Burden and Antimicrobial Resistance Pattern of Multidrug- Resistant Acinetobacter baumannii in Burn Patients at a Tertiary Care Hospital in Dhaka

MDR A. baumannii in Burn Patients, Dhaka

Abstract

Background: Acinetobacter species, particularly Acinetobacter baumannii, are among the most prevalent Gram negative pathogens responsible for hospital-acquired infections worldwide. These infections are widespread in Intensive Care Units (ICUs) and burn wards. Due to the organism’s ability to survive on surfaces for extended periods; its eradication from healthcare environments remains a significant challenge. In recent years, the alarming rise in antibiotic resistance among A. baumannii strains has become a major global health concern.

Objectives: To explore the burden and antimicrobial resistance patterns of Multidrug-resistant (MDR) Acinetobacter baumannii isolates among burn patients admitted to a tertiary care burn hospital in Dhaka city.

Method: This cross-sectional study was carried out on 200 samples over six months in the Department of Microbiology at the National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh. Wound swab specimens were obtained from burn patients from the Intensive Care Unit (ICU) and High Dependency Unit (HDU) and general burn wards. Acinetobacter baumannii isolates were identified by conventional culture and biochemical methods. Antimicrobial susceptibility was done using the conventional disc diffusion method as well as the VITEK® 2 automated system due to the high burden of MDR organisms. Antimicrobial susceptibility testing was conducted in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines-2025. Tigecycline was used, as most of the isolates were MDR pathogens. Based on predefined criteria, the isolates were categorized as MDR organisms.

Results: A total of 200 Acinetobacter spp. isolates were analyzed. The majority of patients were aged under 20 and the mean age was 23.3 ± 21.1 years, with a male-to-female ratio of 1.1:1. Overall, 98.5% of the isolates were classified as MDR, whereas only 1.5% were non-MDR. Resistance to cephalosporins and fluoroquinolones was markedly high. Carbapenem resistance to meropenem and imipenem was also high. Similarly, high resistance rates were observed for aminoglycosides, including gentamicin and amikacin. Relatively better susceptibility was noted for minocycline, tigecycline, colistin, and cefoperazone-sulbactam. The majority of susceptible isolates were MDR. Universal resistance to co-trimoxazole was observed. Overall, the findings demonstrate a high burden of multidrug resistance among Acinetobacter spp., with limited therapeutic options remaining effective.

Conclusion: The study reveals a high burden of MDR Acinetobacter spp. in burn patients, with limited sensitivity to most antibiotics. The findings highlight the urgent need for antimicrobial stewardship and strict infection control in burn units.

Bangladesh Medical Res Counc Bull 2026;52(1): 13-22