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Prevalence of Multidrug Resistant Pseudomonas aeruginosa Isolated from Clinical Specimens in Tertiary Care Hospital
Samikshya Sharma1, Madhu Dixit Devkota2, Bharat Mani Pokhrel2
1Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu 44618, Nepal.
Background:
Pseudomonas aeruginosa is an opportunistic pathogen, which causes nosocomial infections in human. The rapid increase in drug resistance of this pathogen is a global concern. The aim of this study was to determine the clinical burden of P.aeruginosa, its antibiotic susceptibility pattern along with metallo-β-lactamase (MBL) detection.
Methods:
The descriptive cross-sectional study was conducted in Upendra Devkota Memorial National Institute of Neurological and Allied Sciences from January to August 2021. Isolation and identification of P. aeruginosa from clinical specimens was performed by using standard laboratory procedure. All bacterial isolates were phenotypically screened for multidrug resistance using Kirby Bauer disc diffusion method. All the multidrug resistant P.aeruginosa were phenotypically screened for MBL producer by Imipenem-EDTA combined disc diffusion test (CDDT).
Results:
A total of 770 samples were processed of which 36 isolates of P. aeruginosa were obtained. P.aeruginosa was isolated mainly from tracheal aspirates, sputum, blood and urine. Among 36 isolates, 50% were found to be multidrug resistant (MDR). More percentage of P.aeruginosa isolates were found resistant to aztreonam, ofloxacin and levofloxacin (52.8%). Furthermore, this study reveals antibiotics like piperacillin/tazobactam and carbapenem were found to be good choice for the treatment of infection caused by this organism. Among MDR isolates 66.7% were found to be MBL producer.
Conclusions:
The data in this study highlights the prevalence of multidrug resistant, MBL producer, and colistin resistant P.aeruginosa in clinical specimens. In this study, carbapenems and piperacillin/tazobactam were found to be most effective antimicrobial drugs for empirical therapy in P.aeruginosa infections.
Insights
Multidrug resistant Pseudomonas aeruginosa is a growing concern in hospitals. This study found 50% of isolates were resistant, with many producing metallo-beta-lactamases (MBLs), but carbapenems and piperacillin/tazobactam showed effectiveness.
Area of Science:
- Clinical microbiology
- Infectious diseases
- Antimicrobial resistance
Background:
- Pseudomonas aeruginosa is a significant opportunistic pathogen causing hospital-acquired infections.
- Increasing antibiotic resistance in P. aeruginosa poses a global health threat.
- Understanding resistance patterns is crucial for effective treatment strategies.
Purpose of the Study:
- To assess the clinical prevalence of P. aeruginosa.
- To determine the antibiotic susceptibility profile of P. aeruginosa isolates.
- To detect metallo-beta-lactamase (MBL) production in resistant strains.
Main Methods:
- A descriptive cross-sectional study was conducted from January to August 2021.
- Standard laboratory procedures were used for P. aeruginosa isolation and identification.
- Kirby Bauer disc diffusion and Imipenem-EDTA combined disc diffusion tests were employed for resistance and MBL screening.
Main Results:
- Out of 770 samples, 36 P. aeruginosa isolates were identified, primarily from tracheal aspirates, sputum, blood, and urine.
- Fifty percent of the isolates exhibited multidrug resistance (MDR).
- Resistance was high to aztreonam, ofloxacin, and levofloxacin (52.8%), while piperacillin/tazobactam and carbapenems showed good efficacy. 66.7% of MDR isolates were MBL producers.
Conclusions:
- The study highlights the prevalence of multidrug-resistant, MBL-producing P. aeruginosa.
- Carbapenems and piperacillin/tazobactam are recommended as effective empirical treatments for P. aeruginosa infections.
- Colistin resistance was also noted in clinical specimens.
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