Multidrug Resistance Among XXXX Isolates from Iran: Changes in Antimicrobial Susceptibility Patterns and Genotypic Profile.

@entity1 @entity1214 @entity2890 @entity3273 @entity3064 @entity9001 @entity19650
Background and Aim: Widespread multidrug-resistant @entity3064 (MDR-AB) strains have limited therapeutic options for treating intensive care unit (ICU) @entity1 with MDR-AB infection in Iran. We aimed to evaluate MDR-AB diversity and antimicrobial susceptibility in Tehran (Iran) to address the need for feasible and effective control approaches against @entity19650 . Methods: We used amplified fragment length polymorphism (AFLP) and minimum inhibitory concentration (MIC) determinations to compare genotypic diversity and susceptibility patterns of 100 MDR-AB isolates from ICU @entity1 in two medical centers in Tehran (Iran), from 2006 to 2011. Results: Within 5 years, drastic genotypic changes occurred among MDR-AB isolates, and resistance to antimicrobials increased 0-30%. In 2011, 6-100% of isolates were resistant to every agent tested. All isolates remained susceptible to either @entity1214 or @entity2890 , however, MIC50 concentrations against these agents increased. Novel international clone (IC) variants (not IC I-III types) comprised 36% MDR-AB isolates in 2011. Conclusions: The MDR-AB population in Tehran is rapidly changing toward growing resistance to various antimicrobials, including @entity3273 and @entity9001 . Although increasing resistance to last-resort antimicrobials is alarming, simultaneous susceptibility of all MDR-AB isolates to some conventional antibiotics highlights the merits of investigating their synergistic activity against extended-spectrum and pandrug resistant A. baumannii. Integrating the novel Iranian MDR-AB IC variants into epidemiologic clonal and susceptibility profile databases can help global efforts toward the control of MDR-AB pandemic.
