Aim Recently increased attention and interest for Acinetobacterbaumanniiare the result of the occurrence of multidrug resistant (MDR), extensive drug resistant (XDR) and pandrug resistant (PDR) isolates around the world. The aim of this study was to examine the resistance of A. baumannii isolates to antimicrobials in Clinical Centre University of Sarajevo, Bosnia and Herzegovina. Methods Two hundred and fifty-seven A.baumannii isolates were collected between July 2011 and June 2012 in different wards and from different clinical samples.Multidrug resistant, XDR and PDR were defined according to international expert proposal for interim standard definitions for acquired resistance. Results A total of 257A. baumannii isolates showed eleven different patterns of resistance,of which ten patterns corresponded to MDR and one corresponded to XDR (sensitive only to colistin). Multidrug resistant and XDR strains were the most common at Intensive Care Units andsurgical departments. The largest numbers of isolates were found in wound swabs, blood and bronchial aspirate. Conclusion This is the first report of XDR A. baumannii in the 2000-bed Clinical Centre University of Sarajevo, Bosnia-Herzegovina. Although XDR strains have been detected,the resistance to colistinhasnot. The elevated prevalence of these strains indicates that local antibiotic prescription policies should be revised and infection prevention and control should be improved.
Souli M, Galani I, Giamarellou H. Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe. Euro Surveill 2008:1–11.
2
Hammami S, Ghozzi R, Saidani M, Redjeb S. Carbapenem-resistant Acinetobacterbaumannii producing the carbapenemase OXA-23 in Tunisia. Tunis Med 2011:638–43.
3
Mireya U, Martí P, Xavier K, Miguel C, Magda M, C. Nosocomial infections in paediatric and neonatal intensive care units. J Infect 2007:212–20.
4
Playford E, Craig J, Iredell J. Carbapenem-resistant Acinetobacter baumanniiin intensive care unit patients: risk factors for acquisition, infection and their consequences. J Hosp Infect 2007:204–11.
5
Nowak P, Paluchowska P, Budak A. Distribution of blaOXA genes among carbapenemresistant Acinetobacter baumannii nosocomial strains in Poland. New Microbiol 2012:317–25.
6
Wilks M, Wilson A, Warwick S, Price E, Kennedy D, Ely A, et al. Control of an outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus colonization and infection in an intensive care unit (ICU) without closingthe ICU or placing patients in isolation. Infect Control Hosp Epidemiol 2006:654–8.
7
Mostofi S, Mirnejad R, Masjedian F. Multi-drug resistance in Acinetobacter baumannii strains isolated from the clinical specimens of three hospitals in Tehran-Iran. Afr Jmicrobiol Res 2011:4467–70.
8
Choi S, Choo E, Kwak Y, Kim M, Jun J, Kim M, et al. Clinical characteristics and outcomes of bacteremia caused by Acinetobacter species other than A. baumannii: comparison with A. baumannii bacteremia. J Infect Chemother 2006:380–6.
9
Mostachio A, Van Der Heidjen I, Rossi F, Levin A, Costa S. Multiplex PCR for rapid detection of genes encoding oxacillinases and metallo-βlactamases in carbapenem-resistant Acinetobacter spp. J Med Microbiol 2009:1522–4.
10
Uskudar G, Kilic A, Gozen A, Bedir O, Basustaoglu A. Proceedings of 21 st European Congress of ClinicalMicrobiology and Infectious Diseases (ECCMID)/27 th International Congress of Chemotherapy (ICC). Clin Microbiol Infect n.d.:134–5. doi: 10.1111/clm201117issue-s4/issuetoc.
11
Wareham D, Bean D, Khanna P, Hennessy E, Krahe D, Ely A, et al. Bloodstream infection due to Acinetobacter spp. epidemiology, risk factors and impact of multi-drug resistance. Eur J Clin Microbiol Infect Dis 2008:607–12.
12
Zhang J, Zhu W, Tian S, Chu Y, Chen B. Clinical and epidemiologicaldescription of imipenem-resistant Acinetobacter baumannii causing nosocomialinfections in a regional teaching hospital in China. Afr J Microbiol Res 2011:1527–31.
13
Lin Y, Hsia K, Chen Y, Sheng W, Chang S, Liao M, et al. Genetic basis of multidrug resistance in Acinetobacter clinical isolates in Taiwan. Antimicrob Agents Chemother 2010:2078–84.
14
Goic-Barisic I, Bedenic B, Tonkic M, Katic S, Kalenic S, Punda-Polic V. First report of molecular characterization of carbapenem-resistant Acinetobacter baumannii in different intensive care units in University hospital Split. Croatia J Chemother 2007:416–8.
15
Bogiel T, Kwiecinska-Pirog J, Jachna-Sawicka K, Gospodarek E. Carbapenem-resistant Acinetobacter baumannii strains. Med Dosw Microbiol 2010:119–26.
16
Mcgowan J. Resistance in nonfermenting gramnegative bacteria:multidrug resistance to the maximum. Am J Med 2006;(1):29–36.
17
European Centre for Disease Prevention and Control/European MedicinesAgency. ECDC/EMEA joint technical report: the bacterial challenge:time to react 2009.
18
Boucher H, Talbot G, Bradley J, Gilbert D, Rice L, Scheld M, et al. Bad bugs, no drugs: noESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis 2009:1–12.
Gales A, Jones R, Sader H. Global assessment of the antimicrobial activity of polymyxin B against 54 731 clinical isolates of Gram-negative bacilli: report from the SENTRY antimicrobial surveillance programme. Clin Microbiol Infect 2006:315–21.
21
Souli M, Kontopidou F, Koratzanis E, Antoniadou A, Giannitsioti E, Evangelopoulou P, et al. In vitro activity of tigecycline against multiple-drug-resistant, including pan-resistant, gram-negative and gram-positive clinical isolates from Greek hospitals. Antimicrob Agents Chemother 2006:3166–9.
22
Henwood C, Gatward T, Warner M, James D, Stockdale M, Spence R, et al. Antibiotic resistance among clinical isolates of Acinetobacter in the UK, and in vitro evaluation of tigecycline (GAR-936). J Antimicrob Chemother 2002:479–87.
23
Popolo D, Giannouli A, Triassi M, Brisse M, Zarrilli S, R. Molecular epidemiologicalinvestigation of multidrug-resistant Acinetobacter baumannii strains in four Mediterranean countries with a multilocus sequence typing scheme. Clin Microbiol Infect 2011:197–8.
24
Fournier P, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis 2006:692–9.
25
Maragakis L, Perl T. Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options. Clin Infect Dis 2008:1254–63.
26
Magiorakos A, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistantbacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012:268–81.
27
The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters n.d.
28
Evans B, Hamouda A, Towner K, Amyes S. OXA-51-like β-lactamases and their association with particular epidemic lineages of Acinetobacter baumannii. ClinMicrobiol Infect 2008:268–75.
29
Camp C, Tatum O. A review of Acinetobacter baumannii as a highly successful pathogen in times of war. LabMedicine 2010:649–57.
30
Ml J-G. Clinical impact and pathogenicity of Acinetobacter. Clin Microbiol Infect 2005:868–73.
31
Acosta J, Merino M, Viedma E, Poza M, Sanz F, Otero J, et al. Multidrug-resistant Acinetobacter baumannii harboring OXA-24 carbapenemase. Spain Emerg Infect Dis 2011:1064–7.
32
Stoeva T, Higgins P, Bojkova K, Seifert H. Clonal spread of carbapenem-resistant OXA-23-positive Acinetobacter baumannii in a Bulgarian university hospital. Clin Microbiol Infect 2008:723–7.
33
Liakopoulos A, Miriagou V, Katsifas E, Karagouni A, Daikos G, Tzouvelekis L, et al. Identification of OXA-23-producing Acinetobacter baumannii in Greece, 2010 to 2011. Euro Surveill 2012.
34
Perez F, Hujer A, Hujer K, Decker B, Rather P, Bonomo R. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2007:3471–84.
35
Goic-Barisic I, Bedenic B, Tonkic M, Novak A, Katic S, Kalenic S, et al. Occurrence ofOXA-107 and ISAba1 in carbapenem-resistant isolates of Acinetobacter baumannii from Croatia. J Clin Microbiol 2009:3348–9.
36
Bazargani A, Hashemizadeh Z. Bacteremia due to multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL) producing Acinetobacter baumannii. Afr JMicrobiol Res 2011:3483–6.
37
Dhabaan G, Hamimah H, Shorman M. Emergence of extensive drug-resistant Acinetobacter baumannii in North of Jordan. Afr J Microbiol Res 2011:1070–5.
38
Srinivasan V, Rajamohan G, Pancholi P, Stevenson K, Tadesse D, Patchanee P, et al. Genetic relatedness and molecular characterization of multidrug resistant Acinetobacterbaumannii isolated in central Ohio. Ann Clin Microbiol Antimicrob 2009:21.
39
Lin M, Chang K, Lan C, Chou J, Kuo J, Chang C, et al. Molecular epidemiology and antimicrobial resistance determinants of multidrug-resistantAcinetobacter baumannii in five proximal hospitals in Taiwan. Jpn J InfectDis 2011:222–7.
40
He C, Xie Y, Zhang L, Kaang M, Tao C, Chen Z, et al. Increasing imipenem resistance and dissemination of the ISAba1associated blaOXA-23 gene among Acinetobacterbaumannii isolates in an intensive care unit. J Med Microbiol 2011:337–41.
41
Kuo S, Chang S, Wang H, Lai J, Chen P, Shiau Y, et al. Emergence of extensively drug-resistant Acinetobacter baumannii complex over 10 years: nationwide data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program BMC Infectious Diseases 2012:200.
42
Alireza J-N, Masoomeh S, Van Belkum A, Ehsanollah G-R. Nosocomial outbreak of extensively and pan drug-resistant Acinetobacter baumannii in Tertiary Hospital in central part of Iran. Jundishapur J Microbiol 2013:9892.
43
Eser O, Ergin A, Tunckanat F, Hasscelik G. In vitro activity of tigecycline as a therapeutic against multidrug-resistant Acinetobacter spp. New Microbiol 2008:535–42.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
