It’s getting real tough to ‘ESKAPE’ hospital-acquired infections

HYDERABAD: Getting admitted to a hospital may be doing more harm than good. Acinetobacter baumannii bacteria — one of the major causes of hospital-acquired infections — are fast developing multi drug and extreme drug resistant strains, says a new study. Acinetobacter is one of the six ‘ESKAPE’ bacteria that cause most hospital-acquired infections, even inside highly sterile Intensive Care Units (ICUs). The bacteria is known to cause diseases like pneumonia, infections of the blood stream, urinary tract and skin.

The findings, based on a study by researchers from the Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, were published in the Indian Journal of Microbiology Research this month. The researchers visited a tertiary hospital in Hyderabad and isolated 143 strains of Acinetobacter over a span of one year (from July 2016). Of them, a whopping 131 strains (91.6 per cent) were found to be multi drug resistant and 126 (88.1 per cent) had developed extreme drug resistance.

This means many strains of bacteria have become resistant to Carbapenems, a class of antibiotics developed to treat people affected by multiple drug resistant bacteria. Carbapenems was developed for bacteria that had already become resistant to drugs like penicillins, cephalosporins, fluoroquinolones and aminoglycosides. The last resort is to use Colistin or Tigecycline. However, this is not easy as they are mostly dealing with patients in the ICU, whose immunity is already low.

“It’s difficult to treat a patient affected by an extreme drug resistant strain of Acinetobacter as the other drugs which can work on the strain might not suit the patient,” says the lead author of the paper Dr A Swathi. “For example, Colistin is a nephrotoxin, which means a patient with a kidney problem can’t take it. Some patients have survived Acinetobacter infections for over a month, but not all are so lucky,” adds Swathi, who is also a consultant microbiologist.

Where do they hide?
Acinetobacter infection occur in ICU mainly in patients who have invasive treatments going on like being on a ventilator
In the Hyderabad study, most samples of Acinetobacter came from Endotracheal Aspirates, Suction tips and tracheal tips
Acinetobacter is listed as ‘Critical’, in WHO priority pathogens list for Research and Develop-ment of new antibiotics

Solutions
Adopt infection-control practices in hospitals
Doctors must prescribe, administer antibiotics appropriately
Ensure pharmacies don’t sell antibiotics without prescription