Antibiotic susceptibility patterns of <i> Pseudomonas aeruginosa</i> at a tertiary care hospital in Gujarat, India

Abstract

Objectives:The present study was undertaken to assess the antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujarat, India. Due to significant changes in microbial genetic ecology, as a result of indiscriminate use of anti-microbials, the spread of anti-microbial resistance is now a global problem.Materials and Methods:Out of 276 culture positive samples, 56 samples of Pseudomonas aeruginosa were examined and 10 different types of specimen were collected. Microbial sensitivity testing was done using disk diffusion test with Pseudomonas species NCTC 10662, as per CLSI guidelines.Results:The highest number of Pseudomonas infections was found in urine, followed by pus and sputum. Pseudomonas species demonstrated marked resistance against monotherapy of penicillins, cephalosporins, fluoroquinolones, tetracyclines and macrolides. Only combination drugs like Ticarcillin + Clavulanic acid, Piperacillin + Tazobactum, Cefoperazone + Sulbactum, Cefotaxime + Sulbactum, Ceftriaxome + Sulbactum and monotherapy of amikacin showed higher sensitivity to Pseudomonas infections; however, the maximum sensitivity was shown by the Carbapenems.Conclusion:From the present study, we conclude that urinary tract infection was the most common hospital acquired infection. Also, co-administration of β -lactamase inhibitors markedly expanded the anti-microbial sensitivity of semi-synthetic penicillins and cephalosporins. The aminoglycoside group of antibiotics - amikacin - demonstrated maximum sensitivity against pseudomonas species. Therefore, use of amikacin should be restricted to severe nosocomial infections, in order to avoid rapid emergence of resistant strains. Periodic susceptibility testing should be carried out over a period of two to three years, to detect the resistance trends. Also, a rational strategy on the limited and prudent use of anti-Pseudomonal agents is urgently required.

Prevalence of multidrug-resistant, extensively drug-resistant, and pandrug-resistant Pseudomonas aeruginosa from a tertiary level Intensive Care Unit

“…Piperacillin resistance was found to be 70% in our study, which is comparable to a report showing it to be 73%. [14] Emergence of resistance to beta-lactams in P. aeruginosa has become a serious threat, particularly against the third- and fourth-generation cephalosporins. There are a lot of molecular mechanisms involved for resistance against these antibiotics, generation of ESBL enzyme, incorporation of bla genes in integrons, and inability of porin genes to enhance their expression level and/or alteration of antibiotic target sites.…”

“…The resistance to ceftazidime and cefepime observed in our study was similar to that of a previous report from India. [14]…”

In vitro Antimicrobial Synergy Testing of Extensively Drug-Resistant Clinical Isolates at an Organ Transplant Center in Nepal

“…Some other studies have also demonstrated a very good sensitivity of Pseudomonas to carbapenems and some of the aminoglycosides including amikacin. 38 , 39…”

Antibacterial Potentials of some Toothpaste Products against some Oral Bacterial Isolates

“…All the toothpastes at different dilutions showed no inhibitory effects on P. aeruginosa. This could be due to its intrinsic resistance to many antimicrobial agents, mainly due to the synergistic effect of multi-drug efflux system and the bacteria's low outer membrane permeability [36] The MIC and MBC results revealed that sodium fluoride-zinc sulphate, benzyl alcohol-sodium fluorophosphates and sodium fluoride-eugenol toothpastes had bacteriostatic and bactericidal effects on S. aureus, S. mitis, S. salivarius and S. pyogenes. Of these three toothpastes, sodium fluorideeugenol was shown to be the most inhibitory for microorganisms, followed by benzyl alcohol-sodium fluorophosphates and sodium fluoride-zinc sulphate.…”