An Increasing Threat in Libyan Hospitals: Emergence of Extensively-Resistant Acinetobacter Baumannii

Introduction: The prevalence of extensively drug resistance (XDR) Acinetobacter baumannii (AB) is rapidly progressing. The aim of this study was to determine the prevalence of XDR A. baumannii in Tripoli, Libya. Methods: AB isolates were identified and antibiotic susceptibility testing was performed using an automated system to determine the multidrug resistant organisms. XDR-AB was considered when they were non-susceptible to one or more of the agents in all but two or less categories. Results: A total of 250 AB strains isolated from two teaching hospitals were characterized during 2013-2014. Extremely high level of isolates (240/250; 96%) was defined as multidrug resistant organisms. Whereas, extensively drug resistant was evident in 153/250; 61.2% of detected organisms, it was predominantly associated with burn patients (116/153; 75.8%), aged ≤ 30 years old (76.1%) and hospitalized in intensive care unit (ICU) (76.7%). All isolates were susceptible to colistin and tigecycline. This study indicated that pan-drug resistant A. baumannii has not been detected in Libya. Conclusion: XDR-AB infections are endemic in burn patients with a great potential for spread in ICUs, indicating that there is a longstanding infection control problem in these patients.