Frequency and antibiogram of multi-drug resistant pseudomonas aeruginosa in a Tertiary Care Hospital of Pakistan

Farooq, Lubna; Memon, Zahida; Ismail, Muhammad Owais; Sadiq, Sara

doi:10.12669/pjms.35.6.930

Cited by 13 publications

(21 citation statements)

References 13 publications

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“…Another study conducted in Egypt showed highest incidence of P.aeruginosa at the burns unit as well as in ICU (Mahmoud, Zahran, Hindawi, Labib, & Galal, 2013). Another high frequency was also noted in Egypt (56%) (Farooq, Memon, Ismail, & Sadiq, 2019).…”

Section: Resultsmentioning

confidence: 88%

Comparison of in Vitro Activity of Colistin With Ceftolozane/Tazobactam Against Multi Drug Resistant Pseudomonas Aeruginosa “A Last Line Treatment Against Mdr”

Islam¹,

Khan²,

Azhar³

et al. 2020

aijmsr

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Objectives To evaluate and compare in vitro activity of Ceftolazane / Tazobactum and Colistin against Multi Drug Resistant (MDR) strains of Pseudomonas aeruginosa. Methodology After ethical approval this in vitro cross-sectional study was conducted from October 2017 to April 2018. Routine samples of pus, wound swabs, blood, tracheal aspirates and urine were collected and received from the in-patient and out-patient clinics. All the samples were submitted for culture and sensitivity testing at the microbiology laboratory of Ziauddin University Hospital, North Nazimabad campus. All the samples were processed according to the provided microbiological procedures, CLSI Guidelines 2018. Results Forty sample from the out-patient clinics represented pre-dominance of Multi Drug Resistant strains of Pseudomonas aeruginosa (which was found to be 41.2%). On culture and sensitivity testing, it was observed that 60% of the MDR strains of P. aeruginosa were susceptible to Ceftolazane / Tazobactum which was markedly comparable to the susceptibility shown by Colistin (99%).Statistically, P value was highly significant and was found to be 0.0001. Conclusion Colistin showed superior activity as compared to Ceftolazane / Tazobactum against MDR isolates of P. aeruginosa. Thus, Colistin has proven to be a possible and important alternative against MDR isolates of P. aeruginosa, but due to its narrow therapeutic window and toxicity profile this drug can be used only when there is no working alternative, or the infection is severely debilitating.

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Section: Resultsmentioning

confidence: 88%

Comparison of in Vitro Activity of Colistin With Ceftolozane/Tazobactam Against Multi Drug Resistant Pseudomonas Aeruginosa “A Last Line Treatment Against Mdr”

Islam¹,

Khan²,

Azhar³

et al. 2020

aijmsr

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“…A total of fifteen articles published in English, between the period of 2010 and 2020 were identified and reviewed, nine articles were prospective studies (Siddiqua et al, 2018;Farooq et al, 2019;Ahmadi et al, 2016;Rustini et al, 2017;Senthamarai, 2014;Farhan et al, 2019;Ahmed et al, 2019;Al-Marzoqi and Al Taee, 2013;Khan and Faiz, 2016), four were descriptive cross sectional studies (Pokharel et al, 2019;Karami et al, 2020;Mahfoud et al, 2015;Alhusseini et al, 2019), one systemic review and meta-analysis study (Acar et al, 2019) and one retrospective study (Al-Tawfiq et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

“…In Nepal MDRPA prevalence was reported according to the type of specimen where it found to be the highest in tracheal aspirate specimens (100%) and the lowest in pleural fluid samples (0%) (Pokharel et al, 2019). Female to male ratio for MDRPA prevalence was reported in two of the included articles as it was (1.17:1) in Pakistan (Farooq et al, 2019) and (1:3) in Qatar (Ahmed et al, 2019). Further information was reported in Pakistan regarding distribution of MDRPA according to medical ward as it was the highest in surgical ward (27.1%) and the lowest in the gynecology ward (4.1%) (Farooq et al, 2019).…”

Section: Mdrpamentioning

confidence: 97%

“…MDRPA prevalence was reported in seven of the collected articles. The distribution of MDRPA among the specimens was found to be as follows: Pakistan, (55%) (Farooq et al, 2019); Indonesia, (36%) (Rustini et al, 2017); India (41.35%) (Senthamarai, 2014); Egypt (66.6%) (Farhan et al, 2019); Qatar (8.1%) (Ahmed et al, 2019); Saudi Arabia (10.7%) (Khan and Faiz, 2016). In Nepal MDRPA prevalence was reported according to the type of specimen where it found to be the highest in tracheal aspirate specimens (100%) and the lowest in pleural fluid samples (0%) (Pokharel et al, 2019).…”

Section: Mdrpamentioning

confidence: 99%

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Antimicrobial Resistance Pattern of Pseudomonas aeruginosa from Different Clinical Specimens: Survey Article

Ladadweh

Falana

Ma’ali

et al. 2021

American Journal of Pharmacology and Toxicology

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Pseudomonas aeruginosa (P.A.) is a gram-negative, aerobic rod bacterium that mainly grows in soil and watery environments, infrequently being a part of microflora in healthy individuals. Since P.A. favors the growth in moistened areas, it can colonize in any simple aqueous solution, which in turn raises the risk of contamination and infection in hospital settings. The emergence of drug resistant bacterial species has become increasingly prevalent in many health care facilities worldwide. Pseudomonas aeruginosa is one of these pathogens that had developed resistance to many of the previously effective antibiotics. Hence, it is highly valued to know the resistance pattern of P.A. in every health care facility. That in turn would facilitate more accurate and effective empirical regimens selection when dealing with life threatening infections. The purpose of this study is to review antimicrobial resistance patterns of P. aeruginosa from different clinical specimens based on several studies made in different countries and to discuss the distribution of P. aeruginosa infection and antibiotic resistance according to the gender of the patients and the type of specimen. ScienceDirect, PubMed and Google scholar were used during search to find published articles in English language. 15 articles from different countries about antimicrobial resistance patterns of P. aeruginosa were used in this article. Studies done between 2010 and 2020 were chosen. In this study Aminoglycosides (Amikacin), Piperacillin/Tazobactam and Polymyxins (Polymyxin-B and Colistin) were found to be the most effective drugs against P. aeruginosa. On the other hand, the highest resistance rate was against Cefuroxime, Ceftriaxone, Ampicillin, Ticarcillin/Clavulanic Acid, Amoxicillin/Clavulanic Acid, Co-Trimoxazole, Ceftazidime, Cefepime, Aztreonam. Carbapenems (Meropenem and Imipenem) showed inconsistent results as they were found to be the most effective against P. aeruginosa in some places, while in others; they had the highest resistance rate.

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“…Microbial genomics and metagenomics played a key role in the identification of these MDR microbes which helped in designing effective strategies to mitigate or manipulate resistant microbes [ 12 ]. The high prevalence of MDR infections in Pakistan has been evidenced by numerous reports [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Resistome and microbial profiling of pediatric patient’s gut infected with multidrug-resistant diarrhoeagenic Enterobacteriaceae using next-generation sequencing; the first study from Pakistan

Afridi

Ali

Chang

2021

Libyan Journal of Medicine

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A high prevalence of multidrug-resistant (MDR) pathogens has been reported in adult and pediatric populations of Pakistan. However, data describing the effect of MDR microbes on the gut microbiota is scarce. We designed a cross-sectional pediatric study to investigate the effect of MDR microbes’ infection on the gut microbiome and its resistome of children using high-throughput next-generation sequencing (NGS). A cross-sectional study was conducted at a tertiary health care hospital in Peshawar Pakistan, between 5 September 2019 to 15 February 2020. Pediatric patients with acute gastroenteritis (n = 200) were enrolled. All the enrolled pediatric patients underwent initial antimicrobial resistance (AMR) screening using the disk diffusion method. Children with MDR infections were identified and selected for gut microbiome and its resistome profiling using NGS. Out of 200 enrolled pediatric patients, 80 (40%) were found infected with MDR diarrheagenic Enterobacteriaceae consisting of 50 (62.5%) infections caused by extended-spectrum beta-lactamase (ESBL) producing E. coli while 30 (37.5%) by MDR Enterobacter specie. A total of 63 and 17 antibiotic-resistant genes (ARGs) conferring resistance to 7 and 5 classes of antibiotics were identified in the resistomes of MDR diarrheagenic Enterobacteriaceae infected and healthy children, respectively. NGS-based gut microbial profiling of MDR Enterobacter spp ., ESBL producing E. coli infected pediatric patients and healthy controls revealed the predominance of Proteobacteria and Actinobacteria , respectively. An increased abundance of several pathogenic gram-negative bacteria namely E. coli, Enterobacter cloacae , and Salmonella enterica was observed in the gut microbiota of children infected with MDR bacterial infections than that of the healthy controls. This work indicates that children with MDR infections have reduced microbial diversity and enriched ARGs than healthy controls. The emergence of MDR bacterial strains and their association with gut dysbiosis needs immediate attention to regulate antibiotics usage in Pakistani children.

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Frequency and antibiogram of multi-drug resistant pseudomonas aeruginosa in a Tertiary Care Hospital of Pakistan

Cited by 13 publications

References 13 publications

Comparison of in Vitro Activity of Colistin With Ceftolozane/Tazobactam Against Multi Drug Resistant Pseudomonas Aeruginosa “A Last Line Treatment Against Mdr”

Comparison of in Vitro Activity of Colistin With Ceftolozane/Tazobactam Against Multi Drug Resistant Pseudomonas Aeruginosa “A Last Line Treatment Against Mdr”

Antimicrobial Resistance Pattern of Pseudomonas aeruginosa from Different Clinical Specimens: Survey Article

Resistome and microbial profiling of pediatric patient’s gut infected with multidrug-resistant diarrhoeagenic Enterobacteriaceae using next-generation sequencing; the first study from Pakistan

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