Prevalence of Extended Spectrumβ-Lactamase and Antimicrobial Susceptibility Pattern of Clinical Isolates ofPseudomonasfrom Patients of Khyber Pakhtunkhwa, Pakistan

Abstract

Majority of gram negative pathogenic bacteria are responsible for extended spectrum β-lactamases (ESBLs) production, which show resistance to some newer generation of antibiotics. The study was aimed at evaluating the prevalence of ESBL and antibiotic susceptibility pattern of Pseudomonas isolates collected during 2010 to 2014 from tertiary care hospitals of Peshawar, Pakistan. Out of 3450 samples, 334 Pseudomonas spp. isolates comprised of 232 indoor and 102 outdoor patients were obtained from different specimens and their susceptibility pattern was determined against 20 antibiotics. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer agar diffusion method and ESBL production was detected by Synergy Disc Diffusion technique. The mean age group of the patients was 29.9 + 9.15 years. Meronem showed best activity (91.02%) from class carbapenem, β-lactam and β-lactamase inhibitors exhibited 69.16% activity, and doxycycline had a diminished activity (10.18%) to Pseudomonas spp. Outdoor isolates were more resistant than the indoor and during the course of the study the sensitivity rate of antibiotics was gradually reducing. ESBL production was observed in 44.32% while the remaining was non-ESBL. The moderate active antibiotics were amikacin (50.7%), SCF (51.4%), TZP (52.7%), and MXF (54.1%) among ESBL producing isolates. Lack of antibiotic policy, irrational uses (3GCs particularly), and the emergence of antibiotic resistant organisms in hospitals may be causes of high antibiotic resistance.

Antimicrobial susceptibility patterns and CTX-M β-lactamase producing clinical isolates from burn patients in Islamabad, Pakistan

“…were ESBL negative and high susceptibility was observed in ESBL negative isolates (Table 4), which is similar to the finding of other works [19,32].…”

“…The antibiotic susceptibility patterns revealed that the most potent antimicrobial agents were meropenem and imipenem with 88.88% and 84.88% susceptibility which resembles to the findings of previous literature [19,30]. Similarly, high activity of aminoglycosides has been investigated [19,31] and in the current study amikacin showed high susceptibility (81.77%) against the isolates.…”

“…Similarly, high activity of aminoglycosides has been investigated [19,31] and in the current study amikacin showed high susceptibility (81.77%) against the isolates. While the data revealed that the isolates showed high resistance to ampicillin (84%), and in the previous studies conducted in Pakistan, isolates were highly resistant to penicillin [19,32,33]. Moreover, 39.5% (89/225) isolates were ESBL positive while remaining 60.5% (136/225)…”

“…Hence, skin damage along with compromised blood supply around wound and immunodeficiency increase acquisition of nosocomial infection in burn patients [1,7-resistant strains thus limiting therapeutic options [3,13,[16][17][18][19]. The primary cause for production of multiple drug resistant strains is β-lactamases particularly extended spectrum β-lactamases (ESBL) whose incidence is steadily increasing all over the world [9,16,[19][20][21][22][23][24]. Most prevalent types of ESBL are TEM (TEM1-2), SHV-1 and CTX-M which are produced by Gram negative bacilli.…”

Phenotypic Detection of Extended Spectrum Beta-Lactamases in Uro-pathogens. An Experience from Qazi Hussain Ahmed Medical Complex, Nowshera

“…23 Another study reported that the sensitivity pattern to E.Coli-ESBL was amikacin (50.7%), SCF (51.4%), TZP (52.7%), and MXF (54.1%) that matched our findings. 24…”