Incidence of Multidrug Resistant Pseudomonas Aeruginosa Isolated from Burn Patients and Environment of Teaching Institution

Abstract

Context: Pseudomonas aeruginosa is an important pathogen which causes nosocomial infections in immunocompromised patients, especially in hospitalized burn patients. In recent times, it has emerged as a widespread Multi Drug Resistant (MDR) pathogen which requires antibiotic susceptibility testing on a regular as well as a periodic basis. Aim of the study:The present study was undertaken to determine the antibiogram of P. aeruginosa which was isolated from inpatients and environmental sources, and to type the strains, based on their antibiogram patterns. Settings and Design:A prospective study was undertaken with 525 samples (blood and wound swabs) which were taken from 60 patients who were admitted to Vardhman Mahavir Medical College and Safdarjang hospital with burn injuries and with 101 samples which were obtained from environmental sources viz. surgical instruments, dressings, suction devices, sinks, antiseptic solutions, etc. Materials and Methods:The strains were cultured and identified by standard microbiological techniques and Kirby-Bauer disc diffusion antibiotic susceptibility testing was done for each. Statistical analysis:Chi-squire tests were done and p-values of less than 0.05 were considered to be significant. Results:Fifty six strains and two strains, respectively, of P. aeruginosa were isolated from inpatients and environmental samples (one strain from sink and one strain from door wall, among the two) respectively. In total, 58 (81%) P. aeruginosa strains were found to be resistant to aminoglycosides, 41-70% were resistant to beta-lactams -piperacillin, ceftazidime, and aztreonam, 34.5% were resistant to piperacillin-tazobactam, 12.06% were resistant to ciprofloxacin and 13-19% were resistant to carbapenems. All strains were sensitive to colistin. P. aeruginosa was resistant to three of the four 'in-use' drugs i.e. piperacillin+tazobactam, imipenem, ceftazidime, and gentamicin, which was taken as MDR, which depicted MDR percentage as 36.2 (21/58). Conclusion:Strategies of optimal prescribing, including control of antibiotic usage, coupled with periodic studies on MDR P. aeruginosa infections in burn patients, appear to be leading priorities which help in improving therapeutic gains in such patients.

Investigation of antimicrobial susceptibility, class I and II integrons among Pseudomonas aeruginosa isolates from hospitalized patients in Isfahan, Iran

“…Pseudomonas aeruginosa is one of the most important pathogen causing a wide range of infections in the hospitals and healthcare settings [ 16 ]. The spread of resistance to antimicrobial agents and the emergence of clinical multidrug resistance P. aeruginosa isolates in clinical settings has become a serious problem in the treatment of nosocomial infections worldwide [ 17 , 18 ]. Resistance to antimicrobial agents can be originated from many resistance genes that present as gene cassettes and transferred through integrons which are located on transmissible plasmids, the chromosome, and transposons [ 10 ].…”

High incidence of type III secretion system associated virulence factors (exoenzymes) in Pseudomonas aeruginosa isolated from Iranian burn patients

“…In the present study, the frequency of MDR in Guilan province (Northern Iran) was estimated 59%, which was lower than that of the studies conducted in capital of Iran in 2011–2013 (93.1%–100%) [19, 20], central parts of Iran in 2015 (95.8%) [21], southwest of Iran in 2014 (76.4%) [22], and Brazil in 2012 (71.4%) [23], whereas it was higher than the studies performed in India in 2014 (33.9%) [24], capital of Iran in 2008 (32.6%) [25], and central parts of Iran in 2013 (26.7%) [26]. These differences in the prevalence of MDR strains might be attributed to the differences in geographical distribution, infection control policies, the nature of infections and sample size.…”

Molecular Analysis of Pseudomonas aeruginosa Strains Isolated from Burn Patients by Repetitive Extragenic Palindromic-PCR (rep-PCR)

“…Multi-drug-resistant (MDR) P. aeruginosa causes 4% -60% nosocomial infections all around the world and accounts for the mortality and morbidity in burn patients (3). Due to its intrinsic resistance to numerous antibiotic classes and its ability to practically resist to all effective antibiotics, P. aeruginosa has been one of the major concerns for nosocomial infections in hospitals in recent years (4).…”