Antimicrobial susceptibility patterns of clinical isolates of Pseudomonas aeruginosa isolated from patients of respiratory tract infections in a Tertiary Care Hospital, Peshawar

Abstract

Objective:This study aims to determine the prevalence and susceptibility pattern of Pseudomonas aeruginosa and multidrug-resistant (MDR) isolates in patients suffering from respiratory tract infection.Methods:A cross sectional study was conducted from January to December 2014 in Northwest General Hospital and Research Centre, Peshawar. A total of 615 sputum samples were collected from both in and out-patients. Sputum samples were collected as per standard procedure and were inoculated on Blood, MacConkey and Chocolate agar. The isolates were identified by standard protocols using biochemical tests. The antibiotic susceptibility pattern of each isolate was checked as per Clinical and Laboratory Standards Institute (CLSI) guidelines using Kirby-Bauer’s disc diffusion method.Results:Out of 615 sputum samples, 354 (57.56%) were culture positive. Out of these a total of 71 (20.05%) strains of Pseudomonas were isolated, where 54.93% was from males and 45.07% were from females (Mean age was 44.29 ± 22.72:). Highest sensitivity was seen to Amikacin (92.86%) followed by Meropenem (91.55%) while lowest sensitivity was seen to Cefoperazone + Sulbactam (16.9%). There were 39.44% MDR strains, out of which 25% were Extensively Drug Resistant (XDR) and 10.71% were Pan Drug Resistant (PDR). In vitro susceptibility of MDR isolates showed highest sensitivity to Amikacin (82.14%) followed by Carbapenems (78.57%). All MDR isolates were resistant to Cefoperazone + Sulbactam. Resistance to Piperacillin + Tazobactam was 96.43%.Conclusion:Pseudomonas aeruginosa is one of the commonly isolated organisms and it is becoming more resistant to commonly used antibiotics. Carbapenems and aminoglycosides were the two classes of drugs that showed highest activity against Pseudomonas aeruginosa.

Antibiotic susceptibility Patterns against Upper Respiratory Tract Pathogens in Tertiary Care Hospitals of Lahore, Pakistan

“…Our data further suggested that the notable gram-negative bacteria, P. aeruginosa, Klebsiella and E. coli, having maximum resistance against antibiotics belonging to penicillin (amoxcillin) and cephalosporin (cefaclor, cefuroxime, ceftriaxone) classes, while antibiotics belonging to carbapenem (imipenem, meropenem), aminoglycosides (amikacin), quinolones (ofloxacin) and piptaz of penicillin class were among the most effective antibiotics against similar gram-negative bacteria. Similar to our findings, a study from Pakistan reported that the most frequent gram-negative isolate was P. aeruginosa (32.2%) followed by Klebsiella (16.5%) and E. coli (12.5%), while imipenem, meropenem and tazobactam were among the most effective antibiotics [40]. These data suggested that the irrational or misuse of antibiotics due to self-prescribing upon experiencing similar symptoms, non-adherence to standard treatment guidelines [19], [20], poor knowledge of clinician and the patient, and limited finances, could contribute to antimicrobial resistance towards the majority of first line and even the second line therapeutic options in various gram-negative URTP.…”

Invasive device-associated infections caused by Pseudomonas aeruginosa in critically ill patients: evolution over 10 years

“…In other studies, resistant isolates reached 47% in pediatrics ICUs from India 8 or 40% in strains recovered from respiratory samples in a hospital in Pakistan. 9 The increase of multiresistant strains in ICU-acquired infections suggests the existence of reservoirs that should be identified and eradicated. The clinical impact of multiresistance to anti-pseudomonal antimicrobial agents includes delay in the administration of appropriate treatment, longer ICU stay, more days on mechanical ventilation, and higher mortality.…”

Bovine esophageal and glossal ulceration associated with <i>Pseudomonas aeruginosa</i> and <i>Fusobacterium</i> spp. in a 10-month-old Holstein heifer

“…Pseudomonas aeruginosa is an aerobic Gram-negative bacillus and an opportunistic pathogen that is abundant in various habitats. It has been implicated in different opportunistic infections and nosocomial outbreaks in human hospitals [ 21 ]. A large number of hospital outbreaks have been linked to environmental sources, particularly water systems [ 3 , 27 ].…”

“…A large number of hospital outbreaks have been linked to environmental sources, particularly water systems [ 3 , 27 ]. The species can evidently rapidly acquire resistance to various antimicrobial agents, and is capable of forming a biofilm [ 18 , 21 ], which acts as a direct barrier to phagocytic cells and offers innate resistance to antibiotics and disinfectants [ 10 ]. Most P. aeruginosa infections are difficult to treat because of the pathogen’s ability to resist many structurally unrelated antibiotics via both intrinsic and acquired antibiotic resistance mechanisms [ 13 ].…”

“…In recent decades, numerous enzymes belonging to this category have been detected in P. aeruginosa , including extended-spectrum beta-lactamases such as OXA, VEB, PER, SHV and TEM [ 14 , 16 ]. Although P. aeruginosa is one of the commonly isolated bacteria infecting the skin and respiratory tract in humans [ 21 , 29 ], few reports have described the histopathological features of infectious lesions caused by this species.…”