Shahram Shahraki Zahedani , Rogaye Javadi ,
Volume 12, Issue 2 (3-2018)
Abstract
ABSTRACT
Background and Objectives: Acinetobacter baumannii is an opportunistic pathogen associated with nosocomial infections. Treatment of infections caused by this bacterium has become challenging due to increasing rate of resistance to a wide range of antibiotics such as carbapenems. One of the main mechanisms of resistance to carbapenems is the production of carbapenemase. The objective of this study was to evaluate antibiotic resistance patterns and frequency of carbapenemase-producing A. baumannii strains using the CarbAcineto NP Test.
Methods: In this descriptive cross-sectional study, 130 A. baumannii isolates were collected from clinical specimens of teaching hospitals in Zahedan in 2016. After determining the antibiotic resistance patterns, all A. baumannii isolates were examined using the phenotypic method of CarbAcineto NP test to evaluate production of carbapenemase enzymes.
Results: Based on the antibiogram results, more than 90% of the isolates were resistant to the antibiotics tested in this study. However, the lowest rate of resistance was observed against colistin, minocycline, tigecycline and doxycycline, respectively. Based on the results of the CarbAcineto NP test, 96% of carbapenem-resistant strains were positive for the production of carbapenemases.
Conclusion: Due to the high resistance of A. baumannii to carbapenems, they are not currently suitable for the treatment of infections caused by this bacterium. However, since most carbapenem-resistant strains are susceptible to colistin, minocycline, tigecycline, and doxycycline, these antibiotics or their combination are recommended for the treatment of the infections caused by the resistant strains. Rapid identification of carbapenemase-producing bacteria using efficient methods such as CarbAcineto NP test is essential to prevent their spread, particularly in hospitals.
KEYWORDS: Acinetobacter baumannii, Carbapenemase, CarbAcinetoNP Test.
Sarah Ahmed Hasan, Waad Mahmood Raoof, Khaled Khalil Ahmed,
Volume 19, Issue 4 (7-2025)
Abstract
Background: Carbapenems are broad-spectrum β-lactam antibiotics, often reserved as last-line treatment for infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Carbapenemase producing organisms (CPOs) pose a serious public health threat, contributing to severe healthcare-associated infections and increased mortality rates. This study aimed to determine the prevalence of CPOs and their antibiotic resistance patterns in isolates from burn and wound infections.
Methods: A total of 250 clinical samples (140 wound swabs and 110 burn swabs) were collected from hospitalized patients in Kirkuk and Sulaimaniyah hospitals between January and July 2023. Specimens were cultured on MacConkey agar and cetrimide agar and incubated at 37°C for 18–24 hours. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix™ M50 system, while carbapenemase production was confirmed using the BD RAPIDEC® CARBA NP assay.
Results: Among the isolates, 27 (38.02%) were confirmed as carbapenemase-producing and exhibited multidrug resistance. The distribution was as follows: Pseudomonas aeruginosa (44.44%, 12 isolates), Escherichia coli (33.33%, 9 isolates), Enterobacter cloacae (18.51%, 5 isolates), and Klebsiella pneumoniae (3.7%, 1 isolate). Notably, CP-P. aeruginosa and CP-K. pneumoniae showed the highest resistance, being resistant to 15 antibiotics across seven different classes.
Conclusion: This study reveals a high prevalence of MDR CPOs in burn and wound infections, likely due to antibiotic misuse or overuse. The findings highlight the urgent need for novel therapeutic strategies to combat carbapenem-resistant pathogens, which are associated with increased global morbidity and mortality.
Behin Omidi, Sana Zarrin, Yasaman Ghazzagh, Yasin Sarveahrabi,
Volume 20, Issue 4 (9-2026)
Abstract
Background: Antimicrobial resistance (AMR) represents one of the most significant global health threats of the 21st century, undermining advances in modern medicine. Iran, as a geographically and demographically strategic nation, faces a severe and escalating AMR crisis. This review synthesizes current evidence on the epidemiology, molecular mechanisms, and systemic drivers of AMR in Iran, while outlining priorities for effective national response.
Methods: A structured review was conducted of studies published between January 2015 and November 2025 in PubMed, Scopus, and Web of Science, supplemented by national and Persian-language databases. Eligible studies investigated the prevalence, molecular characteristics, and clinical outcomes of antibiotic-resistant bacteria in Iran. Data were extracted and narratively synthesized.
Results: Iran faces an alarming burden of MDR and drug resistant (XDR) Gram negative pathogens, notably Acinetobacter baumannii, Pseudomonas aeruginosa and carbapenem resistant Enterobacteriaceae, with carbapenem resistance rates exceeding 80-90%. Widespread dissemination of key carbapenemase genes (blaNDM, blaOXA-48, blaVIM) has been documented. Gram positive pathogens, including methicillin resistant Staphylococcus aureus and vancomycin resistant Enterococci, also remain highly prevalent. The crisis is driven by unregulated over the antibiotic use, weak infection prevention and control measures, fragmented surveillance, and limited diagnostic capacity.
Conclusion: AMR in Iran has reached critical levels, constituting a national public health emergency. Urgent, coordinated reforms across integrated surveillance, mandatory antimicrobial stewardship, strengthened infection prevention and control, One Health integration, expanded research, and public engagement are required. Without decisive national action, Iran risks a post antibiotic era in which routine infections and medical procedures become life threatening.
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