Growing Menace of Antibacterial Resistance in Clinical Isolates ofPseudomonas aeruginosain Nepal: An Insight of Beta-Lactamase Production

Abstract

Introduction. Pseudomonas aeruginosa is the most frequently isolated organism as it acts as the opportunistic pathogen and can cause infections in immunosuppressed patients. The production of different types of beta-lactamases renders this organism resistant to many commonly used antimicrobials. Therefore, the aim of this study was to document the antibiotic resistance rate in Pseudomonas aeruginosa isolated from different clinical specimens. Methods. Pseudomonas aeruginosa recovered was identified by standard microbiological methods. Antibiotic susceptibility testing was performed by modified Kirby-Bauer disc diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines and all the suspected isolates were tested for the production of ESBLs, MBLs, and AmpC. Results. Out of total (178) isolates, 83.1% were recovered from the inpatient department (IPD). Majority of the isolates mediated resistance towards the beta-lactam antibiotics, while nearly half of the isolates were resistant to ciprofloxacin. Most of the aminoglycosides used showed resistance rate up to 75% but amikacin proved to be better option. No resistance to polymyxin was observed. ESBLs, MBLs, and AmpC mediated resistance was seen in 33.1%, 30.9%, and 15.7% isolates, respectively. Conclusions. Antibiotic resistance rate and beta-lactamase mediated resistance were high. Thus, regular surveillance of drug resistance is of utmost importance.

Emergence of multidrug-resistant non-fermentative gram negative bacterial infection in hospitalized patients in a tertiary care center of Nepal

“…Fatima et al [30] and Xie et al [29] reported a lower resistance rate in P. aeruginosa against beta-lactam antibiotics. Our finding well correlates with the observations of other studies [5,31,32]. All the isolates of B. cepacia complex were found susceptible to co-trimoxazole, 72.7% to doxycycline, 66.7% to meropenem, and only 12.1% to ceftazidime.…”

Antimicrobial resistance patterns of Pseudomonas aeruginosa isolated from canine clinical cases at a veterinary academic hospital in South Africa

“…The results of this study and other studies suggest that resistance against β-lactams is common amongst P. aeruginosa (Ansari et al 2016 ; Mishra et al 2012 ; Rafiee et al 2014 ). This resistance is attributed to intrinsic resistance mediated by low membrane permeability and production of AmpC beta-lactamase amongst P. aeruginosa isolates (Pechère & Köhler 1999 ).…”

Extended Spectrum Beta Lactamase and Metallo Beta Lactamase producing Pseudomonas aeruginosa at Tertiary care Hospital of Nepal

“…Similarly, the study carried out by Ansari et al 2016 and Khanal et al 2013 Polymyxin B was found to be the most effective drug against P. aeruginosa with 96% susceptibility which is in accordance with the similar study carried out by Kumar et al 2014, Sharma et al 2016and Tankhiwale 2016 that showed 94%, 95% and 94.5% susceptibility respectively. In a similar study carried out by Bhandari et al 2012, Parajuli et al 2014and Patel and Garala 2014.6%, 64.2% and 73% of P. aeruginosa isolates was sensitive toward Polymyxin B respectively which is less than our fi ndings.…”

“…Thus, making the treatment of infections caused by P. aeruginosa diffi cult or impossible to treat and increasing global threat in community and hospital settings (Ansari et al 2016;Hirsh and Tam 2010;Solomon et al 2017).…”