Antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujarat, India

Jagrutia Patel,Somsuvrab Ghatak,Virena Javiya,Kamleshr Patel

doi:10.4103/0253-7613.44156

Abstract

Objectives:The present study was undertaken to assess the antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujarat, India. Due to significant changes in microbial genetic ecology, as a result of indiscriminate use of anti-microbials, the spread of anti-microbial resistance is now a global problem.Materials and Methods:Out of 276 culture positive samples, 56 samples of Pseudomonas aeruginosa were examined and 10 different types of specimen were collected. Microbial sensitivity testing was done using disk diffusion test with Pseudomonas species NCTC 10662, as per CLSI guidelines.Results:The highest number of Pseudomonas infections was found in urine, followed by pus and sputum. Pseudomonas species demonstrated marked resistance against monotherapy of penicillins, cephalosporins, fluoroquinolones, tetracyclines and macrolides. Only combination drugs like Ticarcillin + Clavulanic acid, Piperacillin + Tazobactum, Cefoperazone + Sulbactum, Cefotaxime + Sulbactum, Ceftriaxome + Sulbactum and monotherapy of amikacin showed higher sensitivity to Pseudomonas infections; however, the maximum sensitivity was shown by the Carbapenems.Conclusion:From the present study, we conclude that urinary tract infection was the most common hospital acquired infection. Also, co-administration of β -lactamase inhibitors markedly expanded the anti-microbial sensitivity of semi-synthetic penicillins and cephalosporins. The aminoglycoside group of antibiotics - amikacin - demonstrated maximum sensitivity against pseudomonas species. Therefore, use of amikacin should be restricted to severe nosocomial infections, in order to avoid rapid emergence of resistant strains. Periodic susceptibility testing should be carried out over a period of two to three years, to detect the resistance trends. Also, a rational strategy on the limited and prudent use of anti-Pseudomonal agents is urgently required.

Highlights

Multiple antibiotic resistance in bacterial populations is a pervasive and growing clinical problem, which is recognized as a threat to public health
Two hundred and seventy six samples obtained from sputum, endo-tracheal Tract secretion, broncho-alveolar lavage, blood, urine, body tissues, pus, semen, cerebro-spinal fluid (CSF), and body fluids and costal bronchial Secretions (CBS) reported the presence of bacterial infection
Of the 572 samples subjected to culture sensitivity, 276 reported presence of bacterial infection, thereby suggesting 48.25% as the occurrence level

Summary

Introduction

Multiple antibiotic resistance in bacterial populations is a pervasive and growing clinical problem, which is recognized as a threat to public health. There is a need to conduct area-specific monitoring studies to profile different pathogens responsible for specific infections and their resistance patterns, so as to generate data that would help clinicians to choose the correct empirical treatment. Pseudomonas aeruginosa (P. aeruginosa) is an epitome of opportunistic nosocomial pathogen, which causes a wide spectrum of infections and leads to substantial morbidity in immuno-compromised patients. The mortality due to nosocomial pseudomonal pneumonia is approximately 70%.[1] P. aeruginosa demonstrates resistance to multiple antibiotics, thereby jeopardizing the selection of appropriate treatment.[2] the present study was undertaken to find out the antibiotic susceptibility patterns of pathogenic isolates of Pseudomonas aeruginosa from various specimens of hospital acquired infections (HAI)

Objectives

Methods

Results

Conclusion