Antimicrobial resistance of acinetobacter baumannii infection of lower respiratory tract and mortality – A cross-sectional study from a tertiary care teaching hospital in Kerala

Background: Acinetobacter baumannii has evolved as a common Multi Drug Resistant (MDR) microbe. This study was conducted to find the profile of antimicrobial resistance and mortality and their associated factors in A. baumannii infection of lower respiratory tract. Materials and Methods: This was a record based cross sectional study done in a tertiary care teaching hospital in Kerala. Records of all the 63, A. baumannii lower respiratory infection in 2017, were retrieved and analyzed. MDR was defined as resistance to at least one agent of three or more antimicrobial classes. Proportion of MDR, carbapenam resistance and resistance to other major antimicrobials were calculated. Determinants of carbapenam resistance and its associated antimicrobial resistance were explored. Proportion of mortality and the associated factors were explored. Student’s t-test, chi-square test or fisher exact test were used appropriately. Results: Proportions of MDR and carbapenam resistance were 85.7% and 41.3% respectively. Highest proportion (90.5%) was resistant to piperazillin-tazobactam. Carbapenam resistance was associated with MDR (p-value95% CI: 63.9% to 85.3%). Older age and ICU stay prior to infection were associated with mortality (p-value Conclusions: Rates of antimicrobial resistance in Acinetobacter baumannii and the mortality were high in the setting, comparable to reports from other parts of India. The drug resistance increases hospital care burden. There is an urgent need to implement stringent infection control measures. Keywords: Acinetobacter baumannii; Nosocomial infection; Antimicrobial resistance; Multi Drug Resistance; ESKAPE.