The Clinical Impression of NDM-producing Acinetobacter baumannii in Intensive Care Units of the University Referral Hospital in North India

Aims and background: Carbapenem-resistant Acinetobacter baumannii (CRAb), a major public health threat, causes severe infections in Intensive Care Unit (ICU) patients. It resists (3-lactam antibiotics through mechanisms like New Delhi metallo-beta-lactamase (NDM). Materials and methods: In ICU patients, 69 Acinetobacter species were isolated from 86 non-fermenting Gram-negative bacilli. Isolates were identified using biochemical methods and Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS), and carbapenem resistance detection was done by both phenotypic (mCIM and eCIM) and molecular methods. Results: Out of 66 A. baumannii, 61 were carbapenem-resistant, with 20 confirmed as NDM producers. NDM-positive isolates exhibited higher resistance and were associated with significant mortality (75%). Conclusion: NDM-positive Acinetobacter isolates are significant ICU pathogens with poor outcomes. Key risk factors include prolonged ICU stays, prior antimicrobial use, and inadequate therapy. Early detection and infection control are crucial. Clinical significance: NDM-positive Acinetobacter infections in ICU patients are linked to poor outcomes, highlighting the need for early detection and control measures.