Evaluation of Antibiotics Pattern of Extended Spectrum Beta-Lactamase Producing Multi-Drug Resistant Pseudomonas aeruginosa

Anees Muhammad, Ihsan Ali, Muhammad Owais, Sadiq Noor Khan, Irfan Qadir Afridi, Nasir Ali

Abstract


Background: Pseudomonas aeruginosa (Ps. aeruginosa) is considered as an opportunistic pathogen and the leading cause of morbidity and mortality in immunocompromised individuals. Globally, approximately 10-15% of the nosocomial infections are caused by Ps. aeruginosa. The Ps. aeruginosa can acquire resistance against broad-spectrum antibiotics. According to recent studies increased mortality has been observed due to infection with extended-spectrum-beta-lactamase (ESBL) producing Ps. aeruginosa strains. This study was designed to determined antibiogram of ESBL producing multi-drug resistant Ps. aeruginosa in Khyber Pakhtunkhwa.

Methods: The clinical confirmed Ps. aeruginosa samples were collected according to the standard protocol, at Khyber Teaching Hospital (KTH), Peshawar. All collected samples were sub- cultured on appropriate culture media. After isolation and identification, the antibiotics susceptibility testing was performed. The detection of ESBL was carried out by the double-disc diffusion method. Carbapenemase-producing bacteria was confirmed by the modified Hodge test. Descriptive analysis was performed for statistical analysis of collected data.

Results: A total of one hundred and sixty-two (n=162) Ps. aeruginosa confirmed isolates were collected, in which 59.3% were male and 40.7% were from female patients. The percentages of ESBL and carbapenemase producing Ps. aeruginosa isolates were 5.5% and 23.5%, respectively. The multidrug resistance was observed against 27.2% isolates. Among tested antibiotics highest percentages of resistance was observed against ciprofloxacin (43%) and ceftazidime (39.5%). 

Conclusion: We observed highest level of drug resistance in Ps. aeruginosa clinical isolates against tested antibiotics and majority of the isolates were Multi-drug resistant (MDR).

Keywords: Pseudomonas; Multi-Drug Resistant; Extended Spectrum Beta Lactamases; Antibiotics Susceptibility


Full Text:

PDF

References


Pang Z, Raudonis R, Glick BR, Lin T-J, Cheng Z. Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies. Biotechnology advances, (2019); 37(1): 177-192.

Gellatly SL, Hancock RE. Pseudomonas aeruginosa: new insights into pathogenesis and host defenses. Pathogens and disease, (2013); 67(3): 159-173.

Yayan J, Ghebremedhin B, Rasche K. Antibiotic resistance of Pseudomonas aeruginosa in pneumonia at a single university hospital center in Germany over a 10-year period. Plos one, (2015); 10(10): :e0139836.

Sonbol FI, Khalil MAEF, Mohamed AB, Ali SS. Correlation between antibiotic resistance and virulence ofPseudomonas aeruginosa clinical isolates. Turkish journal of medical sciences, (2015); 45(3): 568-577.

Bassetti M, Vena A, Croxatto A, Righi E, Guery B. How to manage Pseudomonas aeruginosa infections. Drugs in context, (2018); 72: 125-27.

Lister PD, Wolter DJ, Hanson ND. Antibacterial-resistant Pseudomonas aeruginosa: clinical impact and complex regulation of chromosomally encoded resistance mechanisms. Clinical microbiology reviews, (2009); 22(4): 582-610.

Dash M, Padhi S, Narasimham MV, Pattnaik S. Antimicrobial resistance pattern of Pseudomonas aeruginosa isolated from various clinical samples in a tertiary care hospital, South Odisha, India. Saudi Journal for Health Sciences, (2014); 3(1): 15.

Ali Z, Mumtaz N, Naz SA, Jabeen N, Shafique M. Multi-drug resistant Pseudomonas aeruginosa: a threat of nosocomial infections in tertiary care hospitals. JPMA, (2015); 65(12): 12-16.

Chen Z, Niu H, Chen G, Li M, Li M, et al. Prevalence of ESBLs-producing Pseudomonas aeruginosa isolates from different wards in a Chinese teaching hospital. International journal of clinical and experimental medicine, (2015); 8(10): 19400.

Institute CaLS. Performance Standards for Antimicrobial Susceptibility Testing. CLSI, (2018); M100, 28th ed.

Amjad A, Mirza IA, Abbasi S, Farwa U, Malik N, et al. Modified Hodge test: A simple and effective test for detection of carbapenemase production. Iranian journal of microbiology, (2011); 3(4): 189-193.

Laudy AE, Rog P, Smolińska-Król K, Ćmiel M, Słoczyńska A, et al. Prevalence of ESBL-producing Pseudomonas aeruginosa isolates in Warsaw, Poland, detected by various phenotypic and genotypic methods. PloS one, (2017); 12(6): e0180121

Senthamarai S. Resistance pattern of Pseudomonas aeruginosa in a tertiary care hospital of Kanchipuram, Tamilnadu, India. Journal of clinical and diagnostic research: JCDR, (2014); 8(5): DC30.

Samad A, Ahmed T, Rahim A, Khalil A, Ali I. Antimicrobial susceptibility patterns of clinical isolates of Pseudomonas aeruginosa isolated from patients of respiratory tract infections in a Tertiary Care Hospital, Peshawar. Pakistan journal of medical sciences, (2017); 33(3): 670-674.

Shah DA, Wasim S, Abdullah FE. Antibiotic resistance pattern of Pseudomonas aeruginosa isolated from urine samples of Urinary Tract Infections patients in Karachi, Pakistan. Pakistan journal of medical sciences, (2015); 31(2): 341-345.

Ullah F, Malik SA, Ahmed J. Antimicrobial susceptibility and ESBL prevalence in Pseudomonas aeruginosa isolated from burn patients in the North West of Pakistan. Burns, (2009); 35(7): 1020-1025.

Saaiq M, Ahmad S, Zaib MS. Burn wound infections and antibiotic susceptibility patterns at Pakistan Institute of Medical Sciences, Islamabad, Pakistan. World journal of plastic surgery, (2015); 4(1): 9-15.

Aneela S, Abrar S, Saeed M, Hussain S, Hannan A, et al. Distribution of Extended-spectrum β-lactamase and Metallo-β-lactamase-producing Pseudomonas aeruginosa in Tertiary Care Hospitals of Lahore, Pakistan. Journal of Islamabad Medical & Dental College, (2019); 8(1): 23-28.

Ullah W, Qasim M, Rahman H, Bari F, Khan S, et al. Multi drug resistant Pseudomonas aeruginosa: Pathogen burden and associated antibiogram in a tertiary care hospital of Pakistan. Microbial pathogenesis, (2016); 97: 209-212.




DOI: http://dx.doi.org/10.62940/als.v7i3.889

Refbacks

  • There are currently no refbacks.