Clinico-epidemiological profile of Acinetobacter and Pseudomonas infections, and their antibiotic resistant pattern in a tertiary care center, Western Nepal

Abstract

Background: Infections caused by Acinetobacter species and Pseudomonas species, especially multidrug-resistant (MDR) strains pose a serious management challenge with a public health threat.
 Materials and Methods: A hospital-based retrospective study of patients who were infected with Acinetobacter spp or Pseudomonas aeruginosa was carried out at Manipal Teaching Hospital from 2014 to 2016.
 Results: A total of 170 cases of infections with Acinetobacter spp. and 313 cases with Pseudomonas aeruginosa were studied. The rate of nosocomial infections was higher than non-nosocomial infections. ICU was found as the major hub for both the organisms; (53.5% of cases due to Acinetobacter spp. and 39.6% due to Pseudomonas aeruginosa). Most isolates were of respiratory tract origin (Acinetobacter 74.7% and Pseudomonas aeruginosa 65.8%). Percentage resistance of Acinetobacter spp. towards polymyxin B was found to be quite low (18.8%). Similarly, resistance rates of Pseudomonas aeruginosa against amikacin were also found to be low, i.e., 17.4%. A higher prevalence of multidrug resistance was seen among Acinetobacter spp than among Pseudomonas aeruginosa (75.9% vs. 60.1%). The hospital stay was longer for patients infected with MDR isolate (p=0.001 for Acinetobacter spp. and p=0.003 for Pseudomonas aeruginosa). The mortality rate was higher in infections due to Acinetobacter spp (15.9%) as compared to Pseudomonas aeruginosa (8.3%).
 Conclusion: These clinico-epidemiological data will help to implement better infection control strategies. Developing a local antibiogram database will improve the knowledge of antimicrobial resistance patterns in our region, facilitating the treating physician in advocating empiric therapy if need be.

Metallo-β-lactamase-producing Pseudomonas aeruginosa Isolates from Two Tertiary Care Centres in a District of Nepal: A Descriptive Cross-sectional Study

“…MDR rates in Nepal have been calculated by numerous studies and range from 21 to 89%. 14 , 16 , 19 In the current study among the MBL-Pseudomonas aeruginosa, 74 (71.84%) MDR isolates were found. A Nepal study found a similar incidence of MDR in Pseudomonas aeruginosa , but it's challenging to pinpoint trends due to varying percentages of resistance levels.…”

Uropathogens and their antimicrobial-resistant pattern among suspected urinary tract infections patients in eastern Nepal: A hospital inpatients-based study

“…Prevalence of P. aeruginosa exceeding A. baumannii has been documented in several studies. 29,30 The least isolated species among gram-negative uropathogens in our study was found to be P. mirabilis (1.55%). A study done by Jamil et al 31 also concluded that P. mirabilis had the least prevalence approximately 1%-2% after reviewing various studies.…”

The Threat of Carbapenem-Resistant Non-Fermenting Gram Negative Bacteria (NFGNB)

“…This is unlike a study assessing Clinicoepidemiological profile of Acinetobacter sp and Pseudomonas infections. The study observed that around 61% males and 39% females were infected with NFGNB respectively 14 . As far as ward-wise distribution is seen, maximum NFGNB were isolated from patients admitted in Surgery ward constituting 46 (35.3%) cases followed by Medical ward consisting of 38(29.23%) cases.…”