SURGICAL SITE INFECTION WITH EXTREME DRUG-RESISTANT ACINETOBACTER BAUMANII: A WAKE-UP CALL!
DOI:
https://doi.org/10.55519/JAMC-02-12363Keywords:
Surgical site infections; Lower middle-income countries; Antibiotic prophylaxisAbstract
Surgical site infections are a common complication of surgery with a high prevalence in lower middle-income countries (LMICS). Excessive focus on antibiotic prophylaxis to prevent surgical site infections while neglecting other precautions like aseptic measures, patient nutrition, proper wound care has resulted in the emergence of antibiotic resistant microbials. Such organisms are a menace to healthcare. They cause prolonged hospital stay, use of expensive drugs, increased mortality and morbidity and overall, greatly increased cost of care per patient. We present a case of extreme drug resistant Acinetobacter spp causing surgical site infection following abdominal surgery, from Peshawar, Pakistan. Our patient was an 18-year-old lady who had undergone abdominoplasty following which she developed high grade fever, pain in abdomen and wound discharge. Empiric antibiotics treatment did not improve her condition. Culture and sensitivity report showed the growth of Acinetobacter spp. Which was resistant to almost all of the commonly used antibiotics, with the exception of tigecycline. Patient was treated with tigecycline which resolved her fever and wound infection and she was discharged in a stable condition. We believe our case highlights the importance of antibiotics stewardship and is a wakeup call to healthcare professionals and policy makers to take necessary steps to herald the danger of antibiotics resistance before it is too late.References
Surgical Site Infection (SSI) | HAI | CDC [Internet]. 2021 [cited 2023 Jul 15]. Available from: https://www.cdc.gov/hai/ssi/ssi.html
Saito H, Inoue K, Ditai J, Weeks AD. Pattern of Peri-Operative Antibiotic Use among Surgical Patients in a Regional Referral and Teaching Hospital in Uganda. Surg Infect (Larchmt) 2020;21(6):540–6.
Lissovoy G de, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: Incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009;37(5):387–97.
De Simone B, Sartelli M, Coccolini F, Ball CG, Brambillasca P, Chiarugi M, et al. Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines. World J Emerg Surg 2020;15(1):10.
Bull AL, Worth LJ, Spelman T, Richards MJ. Antibiotic Prescribing Practices for Prevention of Surgical Site Infections in Australia: Increased Uptake of National Guidelines after Surveillance and Reporting and Impact on Infection Rates. Surg Infect 2017;18(7):834–40.
Sharma A, Singh A, Dar MA, Kaur RJ, Charan J, Iskandar K, et al. Menace of antimicrobial resistance in LMICs: Current surveillance practices and control measures to tackle hostility. J Infect Public Health 2022 2023;15(2):172–81.
Kalungia AC, Mwambula H, Munkombwe D, Marshall S, Schellack N, May C, et al. Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice. J Chemother 2023;31(7–8):378–87.
Butt SZ, Ahmad M, Saeed H, Saleem Z, Javaid Z. Post-surgical antibiotic prophylaxis: Impact of pharmacist’s educational intervention on appropriate use of antibiotics. J Infect Public Health 2019;12(6):854–60.
Jawad A, Heritage J, Snelling AM, Gascoyne-Binzi DM, Hawkey PM. Influence of relative humidity and suspending menstrua on survival of Acinetobacter spp. on dry surfaces. J Clin Microbiol 1996;34(12):2881–7.
Almaghrabi MK, Joseph MRP, Assiry MM, Hamid ME. Multidrug-Resistant Acinetobacter baumannii: An Emerging Health Threat in Aseer Region, Kingdom of Saudi Arabia. Can J Infect Dis Med Microbiol 2018;2018:9182747.
CDC. Centers for Disease Control and Prevention. [Internet]. 2022 [cited 2024 Mar 3]. What Exactly is Antibiotic Resistance? Available from: https://www.cdc.gov/drugresistance/about.html
Cabral BG, Brasiliense DM, Furlaneto IP, Rodrigues YC, Lima KVB. Surgical Site Infection Following Caesarean Section by Acinetobacter Species: A Report from a Hyperendemic Setting in the Brazilian Amazon Region. Microorganisms 2021;9(4):743.
Motbainor H, Bereded F, Mulu W. Multi-drug resistance of blood stream, urinary tract and surgical site nosocomial infections of Acinetobacter baumannii and Pseudomonas aeruginosa among patients hospitalized at Felegehiwot referral hospital, Northwest Ethiopia: a cross-sectional study. BMC Infect Dis 2020;20(1):92.
Causes of Antimicrobial (Drug) Resistance | NIH: National Institute of Allergy and Infectious Diseases [Internet]. 2011 [cited 2023 Jul 15]. Available from: https://www.niaid.nih.gov/research/antimicrobial-resistance-causes
Naylor NR, Evans S, Pouwels KB, Troughton R, Lamagni T, Muller-Pebody B, et al. Quantifying the primary and secondary effects of antimicrobial resistance on surgery patients: Methods and data sources for empirical estimation in England. Front Public Health 2022;10:803943.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Faraz Waheed, Afaq Saeed Khan, Usman Babar, Manahil Saeed Khan
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.