Prevalence, antibiogram profile and cross transmission of Pseudomonas aeruginosa in a tertiary burn unit

Abstract

Aims:Pseudomonas aeruginosa is an opportunistic pathogen that still develops life threatening infections in patients with immunological system defects like burns. The major problem with this organism is the ability to persist during infections due to its high rate of resistance to many drugs. This study was designed to evaluate the prevalence and drug susceptibility profile of Pseudomonas aeruginosa in patients admitted to a burn unit in a tertiary health facility. Methodology and Result: From 80 selected patients, appropriate clinical specimens from burn sites were collected and processed for the isolation and identification of Pseudomonas aeruginosa.. Also, 78 surveillance samples from various environmental sites and hands impressions of nursing staff in the burn unit were cultured for the isolation of Pseudomonas aeruginosa. Drug susceptibility profile showed high resistance for ceftazidime (40.7%) ciprofloxacin (13.1%) and piperacillin (34.6%); furthermore, low resistance for some antibiotics like imipenem (17.5%) pipereracillin/tazobactam (12.3%) and aztreonam (16%) were obtained. In addition, 8 multiresistant Pseudomonas aeruginosa (MRPA) isolates were recovered from clinical specimens and from environmental samples. Conclusion, significance and impact of study: Evidence of high prevalence of clinical and environmental MRPA reported in this study provides the rationale for strict enforcement of infection prevention protocol to minimize cross transmission of bacterial pathogens in hospital burn units and consequent disease burden arising from MRPA.

Prevalence and antimicrobial-resistant patterns of Pseudomonas aeruginosa among burn patients attending Yekatit 12 Hospital Medical College in Addis Ababa, Ethiopia

“…In contrast, the 33% MDR P . aeruginosa isolation rate from this study is lower than the findings from other studies elsewhere, which reported from as low as 40.7% to as high as 100% [ 8 , 9 , 27 , 33 , 39 ]. The possible explanation for such disparity might be differences in the study population, use of different antibiotic regimes, extensive use of the antimicrobial drugs studied in those settings, persistent presence of resistant strains in hospitals, cross-contamination from the laboratory environments during culturing or the quality of hygiene in the hospital environments under study.…”

“…The same low rate of resistance (about 11%) against Amikacin was also documented in other studies including Yemen [ 33 ], Ghana [ 32 ], Kenya [ 25 ], and South Africa [ 20 ]. However, much higher resistance rates were reported from elsewhere for Amikacin: 21% in Turkey [ 23 ], 32.1% in Nigeria [ 8 ], 48.1% in Iraq [ 31 ], 50% in Malaysia [ 19 ], 73.2% in India [ 9 ], 75% in Pakistan [ 30 ], and 89.4% in Iran [ 39 ].…”

“…Higher Gentamycin resistance by P. aeruginosa appears to also be a common phenomenon in some countries, like India (84%) [9], Yemen (87%) [33], Iraq (88.5%) [31], and Malaysia (94.3%) [19]. However, some other studies reported lower resistance levels; for example, 9.2% in South Africa [20], 13% in Ghana [32], 24.7% in Nigeria [8], 36% in Turkey [23] and 44.7% in Kenya [25].…”

“…The presence of dead, denatured tissues and a moist environment makes the burn wound vulnerable to infection by P . aeruginosa [ 8 ]. Additionally, a breach in the protective skin barrier, reduced immunity, and prolonged hospital stay are an important factor responsible for infection of burn wounds with such opportunistic pathogens, especially with multi-drug resistant (MDR) P .…”

“…aeruginosa is a commonly known opportunistic pathogen frequently causing serious infection and complications in burned patients throughout the world, which accounts for about 45% of mortality among these patients [6,7]. The presence of dead, denatured tissues and a moist environment makes the burn wound vulnerable to infection by P. aeruginosa [8]. Additionally, a breach in the protective skin barrier, reduced immunity, and prolonged hospital stay are an important factor responsible for infection of burn wounds with such opportunistic pathogens, especially with multi-drug resistant (MDR) P. aeruginosa [9].…”