학술논문
Epidemiology and antimicrobial resistance trends of Acinetobacter species in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data
Document Type
article
Author
Jens Thomsen; Najiba M. Abdulrazzaq; Hussain AlRand; The UAE AMR Surveillance Consortium; Abiola Senok; Adnan Alatoom; Agnes-Sonnevend-Pal; Ahmed Abdulkareem Al Hammadi; Ahmed Elhag Ahmed; Ahmed F. Yousef; Alaa MM Enshasy; Amal Mubarak Madhi; Amna AlBlooshi; Andreas Podbielski; Anju Nabi; Anup Shashikant Poddar; Arun Kumar Jha; Ayesha Abdulla Al Marzooqi; Bashir Aden; Carole Ayoub Moubareck; Dean Everett; Deeba Jafri; Duckjin Hong; Emmanuel Fru Nsutebu; Farah Ibrahim Al-Marzooq; Fatima Al Dhaheri; Fouzia Jabeen; Francis Amirtharaj Selvaraj; Ghada Abdel Wahab; Ghalia Abdul Khader Khoder; Gitanjali Avishkar Patil; Godfred A. Menezes; Hadayatullah Ghulam Muhammad; Hafiz Ahmad; Hala Ahmed Fouad Ismail; Hazim Khalifa; Husein Alzabi; Ibrahim Alsayed Mustafa Alhashami; Imene Lazreg; Irfaan Akthar; John Stelling; Kaltham Ali Kayaf; Kavita Diddi; Krishnaprasad Ramabhadran; Laila Al Dabal; Laura Thomsen; Leili Chamani-Tabriz; Madikay Senghore; Manal Abdel Fattah Ahmed; Maya Habous; Moeena Zain; Mohamud M. Sheek-Hussein; Monika Maheshwari; Mubarak Saif Alfaresi; Mushtaq Khan; Najiba Abdulrazzaq; Nehad Nabeel Al Shirawi; Nesrin Helmy; Pamela Fares Mrad; Pascal Frey; Peter Nyasulu; Prashant Nasa; Rajeshwari T. A. Patil; Rania El Lababidi; Ratna A. Kurahatti; Riyaz Amirali Husain; Robert Lodu Serafino Wani Swaka; Saeed Hussein; Sameh Soliman; Savitha Mudalagiriyappa; Seema Oommen; Shaikha Ghannam Alkaabi; Simantini Jog; Siobhan O‘Sullivan; Somansu Basu; Stefan Weber; Sura Khamees Majeed; Syed Irfan Hussein Rizvi; Tibor Pal; Timothy Anthony Collyns; Yassir Mohammed Eltahir Ali; Yousuf Mustafa Naqvi; Zahir Osman Babiker; Zulfa Omar Al Deesi
Source
Frontiers in Public Health, Vol 11 (2024)
Subject
Language
English
ISSN
2296-2565
Abstract
IntroductionAcinetobacter spp., in particular A. baumannii, are opportunistic pathogens linked to nosocomial pneumonia (particularly ventilator-associated pneumonia), central-line catheter-associated blood stream infections, meningitis, urinary tract infections, surgical-site infections, and other types of wound infections. A. baumannii is able to acquire or upregulate various resistance determinants, making it frequently multidrug-resistant, and contributing to increased mortality and morbidity. Data on the epidemiology, levels, and trends of antimicrobial resistance of Acinetobacter spp. in clinical settings is scarce in the Gulf Cooperation Council (GCC) and Middle East and North Africa (MENA) regions.MethodsA retrospective 12-year analysis of 17,564 non-duplicate diagnostic Acinetobacter spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010–2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET.1ResultsSpecies belonging to the A. calcoaceticus-baumannii complex were mostly reported (86.7%). They were most commonly isolated from urine (32.9%), sputum (29.0%), and soft tissue (25.1%). Resistance trends to antibiotics from different classes during the surveillance period showed a decreasing trend. Specifically, there was a significant decrease in resistance to imipenem, meropenem, and amikacin. Resistance was lowest among Acinetobacter species to both colistin and tigecycline. The percentages of multidrug-resistant (MDR) and possibly extensively drug-resistant (XDR) isolates was reduced by almost half between the beginning of the study in 2010 and its culmination in 2021. Carbapenem-resistant Acinetobacter spp. (CRAB) was associated with a higher mortality (RR: 5.7), a higher admission to ICU (RR 3.3), and an increased length of stay (LOS; 13 excess inpatient days per CRAB case), as compared to Carbapenem-susceptible Acinetobacter spp.ConclusionCarbapenem-resistant Acinetobacter spp. are associated with poorer clinical outcomes, and higher associated costs, as compared to carbapenem-susceptible Acinetobacter spp. A decreasing trend of MDR Acinetobacter spp., as well as resistance to all antibiotic classes under surveillance was observed during 2010 to 2021. Further studies are needed to explore the reasons and underlying factors leading to this remarkable decrease of resistance over time.