Multidrug resistance of Pseudomonas aeruginosa as known from surveillance of nosocomial and community infections in an Indian teaching hospital

Abstract

Aim The aim of the present study was to record nosocomial and community-acquired accounts of antibiotic resistance in Pseudomonas aeruginosa strains, isolated from clinical samples of a hospital by surveillance, over a period of 18 months (November 2009-April 2011. Subject and Methods Clinical samples from nosocomial sources, i.e. wards and cabins and intensive care unit (ICU) and neonatal intensive care unit (NICU) sources, and community (outpatient department, OPD) sources of a hospital were used for isolating strains of P. aeruginosa. Results Of 368 isolated strains of P. aeruginosa, a total of 201 (54.62%) strains were from nosocomial and 167 (45.38%) strains were from community samples. There were 42 (25.14%) extended spectrum β-lactamase (ESβL) strains among the 167 isolates from the community samples. And from wards and cabins, there were 29 (23%) ESβL strains among the 126 isolates. Of the 75 isolates from ICU and NICU, there were 25 (33.33%) ESβL strains; the total of nosocomial ESβL strains was 54 (26.86%) in this study from the total of 201 P. aeruginosa isolates. In a computation of the χ 2 test of independence for assessing incidences of ESβL strains among all multidrug-resistant (MDR) strains, it was inferred that ESβL strains were equally distributed in wards and cabins, ICU and NICU or community, similar to the rest of the other MDR P. aeruginosa strains. Fifteen antibiotics were used for assessing antibiotic sensitivity of all isolated P. aeruginosa strains and a progressive increase of percent values of drug resistance was recorded. Conclusion This study on surveillance of a hospital revealed the daunting state of occurrence of MDR P. aeruginosa. A progressive increase of percent values of drug resistance to 15 antibiotics used for antibiotic sensitivity of P. aeruginosa strains was recorded.

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

“…Among 244 clinical isolates of staphylococci reported from Karnataka, India, 13.1% strains had inducible clindamycin resistance with the MLSB phenotype; among them, 10 isolates were MRSA (38.4% of the total MRSA), 16 were MSSA (12.9% of the total MSSA) and 6 were "coagulasenegative staphylococci" or CONS, i.e., 6.3% of the total isolated CONS [17] . In another laboratory from Karnataka, 10% isolates had inducible clindamycin resistance, 9% had constitutive resistance and 8% had MS phenotype.…”

“…The MSSA strain, Microbial Type Culture Collections strain number 7443 was used as the reference control. This strain and all isolated strains were subjected to antibiotic sensitivity test, by the disc diffusion method, detailed previously [10] .…”

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

“…To this culture tube, 10 drops of VP I reagent (5% α-napthol, in absolute alcohol) and 2-3 drops of VP II reagent (40% KOH solution) were added and the mixture was allowed to stand for [15][16][17][18][19][20] min for the reaction to complete. The positive result was the appearance of red colour of the mixture, i.e., production of a neutral product, acetoin from the fermentation of glucose by the organism, and alternately yellow colour production indicated the negative result.…”

“…Further, on the lawn-agar of each plate, 8 high potency antibiotic discs (HiMedia) of 18 prescribed antibiotics of five different groups were placed, individually at equal distances from one another. Plates were incubated for 18 h at 37 °C and were examined for size-measurements of zones of inhibition around each disc, following the standard antibiotic susceptibility test chart of Clinical Laboratory Standard Institute (CLSI) guidelines [16] .…”

“…This institute (IMS and Sum Hospital), has reported recently, a surveillance study of the most notorious UTI-causing bacterium, P. aeruginosa [16] . In face of accumulation of a vast majority of literature on MDR bacteria, it has become a matter of compulsion to conduct a regional surveillance on this exasperating class of pathogens, causing morbidity and mortality in females mainly [17] .…”