Multi-drug Resistant Pseudomonas aeruginosa Isolated from Intensive Care Burn Unit

Abstract

This prospective study was conducted on burn patients visiting Victoria Hospital, Kalasipalayan, Bangalore, India from Nov 15, 2010 to June 15, 2011. A total of 100 samples were collected from the burn patients. Pus sample were collected from wound using a sterile cotton swab and transported to the laboratory using Stuart's medium without delay. Speciemen were inoculated on MacConkey agar, Blood agar and Nutrient agar plates and the plates were incubated at 37°C over night. Initial diagnosis of isolates was made on the basis of Gram's staining of pus and culture, colonial morphology on different media, haemolysis on Blood agar, pigment production on nutrient agar and smell in cultures. P. aeruginosa isolates were confirmed by biochemical tests including Oxidase test, Citrate utilization, Aesculin hydrolysis, Gelatin hydrolysis, Nitrate reduction and growth at 42°C. Sugar fermentation tests including Glucose, Sucrose, and Maltose were also performed. The antibiotic susceptibility test of P. aeruginosa isolates were performed by modified Kirby Bauer's Disc Diffusion method using 12 different antibiotics (Amikacin(30mcg), Ciprofloxacin(5mcg), Gentamicin(10mcg), Cefotaxime(30mcg), Imipenem(10 Abstract Background: Pseudomonas aeruginosa is an opportunistic pathogen that develops life-threatening infections in patients with immunological system defects like burn patients. P. aeruginosa is naturally resistant as well as able to get acquired resistance to effective antibiotics which lead to problematic conditions. This study was designed to isolate P. aeruginosa from burn patients and to evaluate drug susceptibility for determination of multidrugresistant isolates of P. aeruginosa. Materials and Methods: A prospective study was carried out on the patients visiting Victoria Hospital, Kalasipalayan, Bangalore, India from Nov 15, 2010 to June 15, 2011. The pus sample was collected using sterile cotton swab from 100 patients with burn wound infections. P. aeruginosa was identified by standard bacteriological methods. The drug susceptibility pattern using 12 different antimicrobial agents (Amikacin, Ciprofloxacin, Gentamicin, Cefotaxime, Imipenem, Meropenem, Cefoperozone, Tobramycin, Piperacillin/Tazobactum, Cefepime, Ceftazidime, and Norfloxacin) was performed for all the isolates using Kirby Bauer's Disc Diffusion Method. Results: P. aeruginosa were isolated from 17 clinical samples and all of these isolates were Multidrug Resistance P. aeruginosa (MDRPa). Resistance rates to various antibiotics were as follows: Amikacin (47.1%) Ciprofloxacin (35.5%) Gentamicin (47.1%) Cefotaxime (76.5%) Imipenem (88.2%) Meropenem (94.1%) Cefoperozone (94.1%) Tobramycin (100%) Piperacillin/Tazobactum (82.4%) Cefepime (64.7%) Ceftazidime (70.6%) Norfloxacin (70.6%). Conclusion: Optimization of using antimicrobial agents and control of infection is recommended to prevent the increasing population of MDRPa in the new burn centre setting in this study.

MDR Pseudomonas aeruginosa in Nosocomial Infection: Burden in ICU and Burn Units of a Tertiary Care Hospital

“…A study carried out by Upadhyay et al, in 2014 showed that 17% of P. aeruginosa among infected burns patients, which is almost similar to present study (Upadhaya, 2014 Iraj et al, (2013) showed that resistance to Ciprofloxacin was 63.3% and according to Upadhyay et al, resistance to cefepime was 64.7% which is also similar to our study (Upadhaya, 2014;Iraj et al, 2013). Present study shows least resistance against Imipenem (33.3%), Piperacillin/Tazobactum (33.3%), Colistin (16.7%) similar study done by Iraj et al,obtained 23.3% resistance to Imipenem (Iraj et al, 2013) (Fig.…”

High Incidence of Multidrug Resistant Pseudomonas aeruginosa Isolated from Infected Burn Wounds in a Tertiary Hospital

“…Mozami -Gordarzi and Eftekhar in their study found 94.7% isolates resistant to both imipenem and meropenem. Similarly Upadhaya et al, (2014) showed 94.1% and 88.2% resistance to meropenem and imipenem respectively in their study. …”

“…Bhatt et al, (2015) showed 84% and 75% resistance to gentamicin and tobramycin respectively. However Upadhaya et al, (2014) showed 47.1% and 100% isolates to be resistant to gentamicin and tobramycin respectively.…”

“…Similarly Saderi et al, (2014) showed 69% isolates to be MDR.However S Upadhaya et al, (2014) and MoazamiGoudarzi and Eftekhar (2012) showed 100% MDR isolates in burns patients.…”

Incidence of carbapenem-resistant pseudomonas aeruginosa in clinical samples

“…In the past few decades, MDRPs increasing worldwide recognized as a pathogens in a variety of serious infections in hospitalized patients. [1][2][3] The carbapenemes have been drug of choice for the treatment of serious infection caused by gram negative bacterial infections. [4] Pseudomonas shows resistance to carbapenem due to decrease outer membrane permeability, increased efflux system, alteration penicillin binding protiens and carbapenem hydrolyzing enzymes carbapenemase.…”