Pathogen burden & associated antibiogram of Pseudomonas spp. in a tertiary care hospital of India

Abstract

Antimicrobial resistance particularly in Gram-negative bacilli is an increasing problem worldwide. Pseudomonas spp. is one the most common Gram-negative bacteria associated with nosocomial infections and therefore, its trend of antimicrobial resistance needs to be studied. The aim of this study was to evaluate the rate of antimicrobial resistance and changes in resistance pattern over a period of five years (2012-2016) in Pseudomonas spp. isolated from trauma patients attending a tertiary care hospital in north India. During the study, a total of 2444 Pseudomonas spp. were isolated from the various clinical sample. The most common species isolated was P. aeruginosa (2331, 95%). The highest level of resistance was observed against levofloxacin (1678, 69%) and the lowest level of resistance was observed against tobramycin (1254, 51%). Irrational and inappropriate use of antibiotics was found to be responsible for multidrug resistance in Pseudomonas spp. Hence, there is an urgent need to emphasize strict antibiotic policy to minimize the misuse of antimicrobials.

Occurrence of Multiple, Extensive and Pan Drug-Resistant Pseudomonas aeruginosa and Carbapenemase Production from Presumptive Isolates Stored in a Biobank at Ethiopian Public Health Institute

“…In this study, P. aeruginosa (98%) was the most prevalent species and the remaining was P. putida (2%) identified as the common cause of human pathogen among the genus Pseudomonas. Similar results were reported in Ethiopia and elsewhere in the world; [11][12][13] these reports included a few uncommon species such as P. luteola, P. stutzeri, P. mendocina, P. pseudoalcaligenes, and P. fluorescens which were not seen in this study.…”

“…This is in agreement with study findings in Ethiopia (28% and 20%) 11 and in Iran (35% and 38%) 16 for both drugs, respectively. In contrast, this number is reported as higher (69% and 55%) in Uganda, 17 (63% and 62%) in Egypt, 18 (65% and 55%) in Mexico, 19 and (66% and 63%) in India 12 for ceftazidime and cefepime respectively. Unnecessary prescription of cephalosporins leads to genetic alteration of the pathogen; particularly over-production of β-lactamases could be the possible reason for the increased resistance seen in those countries.…”

“…This is consistent with the previous finding in Ethiopia that reported 19.7% and 23% resistance to ciprofloxacin and levofloxacin, respectively 11 and 19% average resistance for both drugs were reported in 2019 Europe AMR surveillance. 20 In contrast, Ethiopian researchers reported 35-61%, 14,21,22 Uganda 64%, 17 and India 67% 12 resistance rates for ciprofloxacin. The reason for this discrepancy could be due to merged analysis of intermediate and resistant categories, lower isolates or variation in sample size, different study settings and patient conditions, and considerable geographical difference.…”

Pseudomonas aeruginosaSecreted Biomolecules and Their Diverse Functions in Biofilm Formation and Virulence

“…Similar multi-drug resistance profile of P. aeruginosa was recorded in Asian countries. For example, antibiogram of total 2444 Pseudomonas species isolated from different clinical specimens (blood, pus, tracheal aspirate, urine and sputum from wards, intensive care units (ICUs) and follow up patients) of trauma patients from tertiary care hospitals in India over a period 2012-2016 revealed dominance of P. aeruginosa (95%) [25]. Among 69%, 68%, 67% 66%, 63% and 51% were levofloxacin, gentamicin, ciprofloxacin, ceftazidime, meropenem and tobramycin resistance, respectively [25].…”

“…For example, antibiogram of total 2444 Pseudomonas species isolated from different clinical specimens (blood, pus, tracheal aspirate, urine and sputum from wards, intensive care units (ICUs) and follow up patients) of trauma patients from tertiary care hospitals in India over a period 2012-2016 revealed dominance of P. aeruginosa (95%) [25]. Among 69%, 68%, 67% 66%, 63% and 51% were levofloxacin, gentamicin, ciprofloxacin, ceftazidime, meropenem and tobramycin resistance, respectively [25]. Antibiotic profile of 121 P aeruginosa strains isolated from hospitals of Makkah and Jeddah, Saudi Arabia showed high resistance to antibiotics: meropenem (~30.6%), ticarcillin (22.3%), and imipenem (19%) [26].…”