomial infections.

The spread of multidrug resistance Acinetobacter

strains among hospitalized patients became an

increasing cause of concern.

Despite low pathogenic potential they survive in the

hospital environment for a long time and getting

opportunity to cause hospital acquired infections.

AIMS
To isolate Acinetobacter species from various pus

samples

To study their antibiogram pattern of the Isolated

Organisms

Materials & methodology

A total of 748 pus samples were included.
Isolation, identification and antibiogram of

Acinetobacter species were included in the

study.
Processing of other bacterial isolates was

excluded .
All the samples were processed for Gram stain

& culture by inoculating on blood agar & MA and

Incubated over night at 37 C.

 Acinetobacter species were isolated and

identified by Biochemical testes.

The antibiotic susceptibility testing was done by

Kirby-Bauer disk diffusion method & zones were

interpreted as per CLSI guidelines.

ESBL production was tested by double disk

diffusion method using Ceftazidime

&Ceftazidime- clavulonate discs.

Grams Stain from growth

Blood Agar Plate

Acinetobacter baumannii

Acinetobacter lwoffii

MacConkey agar

Acinetobacter hemolyticus

Capsular Staining

Biochemical
Reactions
Utilization of 10%
Nitrate reduction
lactose

test

A) A. baumannii (+Ve)
B) A. lwoffii(-Ve)

A) Escherichia Coli (+Ve)

B) A. baumannii (-Ve)

Antibiotic susceptibility test

Results
Table-I

(n=748)

Age

Male (51.4%)

Female

0-10 years

20

(48.6%)
17

11-20 years

38

50

21-30 years

55

96

31-40 years

68

72

41-50 years

64

54

51-60 years

73

29

>60 years

67

45

Total

385

363

Most of the patients were in the age group of 21 to 40 years

in females and middle and elderly age group in males.

Age wise & Gender wise

450
400
350
300
250
200
150
100
50
0

Years

Male 385(51.4%)
Female 363 (48.6%)

Isolation
ofn=58(7.8
Species
Table-II
%)
S.NO

Species

n=58

Acinetobacter.

32(55.2%)

baumannii
2

Acinetobacter.

24(41.3%)

lwoffii
3

Acinetobacter.
hemolyticus

2(3.4%)

Isolation of Species

3.40%

41.30%

55.20%

Acinetobacter.bauma
nnii
Acinetobacter. lwoffii
Acinetobacter.
hemolyticus

spp.

(N

Table-III

S.No

58)

Sensitivity patterns in percentage

Antibiotic

Sensitive
Number

Percentage

Tigicycline

53

91.3%

Imipenem

49

84.4%

Piperacillin-

48

82.8%

Tazobactam
4

Levofloxacin

47

81%

Amikacin

26

44.8%

Gentamicin

23

39.7%

Cefotaxime

23

39.7%

Ceftazidime

20

34.5%

Among 58 isolates 45 (77.6%) were ESBL producers

Sensitivity Patterns
60
50
40
30
20
10
0

53

49

48

47
26

23

23

20

Discussion
Acinetobacter Species is widely distributed and

has tremendous colonizing potential hence it is

difficult to explain its significant role in the ICU.

Acinetobacter baumannii is now recognized as

the species of great clinical importance.

In the present study 51.4 % were males and

48.6% were females which correlates with

Smeeta Huidrom et al (66.1% & 33.9%) and
Bhattacharya et al (1.46 : 1).

Middle and elderly age group were more

affected in our study which correlates with
Smeeta Huidrom et al where as Bhattacharya
et al reported the mean age 27 years.

In the present study out of 748 samples 58

(7.8%) were culture positive for Acinetobacter
Species from the samples received from
various areas of hospital. Smeeta Huidrom et
al reported 12.6% and Patwardhan RB et al
reported 13.2% from ICU samples.

 Acinetobacter baumannii was isolated in 55.2%. A.

lwoffii in 41.3% and A. hemolyticus in 3.4% in the

present study which correlates with Bhattacharya
et al who reported 54%, 44% and 2%.

Most of the isolates were sensitive to Tigicycline,

Imipenem, Piperacilline Tazobactum and

Levofloxacin.

ESBL producers were 77.6% in the present study

which correlates with Bhattacharya et al (78.5%)

of ESBL producers in their study.

Conclusion
Acinetobacter infections became a common threat

in Hospital Acquired Infections.

In our study 77.6% of Acinetobacter species

isolated were ESBL producers.

Despite the increase in the frequency of multi

drug resistant
Acinetobacter infections, many
clinicians
and
microbiologists
still
lack
appreciation of the importance of these organisms
in the hospitals.

A combined effort of continuous surveillance

and infection control protocols have to be
implemented to control the increasing incidence of
highly resistance Acinetobacter infections.

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