CC BY-NC-ND 4.0 · Avicenna J Med 2013; 03(04): 97-102
DOI: 10.4103/2231-0770.120501

Frequency, risk factors, and antibiogram of Acinetobacter species isolated from various clinical samples in a tertiary care hospital in Odisha, India

Muktikesh Dash
Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
Sanghamitra Padhi
Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
Swetlana Pattnaik
Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
Indrani Mohanty
Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
Pooja Misra
Department of Radiodiagnosis, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
› Author Affiliations


Background: For the past two decades, Acinetobacter spp. have emerged as an important pathogen globally in various infections. Objectives: This study was conducted to determine the frequency, risk factors, and antibiotic resistance pattern of Acinetobacter spp. from various clinical samples. Materials and Methods: This retrospective, hospital record-based, cross-sectional study included a total of 8749 clinical samples collected from patients at a tertiary care hospital in Odisha, India from July 2010 to December 2012. The samples were processed and identified by standard protocol. The Acinetobacter isolates were tested for antibiotic resistance by Kirby-Bauer disk diffusion method [according to the Clinical and Laboratory Standards Institute (CLSI) guidelines]. Results: From 8749 clinical samples, 4589 (52.5%) yielded significant growth and only 137 (3%, 137/4589) Acinetobacter spp. were isolated. Maximum (56.9%) isolates were obtained from pus/swab, followed by blood (13.1%) and urine (12.4%). Elderly age, being inpatients, longer duration of stay in the hospital, associated co-morbidity, and invasive procedure were found to be significant risk factors in the setup investigated (P is less than 0.05). Out of 137 isolates, 75 (54.7%) were resistant to more than three classes of antibiotics (multidrug resistant) and 8 (5.8%) were resistant to all commonly used antibiotics (pan-drug resistant). Majority of the isolates were sensitive to imipenem, meropenem, and piperacillin/tazobactam, and showed resistance rates of 19%, 22%, and 23%, respectively. All eight pan-drug resistant isolates were 100% sensitive to colistin. Conclusion: This hospital-based epidemiological data will help to implement better infection control strategies and improve the knowledge of antibiotic resistance patterns in our region.

Publication History

Article published online:
09 August 2021

© 2013. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

  • References

  • 1 Dougari HJ, Ndakidemi PA, Human IS, Benade S. Virulence factors and antibiotic susceptibility among verotoxic non O157: H7 Escherichia coli isolates obtained from water and waste water samples in Cape Town, South Africa. Afr J Biotechnol 2011;10:14160-8.
  • 2 Peleg AP, Seifert H, Paterson DL. Acinetobacter baumannii Emergence of a successful Pathogen. Clin Microbiol Rev 2008;21:538-82.
  • 3 Yu Yu, Yang Q, Xu Xw, Kong HS, Xu GY, G BY. Typing and characterization of carbapenems resistant Acinetobacter calcoaceticus - baumannii complex in a Chinese hospital. J Med Microbiol 2004;53:653-6.
  • 4 Falagas ME, Karveli EA. The changing global epidemiology of Acinetobacter baumannii infections: A development with major public health implications. Clin Microbiol Infect 2007;13:117-9.
  • 5 Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care fascilities. Clin Infect Dis 2006;42:692-9.
  • 6 Towner KJ. Clinical importance and antibiotic resistance of Acinetobacter spp. J Med Microbiol 1997;6:186-97.
  • 7 Leung WS, Chu CM, Tsang KY, Lo FH, Ho PL. Fulminant community-acquired Acinetobacter baumannii pneumonia as a distinct clinical syndrome. Chest 2006;129:102-9.
  • 8 Houang ET, Chu YW, Leung CM, Chu KY, Berlau J, Ng KC, et al. Epidemiology and infection control implication of Acinetobacter spp. in Hong Kong. J Clin Microbiol 2001;39:228-34.
  • 9 Halstead DC, Abid J, Dowzicky MJ. Antimicrobial susceptibility among Acinetobacter calcoaceticus-baumannii complex and Enterobacteriaceae collected as a part of yhe tigecycline evaluation and surveillance trail. J Infect 2007;55:49-57.
  • 10 Scott P, Deye G, Srinivasan A, Murray C, Moran K, Hulten E, et al. An outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus complex infection in the US military health care system associated with military operations in Iraq. Clin Infect Dis 2007;44:1577-84.
  • 11 [Internet]. CDC/NHSN Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting; c2013. Available from: [Last updated on 2013 April; cited on 2013 April 28].
  • 12 Collee JG, Miles RS, Watt B. Tests for identification of bacteria. In: Collee JG, Fraser AG, Marmion BP, Simmons A, editors. Mackie and Mc Cartney Practical Medical Microbiology. 14 th ed. Singapore: Churchill Livingstone; 2006. p. 131-49.
  • 13 Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966;45:493-6.
  • 14 Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: Nineteenth Informational Supplement. CLSI document M100-S19. Wayne; PA: USA. Clinical and Laboratory Standards Institute, 2009.
  • 15 Dent LL, Marshall DR, Pratap S, Hulette RB. Multidrug resistant Acinetobacter baumannii: A descriptive study in a city hospital. BMC Infect Dis 2010;10:196.
  • 16 Getchell-White SI, Donowitz LG, Gröschel DH. The inanimate environment of an intensive care unit as a potential source of nosocomial bacteria: Evidence for long survival of Acinetobacter calcoaceticus. Infect Control Hosp Epidemiol 1989;10:402-7.
  • 17 Appleman MD, Belzberg H, Citron DM, Heseltine PN, Yellin AE, Murray J, et al. In vitro activities of nontraditional antimicrobials against multiresistant Acinetobacter baumannii strains isolated in an intensive care unit outbreak. Antimicrob Agents Chemother 2000;44:1035-40.
  • 18 Rit K, Saha R. Multidrug-resistant Acinetobacter infection and their susceptibility patterns in a tertiary care hospital. Niger Med J 2012;53:126-8.
  • 19 Mostofi S, Mirnejad R, Masjedian F. Multi-drug resistance in Acinetobacter baumannii strains isolated from clinical specimens from three hospitals in Tehran-Iran. Afr J Microbiol Res 2011;5:3579-82.
  • 20 Joshi SG, Litake GM, Satpute MG, Telang NV, Ghole VS, Niphadkar KB. Clinical and demographic features of infection caused by Acinetobacter species. Indian J Med Sci 2006;60:351-60.
  • 21 Albrecht MC, Griffith ME, Murray CK, Chung KK, Horvath EE, Ward JA, et al. Impact of Acinetobacter infection on the mortality of burn patients. J Am Coll Surg 2006;203:546-50.
  • 22 Bernards AT, Harinck HI, Dijkshoom L, van der Reijden TJ, van den Broek PJ. Persistant Acinetobacter baumannii? Look inside your medical equipment. Infect Control Hosp Epidemiol 2004;25:1002-4.
  • 23 Chakraborty B, Banerjee D, Chakraborty B. Acinetobacter baumannii: No more a choosy intruder? Indian J Med Sci 2011;65:344-8.
  • 24 Lone R, Shah A, Kadri SM, Lone S, Faisal S. Nosocomial Multi-Drug-Resistant Acinetobacter Infections - Clinical Findings, Risk Factors and Demographic Characteristics. Bangladesh J Med Microbiol 2009;3:34-8.
  • 25 Agoda A, Zarrelli R, Barllitta M, Anzaldi A, Di Popolo A, Mattaliano A. Alert surveillance of intensive care unit acquired Acinetobacter infection in a Sicillian hospital. Clin Microbiol Infect 2006;12:241-7.
  • 26 Bhattacharyya S, Bhattacharyya I, Rit K, Mukhopadhyay PK, Dey JB, Ganguly U, et al. Antibiogram of Acinetobacter spp. isolated from various clinical specimens in a tertiary care hospital, West Bengal, India. Biomed Res 2013;24:43-6.
  • 27 O′Brien TF. Emergence, spread, and environmental effect of anti-microbial resistance: How use of an antimicrobial anywhere can increase resistance to any microbial anywhere else. Clin Infect Dis 2002;34:S78-84.
  • 28 MacDougall C, Polk RE. Antimicrobial Stewardship Programs in Health Care Systems. Clin Microbiol Rev 2005;18:638-56.
  • 29 Towner KJ. Acinetobacter: An old friend, but a new enemy. J Hosp Infect 2009;73:355-63.
  • 30 Walsh TR, Toleman MA, Poirel L, Nordmann P. Metallo-beta-lactamases: The quiet before the storm? Clin Microbiol Rev 2005;18:306-25.
  • 31 Shareek PS, Sureshkumar D, Ramagopalakrishnan S, Ramasubramanian V, Abdul Ghafur K, Thirunarayanan MA. Antibiotic sensitivity pattern of blood isolates of Acinetobacter species in a tertiary care hospital: A rectrospective analysis. Am J Infect Dis 2012;8:65-9.
  • 32 Taneja N, Singh G, Singh M, Sharma M. Emergence of tigecycline and colistin resistant Acinetobacter baumannii in patients with complicated urinary tract infections in north India. Indian J Med Res 2011;133:681-4.
  • 33 Duenas Diez AI, Bratos Perez MA, Eiros Bouza JM, Almaraz Gomez A, Gutierrez Rodriguez P, Miguel Gomez MA, et al. Susceptibility of the Acinetobacter calcoaceticus-A. baumannii complex to imipenem, meropenem, sulbactam and colistin. Int J Antimicrob Agents 2004;23:487-93.
  • 34 Henwood CJ, Gatward T, Warner M, James D, Stockdale MW, Spence RP, et al. Antibiotic resistance among clinical isolates of Acinetobacter in the UK, and in vitro evaluation of tigecycline (GAR-936). J Antimicrob Chemother 2002;49:479-87.
  • 35 Mezzatesta ML, Trovato G, Gona F, Nicolosi VM, Nicolosi D, Carattoli A, et al. In vitro activity of tigecycline and comparators against carbapenem-susceptible and resistant Acinetobacter baumannii clinical isolates in Italy. Ann Clin Microbiol Antimicrob 2008;7:4.
  • 36 Navon-Venezia S, Leavitt A, Carmeli Y. High tigecycline resistance in multidrug-resistant Acinetobacter baumannii. J Antimicrob Chemother 2007;59:772-4.