Multidrug resistance in Pseudomonas aeruginosa isolated from nosocomial respiratory and urinary infections in Aleppo, Syria

Abstract

Introduction: Pseudomonas aeruginosa represents a serious clinical challenge due to its frequent involvement in nosocomial infections and its tendency towards multidrug resistance. Methodology: This study uncovered antibiotic susceptibility patterns in 177 isolates from inpatients in three key hospitals in Aleppo, the largest city in Syria. Results: Exceptionally low susceptibility to most routinely used antibiotics was uncovered; resistance to ciprofloxacin and gentamicin was 64.9% and 70.3%, respectively. Contrarily, susceptibility to colistin was the highest (89.1%). Conclusions: Multidrug resistance was rife, found at a rate of 53.67% among studied P. aeruginosa isolates.

Communicable disease surveillance and control in the context of conflict and mass displacement in Syria

“…Although there are few recent reports, a study from Aleppo in 2014 reported rates of multidrug-resistant Pseudomonas of 54%. 50 Reports from neighbouring countries state multidrug-resistant bacteria isolated from Syrian patients of up to 69%, 51 although this may not be representative of the situation inside Syria. Support and capacity building to the few remaining microbiology facilities in NGCAs could support the early detection of resistant bacteria, amongst other pathogens.…”

A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict

“…Since the first use of armed force and subsequent expansion of violence, data on the availability and efficacy of antimicrobial therapy within Syria have become increasingly limited. Six studies from inside Syria since late 2011 have reported concerns over the increasing burden ofresistant Gram-negative infections and methicillin-resistant Staphylococcus aureus (MRSA), four of these being focused on Aleppo (Alheib et al, 2015;Mahfoud et al, 2015;Al-Assil et al, 2013;Tabana et al, 2015). It is notable that few datasets from within Syria have reported on war-related injuries and their infectious complications; this is likely driven by several factors including political sensitivities and the overwhelmed health systems.…”

“…Alheib and colleagues examined 123 ESBL-producing E. coli and K. pneumoniae specimens in 2015 and found 66% of these isolates to be phenotypically resistant to ciprofloxacin (Alheib et al, 2015). Mahfoud and colleagues tested 177 Pseudomonas aeruginosa urinary and lower respiratory isolates from patients in three intensive care units in Aleppo and showed significant resistance to common anti-pseudomonal agents (piperacillin-tazobactam: 46%; meropenem: 41%; ceftazidime 73%) with colistin as the most reliable antibiotic (11% resistance) (Mahfoud et al, 2015). Al-Assil reviewed 104 patients with positive urine samples to understand the risk factors for the development of ESBL infections and isolated ESBL E. coli in 52% of cases (Al-Assil et al, 2013).…”

Intestinal colonization of infants with multidrug resistant Pseudomonas aeruginos in tertiary care center in Jordan

“…tics including carbapenems which are the drug of choice for treatment of infections of Gram-negative ESBL-producers [17][18]. Reports of carbapenem resistant P. aeruginosa recovered from patients have been documented from different Arab regions, including Jordan, Syria, Egypt, Saudi Arabia, Kuwait and Lebanon [5,[19][20][21][22][23].…”