Extended spectrum and metalo beta-lactamase producing airborne Pseudomonas aeruginosa and Acinetobacter baumanii in restricted settings of a referral hospital: a neglected condition

Abstract

BackgroundFrequently encountered multidrug-resistant bacterial isolates of P. aeruginosa and A. baumannii are common and prevalent in a hospital environment. The aim of this study was to determine the prevalence and pattern of antibiotic resistance, extended spectrum and metallo beta-lactamase producing P. aeruginosa and A. baumannii isolates from restricted settings of indoor air hospital environment.MethodsA hospital-based cross-sectional study was conducted in Wolaita Sodo University Teaching and referral Hospital, Ethiopia from December 1/2015 to April 30/2015. The Air samples were collected from delivery room, intensive care unit and operation theatre of the hospital by active, Anderson six slate sampler technique during the first week of the months, twice a week during Monday’s and Friday’s. Standard microbiological procedures were followed to isolate P. aeruginosa and A. baumannii. Susceptibility testing was performed on isolates using the Kirby-Bauer disk diffusion technique. Extended spectrum beta lactamase production was detected by double disc synergy test and Imipenem-resistant isolates were screened for producing Metallo-beta lactamase.ResultsA total number of 216 indoor air samples were collected from the delivery room, intensive care unit, and operation room. Correspondingly, 43 A. baumannii isolates were identified (13 from delivery room, 21 from intensive care unit and 9 from operation room). Likewise 24 P. aeruginosa isolates were obtained (4 from delivery room, 13 from intensive care unit and 7 from operation room). Extended spectrum beta lactamase and metalo-beta lactamase production were observed in 24 (55.8%) and 13 (30.2%) isolates of A. baumannii respectively, whereas P. aeruginosa showed 15 (62.5%) extended spectrum beta lactamase and 9 (37.5%) metallo-beta lactamase production.ConclusionsExtended spectrum beta lactamase and metallo-beta lactamase producing bacteria in hospital air is a new dimension for specific setting of the study area where antimicrobial resistance is increasing and surgical site infection is prevalent. So, identification of these microorganisms has a great role in reducing the burden of antibiotic resistance and could also provide a significant input for framing hospital infection control policies.

Multi-drug resistance of blood stream, urinary tract and surgical site nosocomial infections of Acinetobacter baumannii and Pseudomonas aeruginosa among patients hospitalized at Felegehiwot referral hospital, Northwest Ethiopia: a cross-sectional study

“…The proportion of nosocomial MDR A. baumannii infection (3.8%) in the present study was in agreement with earlier studies conducted in Africa (2.4-5.7%) [26,29,32]. However, it was lower compared with findings from Sodo (15.3%), Ethiopia [18] and Gaza city (6.9%) [28]. In contrast, it was higher than findings from previous studies in elsewhere (0.42-0.95%) [27,30].…”

“…Similarly, the magnitude of nosocomial MDR P. aeruginosa infection (4.6%) in the present study was comparable with a study in Uganda (5%) [26]. However, it was lower than findings from other parts of Ethiopia (11.1-66.7%) [8,18,25], Ghana (19.5%) [32], India (76.8%) [39] and Italy (8.7%) [27]. In contrast, it was higher compared to a study in China (0.36%) [30].…”

“…This was coherent with studies in Uganda [23], India [39] and Taiwan [41] where 71-77% resistance against ceftazidime reported. Moreover, 70.8 and 92.8% level of resistance against cefotaxime were documented in Sodo, Ethiopia [18] and Southeast China [35], respectively. On the other hand, low level of resistance against ceftazidime reported in other parts of Ethiopia (12.5-29.1%) [18,25] and Italy (31%) [27].…”

“…Nosocomial isolates of MDR A. baumannii and P. aeruginosa complicated the treatment of infections and had adverse effect on clinical outcomes and increases patient treatment costs [18]. Factors such as antimicrobial drug overuse, prescription of drugs without susceptibility testing, self-medication and long duration of hospitalization are reported to the occurrence of MDR [11,19].…”

Therapeutic Challenges of Multidrug Resistant Acinetobacter baumannii in Eastern Africa: Systematic Review

“…Those patients infected with carbapenem resistant strains have a 35.2% proportional chance of cure with these honored drugs and seeks for easily inaccessible drug colistin and resistant to 25.2% of those who had the chance in the poor nations of Eastern Africa.The surgical site infections due A. baumannii in Ethiopia shown that 34.8% of the isolates were pan-resistant, unable to treat with locally available treatment options leading for unnoticed death(30). Similarly, 16.3% of isolates from the operation theatre and delivery rooms were responsible for untreatable infections to patients attending hospitals of Ethiopia(45). Whereas, in Uganda 55% of hospital environment isolates were resistant for carbapenem looking for the unavailable and 25.2% proportionally resistant drug, colistin(29).…”