title: Emerging threat of multidrug resistant bugs--Acinetobacter calcoaceticus baumannii complex and methicillin resistant Staphylococcus aureus.
abstract: BACKGROUND
  Infections caused by bacteria such as multidrug resistant (MDR) Acinetobacter spp. and methicillin-resistant Staphylococcus aureus (MRSA) constitute a worldwide pandemic. Without gathering information about these strains, we cannot reduce the morbidity and mortality due to infections caused by these notorious bugs.
  
  
  METHODS
  This study was conducted to identify the status of MDR Acinetobacter spp. and MRSA in a tertiary care centre of Nepal. Sputum, endotracheal aspirate and bronchial washing specimens were collected and processed from patients suspected of lower respiratory tract infection following standard microbiological methods recommended by the American Society for Microbiology (ASM). Double disk synergy test method was employed for the detection of extended-spectrum beta-lactamase (ESBL) in Acinetobacter isolates. Methicillin resistance in S. aureus was confirmed by using cefoxitin and oxacillin disks.
  
  
  RESULTS
  Different genomespecies of Acinetobacter were isolated; these consisted of Acinetobacter calcoaceticus baumannii complex and A. lwoffii. Around 95% of Acinetobacter isolates were MDR, while 12.9% were ESBL-producer. Of the total 33 isolates of S. aureus, 26 (78.8%) were MDR and 14 (42.4%) were methicillin resistant.
  
  
  CONCLUSIONS
  A large number of MDR Acinetobacter spp. and MRSA has been noted in this study. The condition is worsened by the emergence of ESBL producing Acinetobacter spp. Hence, judicious use of antimicrobials is mandatory in clinical settings. Moreover, there should be vigilant surveillance of resistant clones in laboratories.
authors.affiliation: Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal. smishra7@hotmail.com
authors.forename: Shyam Kumar
authors.initials: SK
authors.lastname: Mishra
authors.forename: Basista Prasad
authors.initials: BP
authors.lastname: Rijal
authors.forename: Bharat Mani
authors.initials: BM
authors.lastname: Pokhrel
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D009390:Nepal
chemical_list: D000900:Anti-Bacterial Agents