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Abstract
To determine the antibiogram of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) in patients with diabetes. The study was carried out in the Microbiology Department of Clinical and Research Laboratory, Baqai Institute of Diabetology and Endocrinology (BIDE) from January 2012 to December 2012. All samples received in the laboratory were processed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Identification of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) was done and antimicrobial susceptibility pattern was determined by disc diffusion method. A total of 585 pathogens were isolated from 542 specimens of patients with diabetes. One hundred twenty one (20.68%) Pseudomonas aeruginosa and 25(4.27%) non-aeruginosa Pseudomonas were detected from 542 samples. Among 108 (18%) samples detecting the growth of Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus (MRSA) were found in 42 (39%) samples. Pseudomonas aeruginosa showed marked susceptibility to imipenem (100%) followed by piperacillin / tazobactam (90.91%). All MRSA positive specimens were susceptible to vancomycin, but highly or completely resistant to the other antimicrobial drugs. Conclusion : In the present study imipenem, piperacillin/tazobactam and sulbactam-cefoperazone were found to be the most effective drugs against Pseudomonas aeruginosa. The majority of MRSA were resistant to one or more than one antimicrobial drugs. Vancomycin and imipenem were the most effective drugsagainstStaphylococcus aureus and MRSA. .
Highlights
Diabetes is a metabolic disorder affecting 371 million people worldwide
Compromised hosts like patients with diabetes are the main target of Pseudomonas aeruginosa and the pathogenicity of the organism is based on its ability to produce a variety of toxins, proteases and ability to resist phagocytosis
Pseudomonas aeruginosa species were identified by Gram staining, motility, catalase, oxidase and pyocyanin production tests, while identification and confirmation of Staphylococcus aureus strains were done by colonial morphology on blood agar, Gram stain, haemolysis, catalase and coagulase tests.[11,12]
Summary
Diabetes is a metabolic disorder affecting 371 million people worldwide. At present, Pakistan has around 6.6 million people with diabetes; the number is anticipated to rise to 11.4 million by the year 2030.1 Patients with diabetes are more prone to life-threatening infections compared to patients without diabetes.[2]Pseudomonas aeruginosa, a known opportunistic pathogen frequently causes serious infections. Compromised hosts like patients with diabetes are the main target of Pseudomonas aeruginosa and the pathogenicity of the organism is based on its ability to produce a variety of toxins, proteases and ability to resist phagocytosis. It may cause severe tissue damage in patients with diabetes. Methicillin-resistant Staphylococcus aureus (MRSA) are commonly seen among those who have weak immune system.[7] MRSA may cause severe infections in hospitalized patients, such as bloodstream infections, surgical wound infections and pneumonia.[8] The frequency of MRSA varied considerably in different studies i.e. from 31.1% in an Iranian study[9] to as high as 63.4% in a study conducted in China.[10]
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