Antimicrobial resistance profiles and associated factors of Acinetobacter and Pseudomonas aeruginosa nosocomial infection among patients admitted at Dessie comprehensive specialized Hospital, North-East Ethiopia. A cross-sectional study

Abstract

Introduction Hospital admitted patients are at increased risk of nosocomial infections (NIs) with multi-drug resistant (MDR) pathogens which are prevalent in the hospital environment. Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii) are common causes of NIs worldwide. The objective of this study is to determine antimicrobial resistance profiles and associated factors of Acinetobacter spp and P. aeruginosa NIs among hospitalized patients. Methods A cross-sectional study was conducted at Dessie comprehensive specialized hospital, North-East Ethiopia, from February 1 to April 30, 2020. A total of 254 patients who were suspected of the bloodstream, urinary tract, or surgical site nosocomial infections were enrolled consecutively. Socio-demographic and other variables of interest were collected using a structured questionnaire. Specimens were collected and processed following standard microbiological procedures. Antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Data were analyzed with SPSS version 23 and p-value < 0.05 was considered statistically significant. Results Overall, 13% of patients had nosocomial Acinetobacter spp and/or P. aeruginosa infections. The culture positivity rate was 16(6.3%) for Acinetobacter spp and 18(7.1%) for P. aeruginosa. Patients admitted in the surgical ward (Adjusted odds ratio (AOR):10.66;95% confidence interval (CI):1.22–93.23), pediatric ward (AOR:14.37;95%CI:1.4–148.5), intensive care unit (AOR:41.93;95%CI:4.7–374.7) and orthopedics (AOR:52.21;95%CI:7.5–365) were significantly at risk to develop NIs compared to patients admitted in the medical ward. Patients who took more than two antimicrobial types at admission were 94% (AOR:0.06; 95% CI:0.004–0.84) times more protected from NIs compared to those who did not take any antimicrobial. About 81% of Acinetobacter spp and 83% of P. aeruginosa isolates were MDR. Amikacin and meropenem showed promising activity against Acinetobacter spp and P. aeruginosa isolates. Conclusion The high prevalence of MDR Acinetobacter spp and P. aeruginosa nosocomial isolates enforce treating of patients with NIs based on antimicrobial susceptibility testing results.

Novel Pseudomonas aeruginosa Strains Co-Harbouring blaNDM-1 Metallo β-Lactamase and mcr-1 Isolated from Immunocompromised Paediatric Patients

“… 6 Recent data show that MDR P. aeruginosa has a high prevalence rate that varies from 15% to 30% globally in hospital settings 7 In African countries alone, 13% of severe healthcare-associated infections are caused by MDR P. aeruginosa . 8 The ST1966 high-risk clone of P. aeruginosa has a high capacity to acquire antibiotic resistance genes and is prevalent in many parts of China, especially in hospital settings (unpublished data). However, no study has reported the occurrence of ST1966 co-harbouring New Delhi Metallo-beta-lactamase-1 (NDM-1) and Klebsiella pneumoniae carbapenemase (KPC) in P. aeruginosa .…”

Nosocomial Infections in Surgical Patients at a Central Academic Hospital in South Africa

“…Staphylococcus aureus has historically been the organism that was most commonly associated with nosocomial infections. In keeping with the current trend, most cases of nosocomial infections were caused by gram negative bacteria [15]. However, S. aureus was the most cultured causative organisms in nosocomial infections among trauma patients and patients who were admitted to the Breast & Endocrine Ward.…”

“…An overwhelming majority of nosocomial infections irrespective of pathogens involved occurred in males. Mekonnen and colleagues also reported a high rate of occurrence of nosocomial infections in males [15]. The overall prevalence of nosocomial infection in the surgical wards was 8.7%, which is slightly lower than in previous reports from setting in other LMICs [15,28].…”

“…The risk of the development of nosocomial infections is higher in surgical patients especially trauma patients and patients who are admitted to units where there is overcrowding [15]. The patients who are admitted to an ICU are also at heightened risk of development of nosocomial infection [9,10,16].…”

“…The risk factors for the development of nosocomial infections include the climatic condition [21,22], gender and age of a patient [12,15,18] and the type of surgery [18]. Nosocomial infections are more prevalent in patients who are HIV positive [15,22,23]; have co-morbidities [18,24,25] which also include obesity [18,[24][25][26] and hypoalbuminaemia [27].…”